Minnesota law prevents Medigap insurers from imposing pre-existing condition waiting periods if the enrollee signs up during their initial six-month open enrollment window. For those who apply after that, Medigap insurers are not allowed to impose pre-existing condition waiting periods if the enrollee wasn’t diagnosed or treated for the condition in the 90 days prior to enrolling in the Medigap plan.
In the fall of 2013, prior to the launch of the ACA’s exchanges, Minnesota’s total Medicaid/CHIP enrollment stood at 873,040. There were 144,481 new Medicaid enrollments through MNsure, the state-run exchange, from October 2013 through April 2014, and total enrollment in Minnesota’s Medicaid program had grown to 1,066,787 by August 2014, an increase of more than 22 percent over the enrollment total prior to October 2013. Many of these enrollees were already eligible prior to 2014, but were not aware of their eligibility.
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Minnesota also prohibits Medigap insurers from basing premiums on an enrollee’s age. Premiums for Medigap plans in Minnesota only vary based on tobacco use and where the enrollee lives. These rating rules also apply to people who are eligible for Medicare before the age of 65, which is somewhat unusual; most of the states that have guaranteed access to Medigap for under-65 enrollees do allow the insurers to charge those enrollees higher premiums.
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.
In all but three states, Medigap plans are standardized under federal rules. But Minnesota is one of three states that have federal waivers that allow the state to do its own Medigap standardization. So instead of the ten Medigap plans (A through N) that are marketed in most states, Minnesota Medigap plans include Basic, Basic with riders, Extended Basic, and Medigap plans F, K, L, M, and N. There are also Medicare Select Medigap plans in Minnesota, just as there are in other states.
“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 program 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 the benefits administered by state governments.
Before enrolling in a Medicare Advantage Prescription Drug plan, it’s a good idea to check that the formulary includes your prescription medications; the formulary is a list of prescription medications covered by the plan. Formularies vary by plan, and not every medication is covered by every Medicare plan, so it’s important to double check. Keep in mind that formularies are subject to change. The formulary may change at any time. You will receive notice from your plan when necessary.
The Minnesota Department of Commerce: provides beneficiaries with information about Medicare Part D Prescription Drug Plans and other insurance options available to them. The office is a resource for information about protection from Medicare fraud and how to report fraud. Additional links are included for federal offices that deal with Medicare and brochures that explain how to enroll in Part D Prescription Drug Plans. This government office also offers downloads of premium guides for supplemental plans available to current Medicare beneficiaries in Minnesota.

Local HMO plans may require referrals to see a specialist, but some Local HMO Medicare Advantage plans include a point-of-service self-referral option, which gives you some flexibility with going to out-of-network providers. Point-of-Service (POS) plans have an option that allows visits to out-of-network providers at an additional cost. If the POS plan offers Medicare Part D coverage, enrollees must get it from the POS plan. If you enroll in a stand alone plan, you will be disenrolled from the Local HMO Medicare Advantage plan.
If you believe you are eligible for medical assistance benefits, you can begin the process of applying for Medicaid at any time. There are number of simple Medicaid application methods currently available in Minnesota; individuals and families are free to choose any of the methods to apply. It may take up to a month to be approved. You can learn about coverage and costs, eligibility, and all of the application options on our site. Please feel free to review the comprehensive information we have provided.
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.
Even when you enroll in Medicare, your out-of-pocket costs, including deductibles, co-insurance and co-pays can be significant. This is especially true in Minnesota where health insurance premiums vary based on location and population density. It is important to consider options that can help reduce your out-of-pocket costs. Medicare supplements (also known as Medigap), Medicare managed-care style health plans (Advantage and Cost plans) and Part D plans can provide you the coverage and protection you may need. These additional plans must be approved by the Minnesota Department of Insurance, so you can rest assured that all plans meet the established criteria.
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Every Medicare beneficiary in the Twin Cities metro area who is currently enrolled in a Medicare Cost Planwill have their plan end on December 31, 2018.  You will need to take action to enroll in new Medicare coverage for 2019. The phaseout of Medicare Cost Plans has been decades in the making due to the high expense of administering the plans. The decision to end the plans was signed into law more than twenty-years ago as part of the Balanced Budget Act of 1997. Since then, there have been several extensions of Medicare Cost Plans. Most recently, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) extended Medicare Cost Plans through 2018 for most counties in Minnesota. 


