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 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.
You should always compare your Medicare insurance options before the Annual Election Period because plans change. It’s critically important to anticipate likely changes to Minnesota Medicare Advantage plans in 2019 for one important reason. While nothing has been finalized as of this article, it’s likely that the government will reduce or eliminate Medicare Cost Plans within many counties of this state.
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).
We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.

Now that you have an idea of the type of Medicare plan options for Minnesotans, would you like some assistance looking for a plan that fits? I’d be happy to help, and you can click on the “View profile” link below to view my profile if you’d like. How about setting up a phone call with me, or having me send you some information by email? You can click on the links below to do that. Some folks prefer to research plans on their own; you can do that easily by clicking on the Compare Plans option on the right.

Your information and use of this site is governed by our updated Terms of Use and Privacy Policy. By entering your name and information above and clicking the Request a Call button, you are consenting to receive calls or emails regarding your Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Plan options (at any phone number or email address you provide) from an eHealth representative or one of our licensed insurance agent business partners, and you agree such calls may use an automatic telephone dialing system or an artificial or prerecorded voice to deliver messages even if you are on a government do-not-call registry. This agreement is not a condition of enrollment.
We have worked with two of Minnesota’s most respected health care companies to bring you two new Medicare Advantage plan options for 2019. Our new plans are set up in an accountable care model: an extra level of coordination between these insurers and our health system to ensure quality coverage, great value, and an exceptional experience. Both plans offer two coverage options to give consumers more choice. Learn more about these plans:
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.
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.
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.
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.

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.


A Special Needs Plan is a type of Medicare Advantage plan limited to people with certain chronic conditions and  other specific characteristics. Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.
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.
It’s been well known that most Medicare Cost plans in Minnesota would be expiring in 2019. Why are Medicare Cost Plans in Minnesota expiring? The simplest answer is, to simplify the options available to you, the consumer. Although some seniors will be able to keep their Cost Plan, Minnesotans in about 66 counties will have to choose either a Medigap Plan or a Medicare Advantage plan this year to replace their Cost Plan.
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.
Other types of Medicare Supplement plans in Minnesota have different sets of basic benefits. Some have deductibles of their own, while some may pay at least part of the Medicare Part B deductible. Every Medicare Supplement plans in Minnesota either covers at least part of the Part A deductible, or lets you add a “rider” on the policy for this purpose at an additional cost.
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.
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.
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.
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.
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.
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)
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.
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.
American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.
Minnesota Medicaid, also known as Medical Assistance (MA), currently provides health insurance to more than 1 million residents. Medicaid in MN enrollment has increased by 19 percent since 2013. You might be wondering, “What is Medicaid in MN?” if you are new to Minnesota. The United States federal government developed Medicaid to help low-income individuals and families get the medical care they need. Now, every state has its own Medicaid program. Keep reading for some basic Minnesota Medicaid information.
Lawmakers addressed the issue in 2016, amending the state’s existing protocol for Medicaid estate recovery. The state announced that pending federal approval, Medicaid estate recovery in Minnesota would be limited to cases in which long-term care was covered. The state intended to make that change retroactive to January 2014, but CMS did not grant approval for that. Instead, the new rules, which limit estate recovery to long-term care costs, apply to estate claims that were pending as of July 1, 2016, and to the estates of people who die after July 1, 2016.
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.

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.


Our carrier partners do not discriminate, exclude people or treat them differently on the basis of race, color, national origin, sex, age or disability. It's important that you are treated fairly. That's why our carrier partners follow federal civil rights laws in our health programs and activities. People with disabilities are offered free aids and services. If you are Interested in this services, call your insurance carrier's toll free number.
The most significant change to the Medicare program, since its enactment in 1965, began on Jan. 1, 2006. Medicare now has a prescription drug benefit (Medicare Part D). In the fall of each year, all Minnesotans with Medicare receive information about the Medicare Part D program and the Annual Open Enrollment Period for Medicare Part D and Medicare Advantage plans. Agencies, organizations and people that work with Minnesotans with Medicare will want to be kept apprised of the latest Part D information and its effect on Minnesotans with Medicare.
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.   

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. 

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.
Your information and use of this site is governed by our updated Terms of Use and Privacy Policy. By entering your name and information above and clicking the Request a Call button, you are consenting to receive calls or emails regarding your Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Plan options (at any phone number or email address you provide) from an eHealth representative or one of our licensed insurance agent business partners, and you agree such calls may use an automatic telephone dialing system or an artificial or prerecorded voice to deliver messages even if you are on a government do-not-call registry. This agreement is not a condition of enrollment.
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.
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.
Minnesota’s Medicaid program has utilized estate recovery (required under state and federal law) since 1967 as a means of recouping Medicaid costs after an enrollee dies. The estate recovery program applies to people who were 55 or older at the time they incurred Medicaid claims, and the program allowed the state to place leins against the enrollees’ estates, so that some or all of the money would be paid back to the state.Prior to the ACA, it was
HealthPartners is committed to helping you be your best, every day. That’s why we work with partners to help you get the care and coverage you need. We have a partnership in Iowa and Illinois with UnityPoint Health. We also have a partnership in North Dakota and South Dakota with Sanford Health. And we have a collaboration in Wisconsin with Bellin Health, ThedaCare and others through Robin with HealthPartners.
We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
“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
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).
We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
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.

According to the Star Tribune, one of the biggest changes happening in Minnesota this year for Medicare recipients may be the reduction in the number of Medicare Cost plans available in your county. Medicare Cost plans are types of Medicare Advantage plans that work like a regular HMO when patients get services inside the network; however, they revert to working like Original Medicare Part A and Part B outside of the plan’s network. This means that beneficiaries can enjoy low costs when they can use a plan doctor, but they will still have their services covered if they need to step outside of the plan’s list of providers.
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.
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