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.
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.
Countable assets include cash, stocks, bonds, investments, credit union, savings, and checking accounts, and real estate in which one does not reside. However, for Medicaid eligibility, there are many assets that are considered exempt (non-countable). Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary home, given the Medicaid applicant or their spouse lives in the home and the equity value is under $585,000 (in 2019). For married couples, as of 2019, the community spouse (the non-applicant spouse) can retain up to a maximum of $126,420 of the couple’s joint assets, as the chart indicates above. This, in Medicaid terminology, is referred to as the Community Spouse Resource Allowance (CSRA).
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.
In order to help seniors look for the best Minnesota Medicare supplemental insurance and save the most money, you can search online. Instead of wasting gas, money, and time going from provider to provider, you can look at many different supplemental insurance policies side by side online. You can compare these quotes for supplemental insurance until you find the one that is right for you and your current budget. You will be able to use the money that you save on things that you would rather use it on in Minnesota. 

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.
Among those losing Cost plans, about 142,000 people are being automatically enrolled in new MA plans from their current insurer, although they are free to make a different choice. Some of those being automatically enrolled in an MA plan are finding their doctor is not in the new health plan’s network, Greiner said, and there are cases where the new MA plan’s drug coverage brings much higher copayment requirements.

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 you are a Minnesota resident enrolled in Original Medicare (Part A and Part B), you have options to also enroll in a Medicare Supplement Insurance plan in Minnesota (also called Medigap or MedSupp) to cover health costs not covered under Original Medicare. Costs not covered under Original Medicare might include deductibles, copayments, coinsurance, and other out-of-pocket costs. Most states, including Minnesota, offer Medigap policies with letters corresponding with different Medicare Supplement Insurance plans with certain standardized benefits.

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.
MNsure NavigatorsMNsure has partnered with a number of trusted organizations across Minnesota. The employees of these organizations, known as navigators, are trained to provide face-to-face help with Medicaid applications. MNsure navigators can help residents apply for MinnesotaCare, Medical Assistance or a qualified health plan (with or without cost-sharing and premium tax reductions.). You can call MNsure or use the MNsure navigator online finder to find a navigator in your area.

Of the more than 300,000 people losing their Cost plans in Minnesota, it’s likely that roughly 100,000 people will be automatically enrolled into a comparable plan with their current insurer, Corson said, unless they make another selection. Details haven’t been finalized, he said. That likely will leave another 200,000 people, he said, who will need to be proactive to obtain new replacement Medicare coverage.
Just because a person is able to answer the question “what are the requirements for Medicaid in MN?” it does not mean that he or she will meet the Medicaid eligibility requirements in Minnesota. Visiting Medicaid offices around Minnesota and talking to a member of staff will clear up any misunderstanding about Medicaid qualifications and Medicaid requirements.

Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. However, this page is focused on Medicaid eligibility for Minnesota elderly residents, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, in an adult foster care home, or in an assisted living facility.
Not surprisingly, the popularity of Medicare Advantage plans varies significantly from one state to another, with only one percent of the Medicare population enrolled in Advantage plans in Alaska (there are no individual Medicare Advantage plans available at all in Alaska; people with Advantage coverage there have employer-sponsored Medicare Advantage plans), versus 56 percent in Minnesota.
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.

If you haven't started receiving Social Security or Railroad Retirement Board benefits four months before you turn 65, you'll need to manually sign up for Medicare. The best time to do so is during your 7-month Medicare Initial Enrollment Period (mentioned above). You can also sign up for a Prescription Drug Plan or Medicare Advantage plan during this time.
Blue Cross plans on sending letters in early July notifying about 200,000 subscribers who stand to lose their Medicare Cost plans. Minnetonka-based Medica, which started sending letters last week, expects that about 66,000 members will need to select a new plan. Officials with Bloomington-based HealthPartners say the insurer sent letters to about 34,000 enrollees this month explaining the change.
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.

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.


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.
Products and services are provided exclusively by our partners, but not all offer the same plans or options. Possible options that may be offered include, but are not limited to, ACA-Qualified Plans, Medicare Plans, Short Term Plans, Christian/Health Sharing Plans, and Fixed Indemnity Plans. Descriptions are for informational purposes only and subject to change. We encourage you to shop around and explore all of your options. We are not affiliated with or endorsed by any government entity or agency.
If you are under 65 and receiving certain disability benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Original Medicare, Part A and Part B, after 24 months of disability benefits. The exception to this is if you have end-stage renal disease (ESRD). If you have ESRD and had a kidney transplant or need regular kidney dialysis, you can apply for Medicare. If you have amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease), you will automatically be enrolled in Original Medicare in the same month that your disability benefits start.

