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. 

You can have a Medicare Advantage plan that is integrated with MA coverage. These plans include all the coverage that Medicare Parts A, B, and D offer plus what MA covers. They are called Special Needs Plans (SNP) plans if you are 18 – 64 years old; Minnesota Senior Health Options (MSHO) if you are 65 or older. With these plans, there’s less paperwork (you only have one insurance card) and you don’t have to worry so much about which of your benefits pays for which medical services. They also offer care coordination as a core part of the plan.
In addition to Medical Assistance Medicaid, the state also provides Minnesota Care (MNCare) for residents with incomes above 138 percent of poverty, up to 200 percent of poverty. MNCare has existed in Minnesota since 1992, but it became a much more robust program in 2014. And as of January 2015, MinnesotaCare transitioned to a Basic Health Program under the ACA. BHPs are a provision of the ACA that any state can implement, but Minnesota was the only state to do so for 2015. New York has now also established a BHP, effective January 2016.
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.
What are the income requirements for Medicaid? In the event that an adult’s income exceeds the 135 percent Federal Poverty Level, he or she may sign up for a different kind of care in Minnesota, called MNCare. State tax from Minnesota hospitals and health care providers fund this program, which includes basic health services for people who do not exceed the income requirement for Medicaid 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.
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.

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.


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.
Blue Cross and Blue Shield of Minnesota has been in business since 1933. With over two million members, Blue Cross and Blue Shield of Minnesota has been meeting the health care needs of persons in Minnesota and around the country. Blue Cross and Blue Shield of Minnesota has long been recognized as one of the highest quality health plans in the Midwest for member satisfaction. As the state’s oldest, largest and most-trusted health plan, Blue Cross and Blue Shield of Minnesota welcomes the opportunity and responsibility to improve the health of Minnesotans and their communities.
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.

DFL lawmakers and Gov-elect Tim Walz are considering various possibilities for a MinnesotaCare buy-in program that would open the coverage up (for a price) to anyone buying their own coverage, or to people in areas of the state where there are limited plan options available in the individual market. The details haven’t been worked out yet, but this is something to watch in Minnesota in 2019.


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