After going through the trouble of choosing a new Medicare Advantage health plan last fall, Wendy Sundstrom is disappointed that she has to do it again this year just to keep seeing the same doctor. .
The 69-year-old St. Louis Park resident faces a problem that all seniors on Medicare Advantage may face if health care providers and insurers can't agree on an in-network deal.
“It's incredibly annoying,” she said of having to change plans. “Either change your insurance or go to another clinic or hospital, and I'm not going to do that. I've been going to Park Nicollet since fifth grade.”
An estimated 59,000 Minnesotans will face this decision regarding their health insurance network in the coming weeks as the 2025 Medicare open offer begins Tuesday.
The state is facing a sharp increase in the potential for disruptions to insurers and provider networks over the next year, with implications for patients ranging from soaring costs to missed appointments in the health care system.
“From an enrollment perspective, this is a really big impact,” said Paul Ginsburg, an economist and health policy professor at the University of Southern California. “If now, all of a sudden, their Medicare Advantage plan doesn’t include the major providers that they use, this is definitely going to get their attention.”
Research shows that it's difficult to predict exactly how many people will make a change. Seniors are less likely to switch insurance during open enrollmentsaid Ginsburg. Some people may not be aware that their network is changing, and others may be disappointed or upset to find out that their doctor won't be included next year, he said. says.
Park Nicollet, where Sundstrom's doctors work, is owned by Bloomington-based hospital and clinic operator Health Partners, which announced in July that it would be eligible for the UnitedHealthcare Medicare Advantage plan next year. announced that it would be moved outside the network. Sandstrom changed to a UnitedHealthcare plan in 2024, but will need to change again in 2025 to keep her doctor in-network.
