If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year. Keep in mind that you may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you did not sign up when you were first eligible.

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.

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.
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.
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.
If you didn’t sign up for Medicare A and B when you were first eligible, you have a chance to do so each year from January 1 to March 31, with coverage effective July 1.  You may be subject to a late enrollment penalty, however. For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12 month period that you were eligible but not enrolled.
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.
Most Americans become eligible for Medicare when they turn 65. But younger Americans gain Medicare eligibility after they have been receiving disability benefits for 24 months, or have ALS or end-stage renal disease. Thirteen percent of Minnesota’s Medicare beneficiaries were under age 65 as of 2017, versus 16 percent nationwide. On the high and low ends of the spectrum, 23 percent of Medicare beneficiaries in Alabama, Kentucky, and Mississippi are under 65, while just 9 percent of Hawaii’s Medicare beneficiaries are eligible due to disability.

In the 1980s, in an effort to control costs, Minnesota began implementing PMAP, or pre-paid medical assistance programs.  PMAPs provide blocks of Medicaid funding to non-profit HMOs and a variety of rural health programs across the state. The program was instituted as a demonstration project in 1983, but has continued to be the mechanism by which Medicaid funds are dispersed to providers in Minnesota for three decades.


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.
If you have been receiving Social Security disability benefits or certain disability benefits from the Railroad Retirement Board for 24 months, you'll be automatically enrolled in Original Medicare (Parts A and B). Your Medicare card will arrive three months before your 25 month of disability. You may also choose to enroll in a Medicare Advantage plan or a Prescription Drug Plan.
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
Discrimination is Against the Law. We comply with applicable Federal civil rights laws and Minnesota laws. We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex, sexual orientation, gender or gender identity. Please see our Fairview Patients’ Bill of Rights or HealthEast Patients' Bill of Rights.
In states with lots of rural areas, like Minnesota, Medicare Cost plans tend to be more popular because they offer more flexibility than an HMO. If a plan member gets services inside of the network of Medicare Cost Plans, they work the same way that an HMO works. If the plan member decides to visit a non-network medical provider, Medicare Cost Plans will cover those services the same way that Original Medicare Part A and Part B do. Typically, a Medicare Advantage HMO won’t cover non-emergency services outside of the network at all.
If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year. Keep in mind that you may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you did not sign up when you were first eligible.
If the new coverage requires higher payments at the doctor's office because the clinic is not in-network, the change might not yet be apparent to seniors who haven't visited the doctor in the new year. Seniors can check on the network status of their health care providers by contacting their doctor's office, calling their new health insurer or checking the health plan's online directory of health care providers.
Keep in mind that learning how to qualify for Medicaid in MN will not happen instantly. Local districts usually process applications relating to pregnant females and adults claiming for children within a 30-day period. Disabled beneficiaries must be assessed prior to gaining coverage, so as to determine who is eligible for Medicaid services, what type of services, for what duration, etc. This whole process can take up to 90 days.
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
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.
The logos and brand names used on this page are legal U.S. trademarks. We make no claim to the marks whatsoever, nor do we claim to represent the brands, products or services presented. MedicareWire is a comparison and research website that does not offer Medicare insurance, nor are we compensated for Medicare plan enrollments. We use brand names and logos on this page for editorial purposes, as permitted by U.S. Trademark Fair Use Law.
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.
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.
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.
Even when you enroll in Medicare, your out-of-pocket costs, including deductibles, co-insurance and co-pays can be significant. This is especially true in Minnesota where health insurance premiums vary based on location and population density. It is important to consider options that can help reduce your out-of-pocket costs. Medicare supplements (also known as Medigap), Medicare managed-care style health plans (Advantage and Cost plans) and Part D plans can provide you the coverage and protection you may need. These additional plans must be approved by the Minnesota Department of Insurance, so you can rest assured that all plans meet the established criteria.
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. 

The logos and brand names used on this page are legal U.S. trademarks. We make no claim to the marks whatsoever, nor do we claim to represent the brands, products or services presented. MedicareWire is a comparison and research website that does not offer Medicare insurance, nor are we compensated for Medicare plan enrollments. We use brand names and logos on this page for editorial purposes, as permitted by U.S. Trademark Fair Use Law.
Medicaid is a medical assistance program that provides coverage for various types of medical care. Eligible individuals and families can receive coverage for doctor visits, X-rays, labs, inpatient care, outpatient care and more. However, not all procedures are covered under the federal medical assistance program. To learn about which procedures are covered and to find out all about the Medicaid program, download our comprehensive guide.
As of 2018, there were 370,000 Medicare Cost plan enrollees in Minnesota, but most of them had to switch to new plans (either Medicare Advantage or Original Medicare) for 2019. This is described in more detail below, but Minnesota’s enrollment in private Medicare plans could end up fluctuating significantly for 2019, depending on how many of those enrollees opted to have coverage under Original Medicare versus Medicare Advantage.

