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. 

Medical Assistance (Medicaid) coverage is available for adults if household income does not exceed 138 percent of poverty (MinnesotaCare, with a small monthly premium, is available for those with income up to 200 percent of poverty), for infants with household income up to 283 percent of poverty, for children 1 – 18 with household incomes up to 275 percent of poverty, and for pregnant women with household incomes up to 278 percent of poverty.
Numerous improvements were made to MNCare effective January 1, 2014. The program no longer has a $1,000 copay for hospitalization, or a $10,000 cap on inpatient benefits.  The asset test has been eliminated just as it was for Medicaid, and premiums have been significantly reduced. It used to be available only to applicants who had been uninsured for at least four months, but that provision was eliminated in 2014.
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.

In order to accurately compare the best Medicare Supplement plans in Minnesota it’s best to speak to a licensed insurance agent. It’s best to speak to an independent agent that represents multiple companies. As always, we are here to help. If you’d like to know more about which Minnesota Medigap plan might be right for you, feel free to contact us at your convenience using the toll free number at the top of the page. You can also request quotes using the get quote option at the top of this page.

Medicare Advantage (also called "Part C") and Medicare Cost plans are ways to get a single combined plan including Parts A, B, and D through a private company. With Medicare Advantage plans, you may have less flexibility, but your costs could be lower. With Medicare Cost plans, you have more flexibility, because you can still use Original Medicare to pay for out-of-network providers.
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.
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.
MedicareWire.com is privately owned and operated. We are a non-government resource, providing information about senior health insurance, Medicare, life insurance and other senior products for consumer research and education. This website and its contents are for informational purposes only. If you're looking for the government's Medicare website, please browse to 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.
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.
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.
Prior to the ACA, the vast majority of adults 55 or older who were covered by Medicaid were elderly, low-income residents who needed long-term care (Medicare does not cover long-term care, but Medicaid does if the person’s income and assets are low enough). But starting in 2014, large numbers of residents — many of whom were 55 or older — became eligible for Medicaid, and many were caught off-guard when they found out that leins were being filed against their estates.
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.
A couple of major insurers have already announced new plans to replace Minnesota Cost Plans in certain counties. Typically, these new plans offer broader network coverage within an HMO. One major carrier expects about 200,000 of their Minnesota customers to lose access to a Cost Plan. On the other hand, this change may open opportunities for other companies to expand their own market shares with Minnesota Medicare Advantage plans that can offer greater flexibility, such as PPOs with nationwide networks.
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.
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.
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.
Minnesota made history for kick-starting the Basic Health Program before any other state in the nation. People who are curious about “what are the Medicaid application guidelines?” will be interested to learn that prior to expansion, the process of learning how to qualify for Medicaid in MN was much more generous than it is now. The Medicaid benefits eligibility rules for adults with dependent children used to be up to 100 percent of poverty or 75 percent for adults without dependents.
One of the reasons Medicare Cost has been so popular in Minnesota is that the state has a large population of “snowbirds” — retirees who live in Minnesota during the summer, but head south to warmer climes in the winter. With Medicare Cost plans, the enrollee still has Original Medicare — including the large nationwide network of providers who work with Medicare — in addition to the Medicare Cost coverage. Medicare Advantage plans, in contrast, tend to have localized networks that might not be suitable for a senior who lives in two different states during the year. A Medigap plan plus Original Medicare will allow a person in that situation to have access to health providers in both locations, although Medigap tends to be more expensive than Medicare Advantage. There are pros and cons to both options, and no one-size-fits-all solution.
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.
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.
Prior to the ACA, the vast majority of adults 55 or older who were covered by Medicaid were elderly, low-income residents who needed long-term care (Medicare does not cover long-term care, but Medicaid does if the person’s income and assets are low enough). But starting in 2014, large numbers of residents — many of whom were 55 or older — became eligible for Medicaid, and many were caught off-guard when they found out that leins were being filed against their estates.
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.
We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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.

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.


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.
MedicareWire.com is privately owned and operated. We are a non-government resource, providing information about senior health insurance, Medicare, life insurance and other senior products for consumer research and education. This website and its contents are for informational purposes only. If you're looking for the government's Medicare website, please browse to www.medicare.gov.

Prior to the ACA, the vast majority of adults 55 or older who were covered by Medicaid were elderly, low-income residents who needed long-term care (Medicare does not cover long-term care, but Medicaid does if the person’s income and assets are low enough). But starting in 2014, large numbers of residents — many of whom were 55 or older — became eligible for Medicaid, and many were caught off-guard when they found out that leins were being filed against their estates.

The legislation that introduced Medicare Advantage also created a competition clause that banned Medicare Cost plans from operating in areas where they faced substantial competition from Medicare Advantage plans, but the implementation of the competition clause was delayed for many years. In 2015, legislation (MACRA) called for the competition clause to be implemented as of 2019.
Surprisingly, a large percentage of these new enrollees were not newly eligible. In fact, they had always been eligible, they just were not well-versed on the topic of “What are the Medicaid application guidelines?” Enrollment figures shrunk from 1,066,787 to 1,019,309 by August 2015, before creeping back up to 1,026,023 in July the following year.
×