The program's annual enrollment period ends Friday. If you take no action, you'll automatically remain enrolled in your current plan. However, if you pass on the opportunity to see whether a better option exists, that decision could come with a cost. ... Also, look closely at your prescription drug coverage, whether through an Advantage Plan or a stand-alone Part D plan. Even if your premium goes down, the price of certain drugs could be higher for you. (O'Brien, 12/5)

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.


Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug plan, or have creditable prescription drug coverage(that is, drug coverage that is expected to pay at least as much as standard Medicare prescription drug coverage). Some people may choose to delay Medicare Part D enrollment if they already have creditable drug coverage through an employer group plan.
You may choose not to enroll in Medicare Part B when you are first eligible because you are already covered by group medical insurance through an employer or union. If you lose your group insurance, or if you decide you want to switch from your group coverage to Medicare, you can sign up at any time that you are still covered by the group plan or during a Special Enrollment Period(SEP).
A “Welcome to Medicare” packet is mailed out a few months before you turn 65. If you are not yet 65 but receive disability benefits from the Social Security Administration, or receive certain disability benefits from the Railroad Retirement Board, then you become eligible for Medicare as soon as you enter into the 25th straight month of receiving those benefits. 

Once you feel fully informed about how to qualify for Medicaid in MN and how to follow the application guidelines for Medicaid, all that will be left to do is apply and enroll. Missing out on the marketplace’s open enrollment period does not mean that beneficiaries will be lacking insurance for long, because if qualifying events occur, Special Enrolment Periods (SEP) may launch. Minnesota shares Medicaid benefit requirements with other states that allow enrollment during SEPs, in the sense that the triggering events for SEPs are the same.
The Initial Enrollment Period is a limited window of time when you can enroll in Original Medicare (Part A and/or Part B) when you are first eligible. After you are enrolled in Medicare Part A and Part B, you can select other coverage options like a Medigap (Medicare Supplement) plan from approved private insurers. The best time to buy a Medigap policy is the six month period that starts the first day of the month that you turn 65 or older and enrolled in Part B. After this period, your ability to buy a Medigap policy may be limited and it may be more costly. Each state handles things differently, but there are additional open enrollment periods in some cases.
Medicare is a federal program that helps seniors in Minnesota and all over the country pay for their medical expenses. It is a program that is split into two main parts. Part A is a program that covers your hospital care and rehabilitation in case you get injured or sick. Part B will help pay for outpatient care, preventive care, and other forms of health care. If you ever get sick in Minnesota, this federal program will help you pay for it and for some of your medication. But this program will not pay for everything. 

If you are not eligible for retirement benefits from Social Security or the RRB, you will not be automatically enrolled into Original Medicare. However, you can still sign up for Medicare Part A and/or Part B during your IEP. You may not be able to get premium-free Medicare Part A, and the cost of your monthly Part A premium will depend on how long you worked and paid Medicare taxes. You will still have to pay a Medicare Part B premium.
Medicare is a federal program that helps seniors in Minnesota and all over the country pay for their medical expenses. It is a program that is split into two main parts. Part A is a program that covers your hospital care and rehabilitation in case you get injured or sick. Part B will help pay for outpatient care, preventive care, and other forms of health care. If you ever get sick in Minnesota, this federal program will help you pay for it and for some of your medication. But this program will not pay for everything.
If you have a Health Savings Account (HSA) with a High Deductible Health Plan (HDHP) based on your or your spouse’s current employment, you may be eligible for an SEP. To avoid a tax penalty, you should stop contributing to your HSA at least 6 months before you apply for Medicare. You can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses (like deductibles, premiums, coinsurance or copayments). If you’d like to continue to get health benefits through an HSA-like benefit structure after you enroll in Medicare, a Medicare Advantage Medical Savings Account (MSA) Plan might be an option.

