If you’re on Medicare in Minnesota (or soon will be), it’s essential to know that 2026 brings significant changes—especially for those enrolled in Medicare Advantage (MA) plans and prescription-drug coverage (Part D). We want to help you understand what’s shifting, how it could affect you in Minnesota, and the steps you should consider now to protect your coverage and rights.
What’s Changing — Big Picture
According to the state site Minnesota Aging Pathways, these are the main changes awaiting Medicare beneficiaries in Minnesota for 2026:
1. Medicare Advantage (MA) Plan Landscape
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Several insurance carriers in Minnesota are dropping plans or shrinking service areas — for example, insurers like UCare Minnesota, HealthPartners, Humana and UnitedHealthcare are reducing or exiting MA plans in Minnesota.
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Because of this, fewer plan options may be available in certain counties.
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Plan costs (premiums, deductibles, out-of-pocket) may increase.
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Networks of doctors/hospitals and drug formularies under Medicare Advantage and Part D are subject to change. It’s important to check that your current providers and medications will still be covered in 2026.
2. Medicare Part D & Prescription Drugs
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In 2026, for Part D:
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Insulin copays will be capped at the lesser of three amounts: $35, or 25 % of the negotiated price of the drug, or 25 % of Medicare’s new Maximum Fair Price.
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All adult vaccines recommended by the Centers for Disease Control and Prevention (CDC) will be covered with no cost sharing, even if received out-of-network. That includes RSV, shingles, Tdap, and possibly travel vaccines.
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Drug-coverage phases are shifting:
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Deductible phase: you’ll pay up to a $615 deductible.
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Initial coverage phase: you pay 25 % cost share (there’s no “coverage gap” or “donut hole” in 2026).
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Catastrophic phase: once you hit a $2,100 maximum out-of-pocket (not including monthly premiums and non-formulary drugs), you’ll have no cost-sharing.
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3. Timing & Enrollment Considerations
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If your MA plan is ending or changing significantly, you will receive an Annual Notice of Change (ANOC). That letter will tell you if your plan is ending, what replacement options may exist, and how/when you can enroll in a new plan.
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The open enrollment period for Medicare is October 15 through December 7. If you anticipate changes in coverage, you should use this window to explore options.
Why These Changes Matter for You
Here are the key implications we see for Minnesota Medicare beneficiaries:
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Plan discontinuation risk: If your MA plan is being discontinued in your county or your insurer is pulling back, you may need to switch plans. It’s not simply renewing what you had — you may need to actively choose a new plan.
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Coverage gaps or surprises: If you stay with a plan without checking its 2026 terms, you might find out in January that your doctor isn’t in-network anymore, your drugs aren’t covered, or your cost-sharing is much higher.
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Prescription cost protections: The new caps on insulin and vaccines are meaningful protections, but they don’t cover everything. If you rely heavily on specific medications or specialty drugs, you’ll want to verify your plan’s formulary for 2026.
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Legal-benefits intersections: For those depending on supplemental benefits (e.g., extra help, Medigap, dual eligibility), changes to MA and Part D can affect eligibility, out-of-pocket exposure, and your rights (for instance guaranteed issue rights if your MA plan disappears).
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Opportunity for proactive planning: This is a moment to review your coverage intentionally—your providers, medications, preferences—and decide whether your current approach is still best for you.
What You Should Do Now
Given these impending changes, we recommend the following steps for our clients in Minnesota:
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Review your ANOC (Annual Notice of Change) when it arrives this fall. Note: Did your MA plan say it’s ending? Are premiums or coverage areas changing?
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Make a list of:
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Your current doctors and clinics (and ask if they will continue accepting your plan in 2026).
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All your prescription medications (with dosage and pharmacy) and check whether they’re still covered under your current plan’s 2026 formulary.
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All supplemental benefits you rely on (e.g., dental, hearing, grocery cards, extra transportation benefits) and see if changes are ahead.
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Compare your options: Our colleagues at American Senior Benefits can help you compare your options.
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Decide if you’ll stay in MA or move back to Original Medicare + Medigap: If Medicare Advantage options in your area are dwindling or cost-sharing is rising, you may lean toward Original Medicare (Parts A & B) with a Medigap plan and a standalone Part D prescription plan.
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Act within the enrollment window: October 15–December 7 is crucial. If your plan ends, you’ll need to select another plan by that deadline (or by the special deadline if your plan is discontinued). Missing the deadline could affect your coverage or incur penalties.
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Keep all communications: Save the ANOC and any plan-closure letters. These may give you “guaranteed issue” rights for Medigap or other protections if your plan is terminated.
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Consult with a professional: Because the legal and benefits implications can get complex—especially if you have dual eligibility (Medicaid + Medicare), chronic conditions, or significant prescription needs—consider a consultation with a benefits advocate at American Senior Benefits.
How Our Colleagues at American Senior Benefits Can Help
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Reviewing your current Medicare Advantage or Medicare Supplement plan terms and how upcoming 2026 changes affect you.
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Helping you evaluate whether switching plans or moving back to Original Medicare makes sense for your circumstance.
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Advising you on rights that may apply if your plan is ending (e.g., guaranteed issue rights for Medigap, special enrollment periods).
Final Thoughts
Change is coming — but you don’t have to face it alone. The 2026 updates to Medicare in Minnesota affect many seniors and could disrupt your current coverage if you don’t act. By starting now, reviewing your situation, and taking intentional steps, you’ll be in a far stronger position.
Action step for this week: Locate your ANOC or plan-change letter, make a list of your providers & medications, and pencil in time during October 15–December 7 to compare your 2026 options.
If you’d like a benefits associate at American Senior Benefits to walk through this with you—review your plan, evaluate alternatives, and clarify your legal rights—please reach out to schedule a consultation. They will help you protect not only your health coverage, but your peace of mind.
This blog post is provided for informational purposes only and does not constitute legal or insurance advice. Every individual’s situation is unique; please consult your attorney, insurance adviser, or benefits specialist for guidance tailored to your needs.
