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.   
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.

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.
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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 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.
If you have more than one type of coverage, including MA, employer-sponsored coverage, Veterans (VA) health benefits, military (TRICARE) benefits, or any other health coverage, one coverage may pay for costs that your other coverage doesn't pay for, meaning you have to pay less out of your own pocket. If you are in this situation, make sure you understand how Medicare interacts with other types of coverage.
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.
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).
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.
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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.
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.
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.
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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 Have an Agent Call Me 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.
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.

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.

Medicare Savings Programs help people on Medicare pay for some of their out-of pocket Medicare costs. The costs paid depend upon your income but can include Medicare Part A and B premiums, co-insurance, copayments, and deductibles. You need to have countable income that is 135% of the Federal Poverty Guidelines (FPG) or less ($1,366/month for an individual, $1,852/month for couples) to qualify for a Medicare Savings Program.
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.
The MedicareWire website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional. On this page we help consumers research and compare Medicare Part C plans. Here's how we promote this page in search:
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.
Since 1997, Minnesota has provided Medicare coverage for approximately 35,000 Medicare-Medicaid eligible individuals over age 65 through the Minnesota Senior Health Options (MSHO) program. Today, the Minnesota demonstration recognizes this program stability and is focused on administrative flexibility rather than developing a new capitated system. The current demonstration will be evaluated for its ability to further promote integration. However, the longevity of the MSHO program provides for unique data analysis opportunities. MSHO claims data are a rich resource for researchers to analyze the impact of integrated care on health care outcomes for Medicare-Medicaid eligible.  To that end, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) published Minnesota Managed Care Longitudinal Data Analysis which highlights the importance of providing integrated options for Medicare-Medicaid eligible individuals. It may be found at this link: https://aspe.hhs.gov/report/minnesota-managed-care-longitudinal-data-analysis
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.
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.
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.

As an alternative to obtaining Original Medicare coverage directly from the government, you may want to consider Medicare Advantage (sometimes referred to as Medicare Part C) in Minnesota. Medicare Advantage plans are offered by private insurance companies that contract with CMS to provide all Original Medicare benefits except hospice care, which is paid by Medicare Part A. Many Medicare Advantage plans also include extra benefits such as routine dental and vision care.

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