The donut hole is being eliminated in 2019 for brand-name drugs, one year ahead of schedule. The gap in prescription drug coverage (the donut hole) starts when someone reaches the initial coverage limit ($3,820 in 2019), and ends when they have spent $5,100 (these thresholds are each slightly higher than they were in 2018). Prior to 2011, Medicare Part D enrollees paid the full cost of their medications while in the donut hole. But the ACA has been steadily closing the donut hole, and it will be fully closed by 2020, when enrollees in standard Part D plans will pay just 25 percent of the cost of their drugs all the way up to the catastrophic coverage threshold. But the Bipartisan Budget Act of 2018 (BBA 2018) closes the donut hole one year early for brand name drugs. As a result of the BBA, enrollees will pay 25 percent of the cost of brand-name drugs (down from the 30 percent that was originally scheduled) and 37 percent of the cost of generic drugs (down from 44 percent in 2018). The cost of closing the donut hole one year early for brand-name drugs is being shifted onto drug manufactures. The Medicare Part D maximum deductible is $415 in 2018, up slightly from $405 in 2018.
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. 

Typically, you can join a Medicare Cost plan anytime the plan is accepting new members. If you’re newly eligible for Medicare, you can enroll anytime during your seven-month Initial Enrollment Period as long as you are enrolled in Medicare Part B. However, if you’re currently enrolled in a Medicare Advantage plan or a Part D drug plan, you must first disenroll from that plan before enrolling in a Cost plan.

1) Medically Needy Pathway – In a nutshell, one may still be eligible for Medicaid services even if they are over the income limit if they have high medical bills in comparison to their monthly income. In Minnesota, this program is referred to as a “Spenddown” program. Basically, persons must pay down their “excess income,” (their income over the Medicaid eligibility limit, which is often referred to as a deductible) on medical bills. This may include health insurance costs, such as Medicare premiums, as well as bills to cover medical services. Once one has paid down his or her excess income to the Medicaid eligibility limit, he or she will receive Medicaid benefits for the remainder of the spenddown period. This program, regardless of name, provides a means to “spend down” one’s extra income in order to qualify for Medicaid.
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.
1. This table reflects the principal but not all MAGI coverage groups. All income standards are expressed as a percentage of the federal poverty level (FPL). For the eligibility groups reflected in the table, an individual’s income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income standards identified in this table to determine if they are income eligible for Medicaid or CHIP. The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to 5% FPL disregard. Other eligibility criteria also apply, for example, with respect to citizenship, immigration status and residency.
If you decide you want Part A and Part B, there are 2 main ways to get your Medicare coverage — Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap).Most people who are still working and have employer coverage don’t need additional coverage. Learn about these coverage choices.

