Special Needs Plans (SNP): Special Needs Plans are for beneficiaries with certain unique situations and meet certain eligibility criteria. These plans may limit membership to people who have certain chronic conditions, live in an institution (such as a nursing home), or are dual eligibles (receive both Medicare and Medicaid benefits). You must meet the eligibility requirements of the Special Needs Plan to enroll; for example, to enroll in a Dual-Eligible Special Needs Plan in your service area, you must have both Medicare and Medicaid coverage.
Discrimination is Against the Law. We comply with applicable Federal civil rights laws and Minnesota laws. We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex, sexual orientation, gender or gender identity. Please see our Fairview Patients’ Bill of Rights or HealthEast Patients' Bill of Rights.
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.
If you are worried that an HMO or PPO plan will try to limit your care, Medicare Advantage is not the only way to get full coverage. For a little more each month you can have the best care available and lower your out-of-pocket expenses. Savvy seniors hold on to their Original Medicare and get the additional coverage they need with a Minnesota Medicare Part D Plan (prescriptions) and Minnesota Medicare Supplement Insurance.
The state was the first to participate in a demonstration program to pilot Medicare Cost plans in the 1970s, and the plans have remained popular over the decades. They didn’t catch on in many other states, however, and Medicare + Choice came on the national scene in the 1990s, replaced by Medicare Advantage in 2003 (there are still Medicare Cost plans in Arizona, California, Colorado, District of Columbia, Florida, Iowa, Maryland, North Dakota, Nebraska, New York, South Dakota, Texas, Virginia, and Wisconsin, but their total enrollment was only about a third of the 625,072 people who had Medicare Cost plans in 2018 — the other two-thirds were in Minnesota).
Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. However, this page is focused on Medicaid eligibility for Minnesota elderly residents, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, in an adult foster care home, or in an assisted living facility.
One of the Medicare Savings Programs (MSPs) is for Qualified Medicare Beneficiaries (QMB). The QMB program covers the premiums for Medicare Part A and Part B. The deductibles, copays, and coinsurance costs are covered as well. An individual can qualify for this program with an income of no more than $1,032 a month. A married couple can also qualify with a combined income of less than $1,392 a month.

It’s important to note that Minnesota has a Medicaid Look-Back Period. This is a period of 60 months (5 years) that dates back from one’s Medicaid application date. During this time frame, Medicaid checks to ensure no assets were sold or given away under fair market value. If one is found to be in violation of the look-back period, a period of Medicaid ineligibility will ensue.


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.


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.   


If you don’t want Medicare Advantage, think about a Medigap policy (Medicare Supplement Insurance). If you get Original Medicare, you can pay an extra monthly premium to get a private Medigap policy that covers some of the expenses that Medicare Parts A and B won’t cover, such as co-insurance, copayments, and deductibles. Medigap policies do not cover prescription drugs (you need Part D for that). Learn more about Medigap policies or find one in your area.
The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from a Minnesota Medicaid program. Alternatively, one might want to take the Medicaid Eligibility Test. IMPORTANT, not meeting all the criteria below does not mean one is not eligible or cannot become eligible for Medicaid in Minnesota. More.
Preferred Provider Organization (PPO) plans: This type of Medicare Advantage plan offers more provider flexibility. PPOs typically have a preferred provider network, but you may also use out-of-network doctors if you choose, although your cost sharing may be higher. Unlike HMOs, you don’t need referrals for specialist care and you aren’t required to have a primary care doctor.
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.
MA plans often include dental, vision and health-club benefits that aren’t part of many supplements. Yet people who buy a supplement have the option of buying “stand-alone” Part D prescription drug coverage from any one of several insurers — a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.
Original Medicare is a federal program that provides health coverage for individuals 65 years old and older and some individuals with qualifying disabilities under the age of 65. In terms of costs and benefits, Original Medicare coverage in Minnesota works the same way as it does in other states. Under Original Medicare, you’re not limited to using providers in a certain network and can use any provider that accepts Medicare patients. To obtain the full value of your benefits and potentially lower your out-of-pocket expenses for covered services, you’ll want to check and make sure your provider also accepts Medicare assignment—that is, the amount Medicare will pay for a particular service, less any deductible and/or coinsurance you may owe.
If you are a Minnesota beneficiary and considering enrollment in a Medicare Advantage plan, it is important to compare and evaluate the Medicare plan options available to you. While similar Medicare Advantage plans may be offered throughout the state, the cost for premiums may vary depending on your county of residence. You should also take note that some Medicare Advantage plans in Minnesota may offer monthly premiums as low as $0. If your service area offers a Medicare Advantage plan with a $0 premium, keep in mind that the plan may still include other costs besides the premium, such as copayments, coinsurance, and deductibles. In addition, you must still pay your Medicare Part B premium.
Because Medigap policies are regulated by State and Federal laws, benefits for all options are the same regardless of insurer. The differences will be in the price, who administers the plan, and which of the ten options the insurer chooses to offer. You may want to choose a health insurer that you already feel comfortable with, or you can shop around for the best prices.
TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

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.
Original Medicare does not provide coverage for outpatient prescription drugs. More than half of Original Medicare beneficiaries nationwide have supplemental coverage via an employer-sponsored plan (from a current or former employer or spouse’s employer) or Medicaid, and these plans often include prescription coverage. Some Medigap plans that were sold prior to 2006 included coverage for prescription drugs, but sales of those plans ceased as of 2006, when Medicare Part D became available. Part D was created under the Medicare Modernization Act of 2003, which was signed into law by President George W. Bush.
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.

