Medicare Advantage changes in 2026: What you can expect

(FOX 9) - Thousands of Medicare Advantage subscribers are looking for answers after learning that major insurers plan to scale back coverage beginning in 2026.

Medicare Advantage coverage

What we know:

UnitedHealth Group said it plans to reduce its Medicare Advantage footprint from 72 to 27 counties throughout Minnesota, affecting about 20% of subscribers.

Blue Cross and Blue Shield of Minnesota (Blue Cross) will continue to offer Medicare Advantage plans in 66 counties across the state. Medicare Cost plans are also available in the remaining 21 counties. Altogether, Blue Cross will continue to offer Medicare plans for seniors in all 87 counties in Minnesota.

Minneapolis-based UCare announced in September it would drop Medicare Advantage coverage entirely.

Meanwhile, HealthPartners, and Aetna have also announced changes for Medicare customers.

FOX 9’s All Day previously spoke with Tim Jopp of Legacy Health Insurance to answer viewer questions about the potential changes. The full Q&A can be found here.

As FOX 9 followers continue to send in their questions, All Day’s Amy Hockert took a deeper dive into what those affected could soon expect.

You can watch a video of the segment and read a transcription of the information provided below.

Medicare and Medicare Advantage differences

Medicare is health insurance for people who are 65 and older, and also people under the age of 65 with disabilities. This is government-funded health insurance. There's part A and there's B, and these are both part of the "original Medicare."

Part A covers things like hospital care, inpatient care and hospice, should you need that. You can see any doctor or hospital, and don't have to worry about networks. It is a pay as you go system, but also there's no spending limit. It does have deductibles and co-pays, but no premiums.

Part B is different in a couple of ways. You do pay a monthly premium that covers things like doctor services and medical supplies.

Both part A and B do not cover prescription drugs, which is considered part D. Medicare Advantage is called part C, and includes parts A, B and D.

Medicare Advantage is a plan that you have to get privately, and some of the things with Medicare Advantage, you do have to use doctors and hospitals that are in-network, unless it's an emergency,

Why do we need to know the difference between Medicare and Medicare Advantage? 

There are annual limits on out-of-pocket costs. So, unlike A and B, [C] can help you keep track of things a little bit because of limits.

Most people with Medicare do not look at their options during open enrollment, and then start the new year with a plan that in many situations is not best for them — they may not be able to afford it, it may not cover their drugs, it may cover the providers they want to go to.

If there's one message we can get out to people, it is this is not the year to ignore Medicare open enrollment.

If my plan is dropped, what will I lose?

As of Jan. 1, if you've got a UCare Medicare Advantage policy, it's going away. You will not have any additional insurance.

So what confuses people is that they still have the original Medicare starting Jan. 1, but they will lose the additional benefits. UCare's got the big bulk of this… but UnitedHealthcare is pulling out of some counties… Aetna is pulling out of a couple of counties. And then Health Partners is pulling out of some counties, but then also eliminating one of their plans.

So it'll default to your A and B Medicare coverage, which you still have some insurance. You just won't have prescription drug coverage, and your deductibles change, your co-pays change, things like that, are different on Medicare than what they're like when you're on a Medicare Advantage plan.

Future preparation for those still working

If you're contributing to a Health Savings Account, you don't want to enroll in Medicare part A right now. Most people, when they turn 65, will take Medicare part A, because it's premium-free. But if you are contributing to a Health Savings Account, don't enroll.

You do not need to enroll in Medicare part B until your employer's group health insurance ends, and you decide to retire. And you have an eight-month time period to enroll in Medicare and purchase the options to fill in the gaps.

If you do have retiree coverage through your employer, you are still going to want to enroll in Medicare part B if you retire and that is the coverage you have.

The significance of that is Medicare part D. You don't enroll until you need it because you're paying a premium for something you don't need if you have employer drug coverage. 

When somebody first enrolls in Medicare part B, they have six months to purchase a Medigap policy without any underwriting or health screening. If you don't purchase it during that period, you can be health screened and the insurance company can deny and refuse to sell you a policy.

What is the deadline to choose a new plan?

Starting on Oct. 1, you can start looking at options and looking at plans and see what's out there. You can't make any changes until Oct. 15 through Dec. 7. So those deadlines, Oct. 15 through Dec. 7, are for people that are not losing their insurance but maybe want to change their plan.

But people who are losing their plan actually have a couple of other deadlines. They can go till Dec. 31, and if they do it before Dec. 31, it would start Jan. 1.

So, you've got Oct. 15 through Dec. 31, if you're losing your plan.

What if I missed the December 31 deadline?

[Enrollment] continues on into January and February. You actually can go all the way till the end of February.

If you sign up in January, your insurance would start Feb. 1.

If you signed up in February, it would actually start on March 1.

What's next:

Those affected are encouraged to go to www.medicare.gov and look at the PlanFinder to compare options.

People can also call 1-800-MEDICARE or contact Minnesota Aging Pathways for more information.