Minnesota is one of just three states in the country (Massachusetts and Wisconsin are the others) that offers its own version of Medicare Supplement insurance. Minnesota has two plans available: the Minnesota Basic Plan and the Minnesota Extended Basic Plan. In  most other states, up to 10 types of standardized plans are available. Medicare Supplement plans are also known as Medigap policies and may help pay Original Medicare out-of-pocket costs, such as copayments and deductibles.
2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care.  For persons in this situation, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. Read more or connect with a Medicaid planner.
Minnesota agents can help you understand other factors that can affect Medicare eligibility, including whether or not you have a permanent disability or a chronic illness. For those who don’t are not eligible for Medicare but are low-income, Minnesota licensed agents can help you choose a plan from the health insurance marketplace that suits your needs and budget.
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.
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.

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.
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.
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 you have health coverage through current employment (either through your work or your spouse’s employer), you may decide to delay Medicare Part B enrollment. You should speak with your employer’s health benefits administrator so that you understand how your current coverage works with Medicare and what the consequences would be if you drop Medicare Part B.


We have worked with two of Minnesota’s most respected health care companies to bring you two new Medicare Advantage plan options for 2019. Our new plans are set up in an accountable care model: an extra level of coordination between these insurers and our health system to ensure quality coverage, great value, and an exceptional experience. Both plans offer two coverage options to give consumers more choice. Learn more about these plans:
Medicaid coverage may be different from one state to another. Though they must comply with federal regulations, every state runs its own program; the federal government does not control it. Some information about Medicaid is true in every state. For instance, in Minnesota Medicaid covers some services that are not covered other states. Other states may cover services Minnesota does not. In addition, the costs may be different; not every beneficiary of Health Link in Minnesota will pay the same monthly premium. Certain low-income Medicaid insurance beneficiaries could pay no premiums at all if they qualify for no-cost coverage.
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.

Products and services are provided exclusively by our partners, but not all offer the same plans or options. Possible options that may be offered include, but are not limited to, ACA-Qualified Plans, Medicare Plans, Short Term Plans, Christian/Health Sharing Plans, and Fixed Indemnity Plans. Descriptions are for informational purposes only and subject to change. We encourage you to shop around and explore all of your options. We are not affiliated with or endorsed by any government entity or agency.
If you’re 65 or older, still working, and covered under a group health plan from your current employer (or your spouse is, and you are both covered under their insurance) — you may qualify for a Special Enrollment Period (SEP). If you do, you can sign up for Medicare Part B during this enrollment period, without having to wait for the GEP or pay a penalty for late enrollment.
The state of Michigan launched a new subsidy program in 2017 that will reduce the cost of Medigap premiums for its residents. It offers considerable savings — up to $125 per month — for certain Medigap beneficiaries who are under 65 and have a disability. For more information, including the online application, visit https://michiganmedigapsubsidy.com.
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.
But as of 2013, a similar analysis determined that four states (Arizona, Florida, Georgia, and Idaho) required issue-age rating (carriers would also have the option to use community rating instead), and the remaining 38 states allowed premiums to be set on an attained-age basis, which means premiums rise as an enrollee gets older (carriers in those states can use issue-age or community rating instead, but most do not).
You become eligible to sign up for Medicare during a seven-month period called the Initial Enrollment Period (IEP). This covers the three months before you turn 65, the month you turn 65, and three months after you turn 65. During IEP, you’re eligible to enroll in Medicare Part A, Medicare Part B, Medicare Advantage (Part C) or a Part D prescription drug plan. If you want your coverage to start the month of your 65th birthday, you must enroll at least one month before your birthday month. If you don’t enroll in Medicare Part B or Part D when you first become eligible, you may have to pay a premium penalty if you enroll later.
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.
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.   
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 65 or older, still working, and covered under a group health plan from your current employer (or your spouse is, and you are both covered under their insurance) — you may qualify for a Special Enrollment Period (SEP). If you do, you can sign up for Medicare Part B during this enrollment period, without having to wait for the GEP or pay a penalty for late enrollment.

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.


“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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