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In addition, both Minnesota Medigap plans and Medicare plans usually come with a package of membership benefits. These extra benefits may help members save money on such non-Medicare expenses as memberships to fitness clubs, dental care, glasses, and even over-the-counter vitamins and medicine. These membership benefits aren’t insurance, but they may offer the same sort of discounts that people enjoy when they have to pay for in-network services with insurance.
As of 2018, there were 370,000 Medicare Cost plan enrollees in Minnesota, but most of them had to switch to new plans (either Medicare Advantage or Original Medicare) for 2019. This is described in more detail below, but Minnesota’s enrollment in private Medicare plans could end up fluctuating significantly for 2019, depending on how many of those enrollees opted to have coverage under Original Medicare versus Medicare Advantage.
People who aren’t yet 65 can enroll in Medicare if they’re disabled and have been receiving disability benefits for at least two years, and 13 percent of Minnesota Medicare beneficiaries are under age 65. Federal rules do not guarantee access to Medigap plans for people who are under 65, but the majority of the states — including Minnesota — have implemented rules to ensure that disabled Medicare beneficiaries have at least some access to Medigap plans. Minnesota law grants a six-month open enrollment period to anyone who enrolls in Medicare Part B, regardless of age (federal rules only grant this window to people who enroll in Part B and are also at least 65 years old).
“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 program 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 the benefits administered by state governments.

Just because a person is able to answer the question “what are the requirements for Medicaid in MN?” it does not mean that he or she will meet the Medicaid eligibility requirements in Minnesota. Visiting Medicaid offices around Minnesota and talking to a member of staff will clear up any misunderstanding about Medicaid qualifications and Medicaid requirements.


Medicare Part D is optional prescription drug coverage. If you have Original Medicare, you can get this coverage through a Medicare Prescription Drug Plan, offered through private Medicare-approved insurance companies. These plans offer stand-alone prescription drug coverage that work alongside Original Medicare, Part A and Part B. A Medicare Advantage Prescription Drug plan also provides the Medicare Part D benefit, covering all Medicare benefits under a single plan.
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.
MA plans feature a network of doctors and hospitals that enrollees must use to get the maximum payment, whereas supplements tend to provide access to a broader set of health care providers, said Shawnee Christenson, an insurance agent with Crosstown Insurance in New Hope. While that might sound good to beneficiaries, supplements can come with significantly higher premiums, Christenson said.
There are 19 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in Minnesota. Of these, the companies that offer the largest variety of plans to choose from are Medica, Ucare, and Humana. In Minnesota,Medica has the largest selection of Medicare Advantage plans while Humana offers the most Medicare Part D plans. The following are all medicare insurance providers in Minnesota:
Of the more than 300,000 people losing their Cost plans in Minnesota, it’s likely that roughly 100,000 people will be automatically enrolled into a comparable plan with their current insurer, Corson said, unless they make another selection. Details haven’t been finalized, he said. That likely will leave another 200,000 people, he said, who will need to be proactive to obtain new replacement Medicare coverage.
Without the flexibility of Medicare Cost plans, state residents might turn to an Basic or an Extended Basic Supplement plan in Minnesota. Insurers may charge more for a Minnesota Medigap plan, but, many times they have more thorough coverage. Minnesota Medigap plans will pay for almost all covered services, so some recipients may end up saving money anyway.
In February 2013, Governor Mark Dayton signed HF9, a bill that expanded access to Medicaid Assistance (Minnesota’s Medicaid program) under the ACA. News reports in 2013 widely reported that Medicaid expansion was expected to provide health coverage for 35,000 newly-eligible Minnesota residents. But Families USA projected estimated in April 2017 that 222,900 people were enrolled in Medicaid in Minnesota due to expansion. 

Before enrolling in a Medicare Advantage Prescription Drug plan, it’s a good idea to check that the formulary includes your prescription medications; the formulary is a list of prescription medications covered by the plan. Formularies vary by plan, and not every medication is covered by every Medicare plan, so it’s important to double check. Keep in mind that formularies are subject to change. The formulary may change at any time. You will receive notice from your plan when necessary.
Of the more than 300,000 people losing their Cost plans in Minnesota, it’s likely that roughly 100,000 people will be automatically enrolled into a comparable plan with their current insurer, Corson said, unless they make another selection. Details haven’t been finalized, he said. That likely will leave another 200,000 people, he said, who will need to be proactive to obtain new replacement Medicare coverage.
Just because a person is able to answer the question “what are the requirements for Medicaid in MN?” it does not mean that he or she will meet the Medicaid eligibility requirements in Minnesota. Visiting Medicaid offices around Minnesota and talking to a member of staff will clear up any misunderstanding about Medicaid qualifications and Medicaid requirements.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
People who aren’t yet 65 can enroll in Medicare if they’re disabled and have been receiving disability benefits for at least two years, and 13 percent of Minnesota Medicare beneficiaries are under age 65. Federal rules do not guarantee access to Medigap plans for people who are under 65, but the majority of the states — including Minnesota — have implemented rules to ensure that disabled Medicare beneficiaries have at least some access to Medigap plans. Minnesota law grants a six-month open enrollment period to anyone who enrolls in Medicare Part B, regardless of age (federal rules only grant this window to people who enroll in Part B and are also at least 65 years old).
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.
Minnesota also prohibits Medigap insurers from basing premiums on an enrollee’s age. Premiums for Medigap plans in Minnesota only vary based on tobacco use and where the enrollee lives. These rating rules also apply to people who are eligible for Medicare before the age of 65, which is somewhat unusual; most of the states that have guaranteed access to Medigap for under-65 enrollees do allow the insurers to charge those enrollees higher premiums.
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. 
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