Medicare Advantage

A Look at Medicare Plan Options Near St. Cloud

A look at Medicare plan options near St. Cloud, Minnesota — plain-language counts and dates for the 2027 plan year.

ST. CLOUD, Minn. — If you live in central Minnesota and are shopping for Medicare coverage, it helps to know what's available close to home. Plan choices are set county by county, so what a neighbor across the county line sees may look a little different from your own list.

St. Cloud sits in Stearns County, where Medicare beneficiaries currently have 16 Medicare Advantage plans to consider. That count comes from CMS Landscape and Plan Finder data, and it gives a useful picture of the local field without singling out any one plan.

What's available in the St. Cloud area

Stearns County beneficiaries can choose from 16 Medicare Advantage plans, offered by 3 carriers with MA-PD (Advantage plans that bundle in prescription drug coverage). Right now, CMS data shows 0 stand-alone Part D drug plans listed at the county level in the Landscape file — a reminder to double-check current listings on Medicare.gov before making a decision, since availability can shift year to year.

About 25,871 people age 65 and older live in Stearns County, so the local Medicare community is a sizeable one. That's worth noting because it often shapes which carriers choose to serve the area.

How plan availability works around the metro

Medicare Advantage and Part D plans are offered on a county basis. That means someone in St. Cloud sees the Stearns County menu, while a friend a short drive away in Benton or Sherburne County may see a different set of plan counts and carriers. If you split time between homes — or you're helping a parent who lives in another county — check each address separately on Medicare's Plan Finder.

A note on Star Ratings

CMS rates Medicare Advantage and Part D contracts on a 1-to-5 star scale for things like customer service, member experience, and how well plans manage chronic conditions. In the St. Cloud area, current CMS data shows 0 contracts rated 4 stars or higher. Star Ratings are one input among many; they aren't a substitute for checking whether your doctors, hospitals, and medications are covered.

What's changing in 2027

A few program-wide updates are worth keeping on your radar as you compare options:

• Part D out-of-pocket cap. Out-of-pocket spending on covered prescription drugs is capped at $2,100 in 2026 and $2,400 in 2027. Once you reach the annual limit, you pay nothing more for covered drugs for the rest of that year.
• Part D deductible. The maximum a Part D plan can charge as a deductible is $615 in 2026 and $700 in 2027. Some plans set theirs lower.
• Coverage gap is gone. As of 2025, the old "donut hole" was eliminated. Part D now has three phases instead of four.
• Medicare Prescription Payment Plan. This optional program lets you spread your drug costs across monthly payments instead of paying large amounts at the pharmacy counter.
• IRMAA thresholds. Higher-income beneficiaries pay an income-related surcharge on Part B and Part D. For 2026, IRMAA kicks in above $109,000 in income for a single filer.

Dates to circle

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect Jan. 1.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or return to Original Medicare (and add a Part D plan).

Where to get unbiased help

Sorting through 16 plans is a lot, and the right choice depends on your own doctors, prescriptions, and budget. A few free, trustworthy places to turn:

• Medicare.gov — the official Plan Finder lets you enter your ZIP code and drug list to compare what's available.
• 1-800-MEDICARE — 24/7 help from Medicare directly.
• Minnesota's State Health Insurance Assistance Program (SHIP), known locally as the Senior LinkAge Line® at 1-800-333-2433 — free, one-on-one counseling from trained volunteers who don't sell plans.