In states with lots of rural areas, like Minnesota, Medicare Cost plans tend to be more popular because they offer more flexibility than an HMO. If a plan member gets services inside of the network of Medicare Cost Plans, they work the same way that an HMO works. If the plan member decides to visit a non-network medical provider, Medicare Cost Plans will cover those services the same way that Original Medicare Part A and Part B do. Typically, a Medicare Advantage HMO won’t cover non-emergency services outside of the network at all.
Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Medicare Advantage depends on contract renewal. Enrollment in the plan after December 31, 2018 cannot be guaranteed. Either CMS or the plan may choose not to renew the contract, or the plan may choose to change the area it serves. Any such change may result in termination of your enrollment. Benefits, premiums, copayments and/or coinsurance may change on January 1 of each year. The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary.

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.
The Medicare-Choices email list is designed to help health insurance counselors, volunteers, attorneys, providers, consumers or other interested parties find resources, receive up-to-date information about Medicare, Medicare Advantage, Medicare Part D, Medicare Advantage, Medical Assistance, Minnesota Long-term Care Partnership or other related public or private benefits.
Final decisions haven’t been made on exactly which counties in Minnesota will lose Cost plans next year, the government said. But based on current figures, insurance companies expect that Cost plans are going away in 66 counties across the state including those in the Twin Cities metro. They are expected to continue in 21 counties, carriers said, plus North Dakota, South Dakota and Wisconsin.
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must offer emergency coverage outside of the plan’s service area (but not outside the U.S.). Many Medicare Advantage Plans also offer extra benefits such as dental care, eyeglasses, or wellness programs. Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay one monthly premium for the plan’s medical and prescription drug coverage. Plan benefits can change from year to year. Make sure you understand how a plan works before you join.
On September 12, 2013, the Centers for Medicare & Medicaid Services (CMS) announced a new partnership with the State of Minnesota to test new ways of improving care for Medicare-Medicaid enrollees. Building on the state's Minnesota Senior Health Options (MSHO) program, CMS and Minnesota will work together to improve the beneficiary experience in health plans that maintain contracts with both CMS as Medicare Advantage Special Needs Plans and with the state to deliver Medicaid services.   
When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.
Products and services are provided exclusively by our partners, but not all offer the same plans or options. Possible options that may be offered include, but are not limited to, ACA-Qualified Plans, Medicare Plans, Short Term Plans, Christian/Health Sharing Plans, and Fixed Indemnity Plans. Descriptions are for informational purposes only and subject to change. We encourage you to shop around and explore all of your options. We are not affiliated with or endorsed by any government entity or agency.
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.
A federal law passed in 2003 created a “competition” requirement for Medicare Cost plans, which stipulated the plans could not be offered in service areas where there was significant competition from Medicare Advantage plans. Congress delayed implementation of the requirement several times until a law passed in 2015 that called for the rule to take effect in 2019.

Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Medicare Advantage depends on contract renewal. Enrollment in the plan after December 31, 2018 cannot be guaranteed. Either CMS or the plan may choose not to renew the contract, or the plan may choose to change the area it serves. Any such change may result in termination of your enrollment. Benefits, premiums, copayments and/or coinsurance may change on January 1 of each year. The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary.
A Medicare Part D Prescription Drug Plan (PDP) can help pay your prescription drug costs. Designed to work alongside Original Medicare coverage, Medicare Prescription Drug Plans are available from private insurance companies approved by Medicare and doing business in Minnesota. You can also enroll in a Medicare Prescription Drug Plan if you enroll in a Medicare Advantage plan that does not include Part D prescription drug coverage in its benefits.
“What are the income requirements for Medicaid in MN?” will probably be a question on your mind ahead of the application stage. Coverage up to 200% FPL is available under Medicaid expansion and MNCare. Nine health organizations across the state supply coverage through this specific scheme and by learning how to qualify for Medicaid in Minnesota, newly eligible residents can enroll in the program. Recipients must know the Medicaid eligibility requirements to take advantage of this scheme administered by state governments… Read More
Private insurance companies must have contracts with Medicare to offer Medicare Advantage plans and Medicare Prescription Drug Plans. Depending on the terms of the contract between the plan and Medicare, not every plan is available statewide or in all service areas. Each year, the plan must renew its contract with Medicare, so the availability of a plan in a specific service area is subject to change.
A federal law passed in 2003 created a “competition” requirement for Medicare Cost plans, which stipulated the plans could not be offered in service areas where there was significant competition from Medicare Advantage plans. Congress delayed implementation of the requirement several times until a law passed in 2015 that called for the rule to take effect in 2019.
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