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.

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.
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.
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.
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).

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.
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.
There are 33 Medicare Advantage Plans available in Hennepin County MN from 8 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. Hennepin County Minnesota residents can also pick from 6 Medicare Special Needs Plans. The highest rated plan available in Hennepin County received a 4.5 overall star rating from CMS and the lowest rated plan is 4 stars

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.
There are 33 Medicare Advantage Plans available in Hennepin County MN from 8 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. Hennepin County Minnesota residents can also pick from 6 Medicare Special Needs Plans. The highest rated plan available in Hennepin County received a 4.5 overall star rating from CMS and the lowest rated plan is 4 stars
Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
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.
Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental 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.


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.
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.
“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.
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.
Private managed care programs for Medicare beneficiaries are particularly popular in Minnesota. Fifty-six percent of all Minnesota Medicare enrollees were enrolled in private Medicare plans in 2017, as opposed to a national average of 33 percent. Minnesota has by far the largest share of its Medicare population enrolled in private plans; the next closest state is Hawaii, where 45 percent of Medicare beneficiaries have private coverage.
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. 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)
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.
Medicare beneficiaries and their caregivers in Minnesota can receive free, confidential, and unbiased one-on-one health insurance counseling through the State Health Insurance and Assistance Program (SHIP). Senior Medicare Patrol (SMP) is another program which aims to empower seniors to identify, help prevent, and report instances of Medicare waste, fraud and/or abuse.
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).
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. 

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 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.

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. 

What happens when your Medicare pays for most of your costs, but not all of your costs? Don’t worry- Medicare Supplement Insurance (Medigap) will pay for the extra costs such as copayments, coinsurance, and deductibles that Medicare may not completely cover. It’s a policy that helps pay for some things that Medicare may not completely pay for.  Medigap plans are sold by private insurance companies licensed to offer these plans in your state. Medigap plans are different than Medicare Advantage Plans (like an HMO and PPO).  Medigap policies do NOT cover most Part D prescription medications. If you want drug coverage, you can add standalone Part D plans available in your service area.
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.   
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.

“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 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.
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.
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