Medicare Advantage Plans Facing Changes for Seniors

FARGO — This year’s open enrollment for Medicare Advantage plans is proving to be confusing for many seniors. Those whose plans are set to be discontinued risk losing coverage if they don’t select a new option.

Due to rising claims costs, several health insurance companies are cutting certain Medicare Advantage plans. Affected individuals need to find new coverage during the open enrollment period, which runs from October 15 to December 7.

It’s important to note that those with Medicare supplement plans, or Medigap, are not impacted by the changes to Medicare Advantage plans.

In North Dakota, about 147,000 residents rely on Medicare. Michelle Comer, president of Highroad Partners, a Fargo-based insurance agency, has expressed concern that the recent shifts in Medicare Advantage plans will significantly affect many older adults. “This has been a particularly chaotic year in the already complex world of Medicare, and we are concerned that some changes will be missed by seniors, with devastating effects,” she shared.

Comer is particularly worried that some seniors may not be able to respond quickly enough. If your plan ends, you’ll need to choose a new one—otherwise, you’ll be without coverage by 2026.

Moreover, many insurance companies aren’t mailing out details about plan coverage due to costs. This could make it difficult for older adults without internet access to effectively compare options, Comer noted.

Insurers are mandated to inform customers multiple times, but Comer pointed out that seniors often receive so much solicitation at this time of year that they may overlook important notices. “Seniors are bombarded with commercials, mail, robocalls, etc. this time of year, and based on our experience, they don’t see the notices carriers need to provide about plan changes,” she added.

Additionally, some insurance firms have stopped compensating brokers, which leaves consumers without an independent source of advice. The reason behind the discontinuation of various Medicare Advantage plans stems from a surge in claims that surpass premiums, making them unsustainable. “To take my word for it, most carrier Medicare Advantage plans are underwater,” Comer stated.

The North Dakota Department of Insurance Securities offers assistance in choosing Medicare coverage options via the State Health Insurance Program (SHIP). If you’re in North Dakota, you can call 888-575-6611 or visit the Insurance.nd.gov/Consumer/Medicare website for more information.