Medicare Advantage, also known as Medicare Part C, is another way to receive Original Medicare benefits and is offered through private insurance companies. At minimum, all Medicare Advantage plans must offer the same Medicare Part A and Part B benefits as Original Medicare. Some Medicare Advantage plans also include additional benefits, such as prescription drug coverage. You must have Original Medicare, Part A and B, to enroll in a Medicare Advantage plan through a private insurer.
Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace website. In offering this website, HealthMarkets Insurance Agency is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov.
When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.
New in 2019 is the Medicare Advantage Enrollment Period from Jan. 1 to March 31. During this time any Medicare beneficiary who begins 2019 enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan that includes Part D, drop their Medicare Advantage plan and return to Original Medicare or enroll in a Part D prescription drug plan. 

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.
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.
MA enrollees who qualify for Medicare must enroll in Parts A and B as a condition of their MA eligibility. When an MA eligible person does not qualify for automatic payment of Medicare premiums, the person may be required to enroll in Medicare if the premiums are found to be cost effective. See Referrals to Medicare to determine who must be referred to apply for Medicare and the steps in the referral process.

“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.


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.
Major changes are coming for close to half of Minnesotans on Medicare in 2019. Are you one of those affected? Unbiased help is just a phone call away. This year’s Medicare open enrollment period is October 15 – December 7. This is the time when anyone on Medicare can change his or her health plan and drug coverage for the following year. Since plans change yearly, your current plan might not meet your needs for next year. In the land of 10,000 lakes, the very popular Cost Plans will be ending in most Minnesota counties as of January 1, 2019. This will require many to pick a new plan. Check out Minnesota’s own Diana Pierce talking about the change in this video. Cost Plans are sold by three companies is Minnesota: Blue Cross Blue Shield of MN, HealthPartners, and Medica. If you have a Cost Plan that is discontinued, you have likely already received communications about the change from the Centers for Medicare and Medicaid and from the company that offers your health plan. Do you need help sorting out your options? We can help!  Health Care Choices for Minnesotans on Medicare, 2019 Edition, is now available online and at MAAA offices. The guide, published by the Minnesota Board of Aging, provides comprehensive information on Medicare options available to Minnesotans. Dates to keep in mind
Medicare prescription drug coverage is optional and does not occur automatically. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage, also known as a Medicare Advantage Prescription Drug plan. Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Please note that you cannot have both a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes drug coverage.

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.
How much does Medicaid cost in Minnesota? Full Medicaid coverage is granted to certain qualified patients, while others may be required to pay fees in the forms of deductibles or co-pays for certain Medicaid services. And, while what is covered by Medicaid means little-to-no-cost for beneficiaries, there are some medical services that are considered what is not covered by Medicaid in MN. How much is Medicaid when a health service is not handled by the government? Medicaid cost estimates vary depending on the patient and types of Medicaid insurance… Read More
For all of those medical expenses and procedures that are not covered under this federal program, you will have to pay out of your own pocket. These expenses can get very expensive and can cause serious financial stress for a senior living in Minnesota. That is why you need to purchase supplemental insurance. Minnesota Medicare supplemental insurance will help you pay for most of those expenses and procedures that the federal program will not cover. Instead of spending those hundreds, possibly thousands, of dollars on these things, you will be able to save your money and enjoy your MN retirement.
Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace website. In offering this website, HealthMarkets Insurance Agency is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov.
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. 

With changes brought about to the healthcare system from the passage of the Affordable Care Act, more people are wondering about Medicare Eligibility. Minnesota HealthMarkets agents can help explain Medicare eligibility in Minnesota, and help you understand whether or not you may qualify. HealthMarkets Insurance Agency can help you determine whether or not you are eligible for Medicare, as well as answer any questions you may have concerning the healthcare marketplace. Our agents can also help you pick out the perfect plan that meets your individual health and financial needs. We can also assist you in enrolling in a plan once you have one selected if you are Medicare eligible.

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.