To enroll in a stand-alone Medicare Part D Prescription Drug Plan, you must have Part A and/or Part B and live in the service area of a plan that provides drug coverage. It’s important to sign up for Medicare Part D prescription drug coverage as soon as you’re eligible. Unless you have creditable prescription drug coverage (that is, prescription drug coverage that is at least as good as Medicare Part D), you may have to pay a Part D late enrollment penalty if you sign up later with a Medicare plan that offers prescription drug coverage.
The Minnesota Department of Health offers information about Medicare plans in Minnesota. The agency serves as a resource for those who need help paying their Medicare premiums and those interested in obtaining prescription drug coverage. The office also offers guidelines for handling complaints about health-care coverage and providers. Information on other types of health-care coverage are also covered by this website, including long-term care insurance. Downloads of publications on specific topics are also available, as well as links to additional resources available through state and federal offices.
If you’re still working and/or have coverage through an employer’s or union’s group health plan, you may choose to delay Part B enrollment to avoid paying a premium for benefits you don’t need. You can sign up for Part B later when your coverage ends or you stop working, using a Special Enrollment Period (SEP). You won’t have to pay a Part B penalty if you had health coverage based on current employment (either your own or through your spouse’s employer).
The average cost of monthly premiums for insurance in Minnesota is $477, which may be too expensive for some of the residents in the state. However, the US federal government offers more affordable Minnesota Medicare insurance coverage for beneficiaries over the age of 65, and some workers with disabilities may qualify as well. The Minnesota state government also offers various assistance programs for Medicare beneficiaries.
If you are a Minnesota beneficiary and considering enrollment in a Medicare Advantage plan, it is important to compare and evaluate the Medicare plan options available to you. While similar Medicare Advantage plans may be offered throughout the state, the cost for premiums may vary depending on your county of residence. You should also take note that some Medicare Advantage plans in Minnesota may offer monthly premiums as low as $0. If your service area offers a Medicare Advantage plan with a $0 premium, keep in mind that the plan may still include other costs besides the premium, such as copayments, coinsurance, and deductibles. In addition, you must still pay your Medicare Part B premium. 

One way to receive your Medicare Coverage is by enrolling in a Medicare Advantage Plan (like an HMO or PPO). Medicare Advantage Plans, sometimes called “Part C” or “MA Plans” are offered by private insurance companies approved by Medicare. It’s important to remember Medicare Advantage Plans are not Medicare Supplements (Medigap). These plans will provide coverage for your approved Medicare Part A (hospital) and Part B (medical) coverage. Many of the Medicare Advantage plans will have a network of contracted providers and facilities. It’s important to understand how the network functions and to be sure the plan you choose contracts with the providers you want to use. When you enroll in a Medicare Advantage Plan, The Centers for Medicare and Medicaid Services (CMS) will send a flat monthly rate to the insurance companies while you are enrolled in their plan. That money is sent whether you have claims or not. Check out our FAQ for a full breakdown of Medicare plans.
While all Medicare Advantage plans must provide all benefits of Original Medicare, plans can include different additional benefits depending on the private health insurer that offers it. Some plans might have a lower deductible and your share of the remaining costs might also be lower. Your Medicare Advantage plan may even cover certain health care services that Original Medicare does not cover like eye exams, hearing aids, dental care or health care received while traveling outside the United 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.
From Oct. 1 through March 31, we take calls from 8 a.m. to 8 p.m. CT, seven days a week. You’ll speak with a representative. From April 1 to Sept. 30, call us 8 a.m. to 8 p.m. CT, Monday through Friday to speak with a representative. On Saturdays, Sundays and federal holidays, you can leave a message and we’ll get back to you within one business day.
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.
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.
Minnesota is one of just three states in the country (Massachusetts and Wisconsin are the others) that offers its own version of Medicare Supplement insurance. Minnesota has two plans available: the Minnesota Basic Plan and the Minnesota Extended Basic Plan. In  most other states, up to 10 types of standardized plans are available. Medicare Supplement plans are also known as Medigap policies and may help pay Original Medicare out-of-pocket costs, such as copayments and deductibles.
One of the Medicare Savings Programs (MSPs) is for Qualified Medicare Beneficiaries (QMB). The QMB program covers the premiums for Medicare Part A and Part B. The deductibles, copays, and coinsurance costs are covered as well. An individual can qualify for this program with an income of no more than $1,032 a month. A married couple can also qualify with a combined income of less than $1,392 a month.

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 can get a Medicare Supplemental plan only if you have Original Medicare. Medigap plans only work with both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). If you have a Medicare Advantage plan, you do not need and cannot be sold a Medicare Supplement plan. Medigap plans do not cover your prescription drugs; for drug coverage you will need Medicare Part D or a Medicare Advantage with prescription drug coverage included.
Beneficiaries in Minnesota can also choose to get Medicare coverage through private insurance companies. The specific plans and benefits available to you will depend on where you live, since not all plans are offered in every location. If you are looking online for private Medicare plans in Minnesota, always make sure to provide your zip code when comparing plans.
Medigap plans can be considered when looking for an alternative to Medicare Advantage plans for 2019.  Unlike the no monthly premium or low premium option that you might be used to with Medicare Part C plans in Minnesota, you will have to pay for a Supplement plan. Your plan will make healthcare costs more affordable in the long run, however. This is because your chosen insurance company will pay most of the expenses like deductibles and coinsurances of Original Medicare Part A and B.
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