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Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. Viewing this Medicare overview does not require you to enroll in any Blue Cross Blue Shield plans. To find out about premiums and terms for these and other insurance options, how to apply for coverage, and for much more information, contact your local Blue Cross Blue Shield company. Each Blue Cross Blue Shield company is responsible for the information that it provides. For more information about Medicare including a complete listing of plans available in your service area, please contact the Medicare program at 1-800-MEDICARE (TTY users should call 1-877-486-2048) or visit www.medicare.gov.
There are several different Medicare enrollment periods that can be easily confused. There's your initial enrollment period, special enrollment periods and a general enrollment period. There's even an Open (Annual) Enrollment Period from October 15th to December 7th that allows you to change your Medicare coverage. There is state-specific information you should also take into consideration when choosing your Medicare coverage.
IMPORTANT: The federal Centers for Medicare & Medicaid Services (CMS) had not released the 2018 Medicare Part A and Medicare Part B premiums, deductibles and coinsurance amounts prior to the print deadline for the 2018 edition of Health Care Choices. As a result, the printed edition of Health Care Choices contains 2017 Medicare Part A and B cost sharing amounts.
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Enrollment issues can also be classed as a qualifying event for Medicaid benefits in MN. To avoid delays and confusion regarding the requirements for Medicaid, it might be worth paying for a short-term health insurance policy until enrolment for Medicaid application guidelines opens again. So long as beneficiaries are aware of how to qualify for Medicaid in Minnesota, financial woes and health worries can become a thing of the past.
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.
1) Medically Needy Pathway – In a nutshell, one may still be eligible for Medicaid services even if they are over the income limit if they have high medical bills in comparison to their monthly income. In Minnesota, this program is referred to as a “Spenddown” program. Basically, persons must pay down their “excess income,” (their income over the Medicaid eligibility limit, which is often referred to as a deductible) on medical bills. This may include health insurance costs, such as Medicare premiums, as well as bills to cover medical services. Once one has paid down his or her excess income to the Medicaid eligibility limit, he or she will receive Medicaid benefits for the remainder of the spenddown period. This program, regardless of name, provides a means to “spend down” one’s extra income in order to qualify for Medicaid.
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.
Medicare is a federal program that helps seniors in Minnesota and all over the country pay for their medical expenses. It is a program that is split into two main parts. Part A is a program that covers your hospital care and rehabilitation in case you get injured or sick. Part B will help pay for outpatient care, preventive care, and other forms of health care. If you ever get sick in Minnesota, this federal program will help you pay for it and for some of your medication. But this program will not pay for everything.
Medicare eligibility is a topic that can be difficult to understand, which is why our licensed agents are prepared to break it down into simple terms that are easy to understand. Medicare is divided into four parts, including hospital insurance (Part A), medical insurance (Part B), Medicare Advantage (Part C), and prescription drug coverage (Part D). Most people age 65 or older are have Medicare eligibility.
A plan must limit membership to these groups: 1) people who live in certain institutions (like a nursing home) or who require nursing care at home, or 2) people who are eligible for both Medicare and Medicaid, or 3) people who have specific chronic or disabling conditions (like diabetes, End-Stage Renal Disease (ESRD), HIV/AIDS, chronic heart failure, or dementia). Plans may further limit membership. You can join a SNP at any time.
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. 

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.
Besides the income limit for Medical Assistance in Minnesota, there is an asset limit. Assets are personal possessions that have value, such as cars, checking and savings accounts, real estate and investments. The asset requirements for Medicaid in MN do not apply to children who are younger than 21 years of age, adults without children, pregnant women and certain other groups. Parents and any caretaker relative who are eligible for MA with a spenddown have certain asset limits. Seniors and people who are 21 years of age and older who are disabled or blind have to adhere to an asset limit as well. Assets that do not need to be noted toward the Medicaid asset limit requirements include the applicant’s place of residence, household goods, personal items like clothing and jewelry and special items owned by an American Indian. 

“What is Medicaid eligibility?” This question may be on your mind if you are new to the program. MN Medicaid eligibility is generally determined by the income level of the individual or household applying for Medical Assistance (MA). Individuals and families that fall within the allowable income range are eligible to receive benefits. In order to qualify for the program all applicants must meet all income and any other requirements.
Seniors who lost their Cost plans and are supplementing original Medicare with a stand-alone Part D prescription drug plan have until Thursday to pick a different Part D plan, according to the Minnesota Department of Commerce. Those who lost Cost plans have until March 4 to buy a Medicare Supplement, or Medigap, insurance policy without having to answer questions about their health history — a process known as "medical underwriting" that sometimes prompts carriers to not offer coverage. 

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.
If you’re automatically enrolled in Medicare Part B, but do not wish to keep it you have a few options to drop the coverage. If your Medicare coverage hasn’t started yet and you were sent a red, white, and blue Medicare card, you can follow the instructions that come with your card and send the card back. If you keep the Medicare card, you keep Part B and will need to pay Part B premiums. If you signed up for Medicare through Social Security, then you will need to contact them to drop Part B coverage. If your Medicare coverage has started and you want to drop Part B, contact Social Security for instructions on how to submit a signed request. Your coverage will end the first day of the month after Social Security gets your request.
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