The question, “Who is eligible for Medicaid?” is a query that Minnesota’s residents want answered. Adults with an income that is 139 percent of the poverty level or below can gain Medical Assistance (MA). MA is the name given to Medicaid in Minnesota. As of June 2016, 1,027,909 people were accepted for Medicaid benefits eligibility in MN, with the uninsured rate decreasing by 39 percent from 2013-2015.

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.
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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 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.
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.
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.
Prior to 2014, Medical Assistance in Minnesota was available to parents with dependent children if their household income was up to 100 percent of poverty, and to adults without dependent children if their household income was up to 75 percent of poverty. Minnesota was already very progressive in providing Medicaid access for most of the state’s low-income population – in many states there was no coverage at all for childless non-disabled adults prior to 2014, and in states that haven’t expanded Medicaid under the ACA, there still isn’t.

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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).

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.


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.
Medicare offers healthcare coverage to Minnesota residents age 65 or older, or to those Minnesota residents that suffer from certain medical disabilities. In 2016, 882,000 people are enrolled in Medicare in Minnesota, accounting for 16.2% of the population in Minnesota. In 2009 an average of about $8,941 was spent per Medicare enrollee in Minnesota, approximately 13.74% lower than the national average of $10,365. Between 2015 to 2030 the number of seniors in Minnesota is expected to rise by an estimated 54.07% according to calculations based off of the 2000 Census. Thus, the number of Medicare enrollees in the state is also projected to grow.
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.
People who qualify for both Medicare and MA coverage are called “dual eligibles.” Most dual eligibles do not have to pay Medicare premiums, because either MA pays them or because the person also qualifies for a Medicare Savings Program (MSP). MA, including Medical Assistance for Employed Persons with Disabilities (MA-EPD), may also help pay for Medicare co-insurance and deductibles, as well as some services Medicare doesn’t cover. That’s why you shouldn’t decline Medicare Parts B or D if you also qualify for MA.
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.
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.
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.
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.

When people were first shown how to qualify for Medicaid in Minnesota in January of 1996, Minnesota was one of the first six states to put the healthcare scheme into action. Minnesota has always put the needs of residents first when laying the ground rules for Medicaid benefits and the state has been controlling costs through the implementation of Pre-paid Medical Assistance Programs, better known as PMAP Medicaid benefits.

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.
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.

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.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
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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