Veterans who receive VA coverage and are eligible for Medicare can also consider enrolling in Medicare Part A and Part B. If you have VA benefits as well as Medicare coverage, your options for care and your coverage net can be widened. Your qualified care would be covered under Medicare Part A and/or Part B, even if you go to a non-VA hospital or doctor.


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.
The state was the first to participate in a demonstration program to pilot Medicare Cost plans in the 1970s, and the plans have remained popular over the decades. They didn’t catch on in many other states, however, and Medicare + Choice came on the national scene in the 1990s, replaced by Medicare Advantage in 2003 (there are still Medicare Cost plans in Arizona, California, Colorado, District of Columbia, Florida, Iowa, Maryland, North Dakota, Nebraska, New York, South Dakota, Texas, Virginia, and Wisconsin, but their total enrollment was only about a third of the 625,072 people who had Medicare Cost plans in 2018 — the other two-thirds were in Minnesota).
Medicaid is a medical assistance program that provides coverage for various types of medical care. Eligible individuals and families can receive coverage for doctor visits, X-rays, labs, inpatient care, outpatient care and more. However, not all procedures are covered under the federal medical assistance program. To learn about which procedures are covered and to find out all about the Medicaid program, download our comprehensive guide.
When calling, please have your Medicare and/or current plan card available. Caregivers welcome. To explore 2019 Medicare plans on your own, visit the Medicare Plan Finder (Medicare.gov). You’ll be able to create an account, view your current plan, and explore 2019 offerings. After October 15, you’ll also be able to enroll in a plan. Take charge. Start learning about your plan options today!

The other two-thirds have Original Medicare, but 81 percent of those enrollees supplement their coverage with employer-sponsored coverage, Medigap, or Medicaid. And more than 25 million Medicare beneficiaries also purchase stand-alone Medicare Part D Prescription drug coverage, since Original Medicare (and some Medicare Advantage plans) does not cover outpatient drug costs.

During your Medigap Open Enrollment Period, you have a “guaranteed-issue right” to buy any Medigap plan sold in your state. This means that insurance companies cannot reject your application for a Medicare Supplement insurance plan based on pre-existing health conditions or disabilities. They also cannot charge you a higher premium based on your health status. Outside of this open enrollment period, you may not be able to join any Medigap plan you want, and insurers can require you to undergo medical underwriting. You may have to pay more if you have health problems or disabilities.


Minnesota had some of the country’s most generous eligibility guidelines for Medicaid prior to expansion under the ACA (up to 100 percent of poverty for adults with dependent children, and up to 75 percent of poverty for those without dependent children). And the state also became the first in the nation to establish a Basic Health Program under the ACA.

If you have Original Medicare (Parts A and B) and would like to buy a Medicare Supplement Insurance (Medigap) plan, the best time to do so is during your Medigap open enrollment period. It lasts six months and begins the month you are enrolled in Medicare Part B. You cannot be denied coverage due to health reasons during this period. You may not have a Medigap plan and a Medicare Advantage plan at the same time.

See whether you would prefer a Medicare Advantage plan. Medicare Advantage plans have to offer at least the basic benefits that Original Medicare offers, but some Medicare Advantage plans might also offer coverage for things that Original Medicare doesn’t cover. Use the Medicare Plan Finder to see if there’s a Medicare Advantage plan that meets your needs.
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.
Eagan-based Blue Cross and Blue Shield of Minnesota says it's seen a net increase in Medicare enrollment of about 4,500 people during 2019, with most activity coming from people moving into Medigap plans. The insurer says that many Cost plan enrollees found the closest fit to their old coverage is original Medicare plus a Medigap supplemental plan plus stand-alone Part D drug coverage.
There are 19 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in Minnesota. Of these, the companies that offer the largest variety of plans to choose from are Medica, Ucare, and Humana. In Minnesota,Medica has the largest selection of Medicare Advantage plans while Humana offers the most Medicare Part D plans. The following are all medicare insurance providers in Minnesota:
Most Americans become eligible for Medicare when they turn 65. But younger Americans gain Medicare eligibility after they have been receiving disability benefits for 24 months, or have ALS or end-stage renal disease. Thirteen percent of Minnesota’s Medicare beneficiaries were under age 65 as of 2017, versus 16 percent nationwide. On the high and low ends of the spectrum, 23 percent of Medicare beneficiaries in Alabama, Kentucky, and Mississippi are under 65, while just 9 percent of Hawaii’s Medicare beneficiaries are eligible due to disability.
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 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. 

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.

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