As an alternative to obtaining Original Medicare coverage directly from the government, you may want to consider Medicare Advantage (sometimes referred to as Medicare Part C) in Minnesota. Medicare Advantage plans are offered by private insurance companies that contract with CMS to provide all Original Medicare benefits except hospice care, which is paid by Medicare Part A. Many Medicare Advantage plans also include extra benefits such as routine dental and vision care.
Medicaid coverage may be different from one state to another. Though they must comply with federal regulations, every state runs its own program; the federal government does not control it. Some information about Medicaid is true in every state. For instance, in Minnesota Medicaid covers some services that are not covered other states. Other states may cover services Minnesota does not. In addition, the costs may be different; not every beneficiary of Health Link in Minnesota will pay the same monthly premium. Certain low-income Medicaid insurance beneficiaries could pay no premiums at all if they qualify for no-cost coverage.
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As is the case nationwide, enrollment in private Medicare plans grew in Minnesota in 2018. As of December 2018, there were 581,822 Minnesota Medicare beneficiaries with private Medicare coverage, which amounts to nearly 58 percent of the state’s Medicare population. Nationwide, most people with private Medicare plans are enrolled in Medicare Advantage plans, but Medicare Cost plans are another type of private Medicare coverage, and as of 2018, Minnesota residents accounted for two-thirds of the national total enrollment in Medicare Cost plans.
A pay-per-visit health coverage plan that allows individuals to go to any doctor, hospital, or other health care supplier who accepts Medicare and who is accepting new Medicare patients. The individual is responsible for paying a deductible and copayment. Under Original Medicare, Medicare pays a portion of the Medicare-approved amount, while the individual pays for his/her share (coinsurance).
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Medicare beneficiaries in Minnesota have the option to enroll in a Medicare Advantage plan as an alternative way to get their Original Medicare, Part A and Part B, coverage. Also known as Medicare Part C, Medicare Advantage plans are available through private insurance companies that contract with Medicare. All Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare, meaning you’ll get the same hospital and medical benefits of Part A and Part B through your Medicare Advantage plan. In addition, some Medicare Advantage plans may also offer additional benefits, such as routine dental, vision, hearing, or prescription drugs.
The program for Qualified Individuals (QI) also pays for Part B premiums, though the application approval and benefits are on a “first come, first served” basis. This is sometimes due to limited funding. For an individual to qualify for the QI program, their income must be less than $1,386 a month. The combined income limit for a married couple is $1,872.
As a result, an estimated 320,000 Medicare Cost enrollees in Minnesota needed new coverage for 2019. There are 21 counties where Medicare Cost plans continue to be available, but Medicare Cost enrollees in the rest of the state were not able to keep their Cost plans. Instead, they had the option to enroll in a Medicare Advantage plan (some were automatically enrolled in a comparable Medicare Advantage plan, although they had an option to pick something else instead), or select a Medigap plan to supplement their Original Medicare. Enrollees whose Medicare Cost plans ended have guaranteed issue rights to a Medigap plan, so they can purchase one even if they had pre-existing medical conditions. But that guaranteed-issue right only lasts for 63 days, which means Monday, March 4, 2019 is the last day these individuals can purchase a Medigap plan without having to go through medical underwriting.
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If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
See whether you would prefer a Medicare Advantage plan. Medicare Advantage plans have to offer at least the basic benefits that Original Medicare offers, but some Medicare Advantage plans might also offer coverage for things that Original Medicare doesn’t cover. Use the Medicare Plan Finder to see if there’s a Medicare Advantage plan that meets your needs.
The Minnesota Board on Aging (MBA) may be helpful for seniors seeking a wide range of information. The office provides education in a broad range of areas, including health-care coverage and Medicare plans. The office was first established in 1956. Since that time, seniors have been able to turn to the Minnesota Board of Aging for a variety of programs, including:
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Private Medicare Advantage plans are an alternative to Original Medicare. There are pros and cons to either option, and the right solution is different for each person. Plan availability varies by county, but Minnesota’s market is robust: Residents throughout the state can select from among at least 13 Advantage plans in 2019, and some counties have as many as 40 plans for sale.
“What is Medicaid eligibility?” This question may be on your mind if you are new to the program. MN Medicaid eligibility is generally determined by the income level of the individual or household applying for Medical Assistance (MA). Individuals and families that fall within the allowable income range are eligible to receive benefits. In order to qualify for the program all applicants must meet all income and any other requirements.
The choice of all Medicare Advantage, Medigap, or Part D plans can vary a lot by county even within Minnesota. We make it easy to find local providers with our online quote forms. You can get an instant, online list of Medicare insurance providers by choosing Minnesota from the drop-down box on the quote form right here on this page. Get ready for the Annual Election Period by starting your comparison today.
Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental coverage. Nationwide, more than half of Original Medicare beneficiaries get their supplemental coverage through an employer-sponsored plan or Medicaid. But for those who don’t, Medigap plans (also known as Medicare supplement plans, or MedSupp) will pay some or all of the out-of-pocket costs they would otherwise have to pay if they had only Original Medicare.
Medicare Advantage beneficiaries in a Preferred Provider Organization are able to see providers outside of their plan’s network, often at a higher cost. Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network. PPO plans typically do not require patients to acquire a referral before visiting with a specialist.
You should always compare your Medicare insurance options before the Annual Election Period because plans change. It’s critically important to anticipate likely changes to Minnesota Medicare Advantage plans in 2019 for one important reason. While nothing has been finalized as of this article, it’s likely that the government will reduce or eliminate Medicare Cost Plans within many counties of this state.