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 

A pay-per-visit health coverage plan that allows individuals to go to any doctor, hospital, or other health care supplier who accepts Medicare and who is accepting new Medicare patients. The individual is responsible for paying a deductible and copayment. Under Original Medicare, Medicare pays a portion of the Medicare-approved amount, while the individual pays for his/her share (coinsurance).
If you are approaching your 65th birthday, meet Medicare eligibility requirements and do not currently receive Social Security or Railroad Retirement board benefits — or if you are under 65 and eligible for Medicare because you have End-Stage Renal Disease (ESRD) — you need to manually enroll for Medicare benefits through The United States Social Security Administration.
If a petitioner is seeking to qualify for Medicaid in Minnesota, he or she must be a resident of the state. To meet Medicaid eligibility requirements, applicants must also be a U.S. national, U.S. citizen or a qualifying non-citizen. Applicants are required to provide a Social Security number for each household member who is requesting MA, unless they qualify for a special exception. Petitioners must meet the MN Medicaid eligibility income limit and asset limit for the program and adhere to any other program rules and regulations. To learn more about eligibility requirements for Medicaid, download our comprehensive guide.
Some residents are not allowed to apply for Medicaid online through ApplyMN or MNsure. Where do you sign up for Medicaid? Applicants who cannot apply online are required to submit a Minnesota Health Care Programs (MHCP) paper application through their local tribal or county office. A paper application is only allowed if everyone in the family meets one of the following:

We are not an insurance agency and are not affiliated with any plan. We connect individuals with insurance providers and other affiliates (collectively, “partners”) to give you, the consumer, an opportunity to get information about insurance and connect with agents. By completing the quotes form or calling the number listed above, you will be directed to a partner that can connect you to an appropriate insurance agent who can answer your questions and discuss plan options.


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.
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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.
Are you tired of paying for all of your healthcare costs? Even if you are under certain Medicare Advantage plans, you can still be on the hook for a lot of costs. Luckily, we can help you find the best Medicare Advantage plans in Minnesota for 2019 that will help you pay for these expenses. Then, you can enjoy retirement instead of worrying so much about money concerning your healthcare.
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.

“What are the requirements for Medicaid in Minnesota?” is a question that many Minnesotans seeking medical coverage may be asking. Candidates who learn how to qualify for Medicaid will improve their chances of a successful application. Minnesota’s Medicaid program, referred to as Medical Assistance (MA), is intended for families and individuals with a financial situation that could be classified as low-income. Most individuals who qualify for Medical Assistance get health care through different health plans. Participants can select a health plan that makes sense for them. Participants who opt to not enroll in a health plan can still receive care, but they will pay on a fee-for-service basis, with health care providers billing the state of Minnesota directly for any services they provide. Understanding Medicaid benefits eligibility guidelines is integral to ensuring that qualified candidates are able to receive assistance. When a candidate meets all Medicaid eligibility requirements, MA provides different types of comprehensive coverage. There are income requirements for Medicaid in Minnesota, just like any other state. Petitioners wanting to know who is eligible for Medicaid in MN can find answers by reviewing the information below.
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Private managed care programs for Medicare beneficiaries are particularly popular in Minnesota. Fifty-six percent of all Minnesota Medicare enrollees were enrolled in private Medicare plans in 2017, as opposed to a national average of 33 percent. Minnesota has by far the largest share of its Medicare population enrolled in private plans; the next closest state is Hawaii, where 45 percent of Medicare beneficiaries have private coverage.
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.
Lawmakers addressed the issue in 2016, and 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.
Medical assistance benefits are available to a wide variety of low-income individuals and families within the United States. However, all Medicaid applicants must meet the established eligibility requirements, which range from income limits to citizenship qualifications. To find out if you or your family is eligible to receive Medicaid benefits, download our comprehensive and complimentary guide.

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.
The best time to enroll in a Medigap plan is during the six-month Medigap open enrollment period which begins the month you’re 65 and you are enrolled in Part B. If you apply for coverage outside of your open enrollment period, you may be required to provide your health history and be medically underwritten. This means you could be denied coverage, or it may cost more. 

Medigap plans can be considered when looking for an alternative to Medicare Advantage plans for 2019.  Unlike the no monthly premium or low premium option that you might be used to with Medicare Part C plans in Minnesota, you will have to pay for a Supplement plan. Your plan will make healthcare costs more affordable in the long run, however. This is because your chosen insurance company will pay most of the expenses like deductibles and coinsurances of Original Medicare Part A and B.
And although 16 percent of Medicare beneficiaries are under 65 and eligible for Medicare due to a disability (including ALS and kidney failure), federal rules do not guarantee access to Medigap plans for enrollees who are under age 65. The majority of the states have implemented regulations to ensure access to at least some Medigap plans for people in this situation, although it varies considerably from one state to another.
The annual open enrollment period for people selecting a Medicare health plan ends Friday, but that doesn’t mean the shopping season is over for more than 300,000 Minnesotans who are losing their Medicare Cost coverage next year. Beginning Saturday, people losing Cost plans will be eligible for a special enrollment period where they have until month’s end to buy replacement coverage that takes effect Jan. 1, and enrollment options that stretch into 2019. (Snowbeck, 12/6)
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