Medica Reduced Insurance Coverage for Nursing Care
Minnesota families face benefit changes for 24/7 care after legislative protections failed to pass this year.
Updated on Sept. 29, 2026 in Nursing Jobs
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Medica has reduced insurance coverage for 24/7 registered nursing care for certain members in Minnesota. The changes affect individuals who are dual-enrolled in Medica and the state's Medical Assistance program.
Why it matters
The reduction in benefits follows the failure of the Minnesota legislature to pass proposed protections for children with disabilities. Families impacted by the change are now facing uncertainty regarding how they will maintain around-the-clock care.
Impacted families rely on 24/7 nursing care to keep members out of hospitals, with some households providing specialized medical support for 6 years. Medica reports that these benefit adjustments were made to ensure alignment with state laws.
The players
Medica
This health insurance provider manages benefit plans for individuals across Minnesota and has recently adjusted its administration of nursing care coverage.
Guinevere Keis
She is a Minnesota resident in Anoka who requires 24/7 registered nursing care to avoid hospitalization.
The details
Medica notified affected members in May 2025 that it was changing how benefits are administered for those dual-enrolled in the private insurance plan and Minnesota's Medical Assistance program. The provider has suggested that families reach out to county waiver case managers to seek additional support services to fill the gap in coverage.
Timeline
Medica notified impacted members of the coverage changes in May 2025.
The benefit administration changes were implemented by the company in 2026.
October 1, 2026, serves as the final deadline for insurance companies regarding these coverage adjustments.
Market Landscape
This development highlights the ongoing struggle to harmonize private insurer policies with Minnesota's Medical Assistance program guidelines. As carriers tighten administrative requirements, families are left to navigate complex waiver systems while state-level legislative safeguards remain stalled.
Impacted families should contact their county waiver case managers immediately to determine if alternative support services are available to cover the loss of nursing hours. Members should review their specific benefit plan documents to understand how the new administration rules affect their household's medical coverage.
The takeaway
Families requiring continuous medical support may need to seek advocacy through county resources to navigate these new administrative hurdles. Securing updated case management is essential for those whose care stability relies on state-subsidized programs.
Further reading
For more information on the evolving landscape of care accessibility, visit the Nursing Jobs section.
Source note: This article includes information reported by CBS News.
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