If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for the coming year, you don’t need to do anything during open enrollment, assuming your current plan will continue to be available. If your plan is being discontinued and isn’t eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment. If you don’t, it means you can keep your plan without doing anything during open enrollment.

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.


Minnesota seniors (those over 65 years) can apply for MA using a paper Medicaid application form. After filling out the application, it should be taken or mailed to the tribal or county office. Seniors that need help paying for a long-term care facility, for example, a nursing home, should apply online through ApplyMN instead of using a paper application.
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.
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.
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.
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.
There’s a new premium bracket for the highest-income Part B and Part D enrollees. Under the terms of the Bipartisan Budget Act of 2018, enrollees with income of $500,000 or more ($750,000 or more for a married couple) will pay a new, higher premium for Part B and Part D coverage in 2019 and future years. For reference, in 2018, the highest income bracket starts at $160,000 ($320,000 for a married couple). The Medicare Trustees’ report projected a Part B premium of $460.70/month for Part B enrollees in the new highest bracket in 2019, and an additional $82.90/month added to the Part D premiums charged by the insurer that provides the Part D coverage.
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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 should pay special attention to the Medicare Open Enrollment Period (OEP), which is also called the Medicare Annual Election Period (AEP). Medicare recipients can enroll in, make changes to or disenroll from a Medicare Advantage plan (Medicare Part C) or a Medicare Prescription Drug plan (Medicare Part D) during this period, which runs from October 15 to December 7 every year. Plan elections made during the 2018 Medicare Open Enrollment Period go into effect January 2019.

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.
Outside of the Part D Initial Enrollment Period and the Annual Election Period, the only time you can make changes to prescription drug coverage without a qualifying Special Election Period is during the Medicare Advantage Disenrollment Period (MADP)–but only if you are dropping Medicare Advantage coverage and switching back to Original Medicare. The Medicare Advantage Disenrollment Period runs from January 1 to February 14.
When people were first shown how to qualify for Medicaid in Minnesota in January of 1996, Minnesota was one of the first six states to put the healthcare scheme into action. Minnesota has always put the needs of residents first when laying the ground rules for Medicaid benefits and the state has been controlling costs through the implementation of Pre-paid Medical Assistance Programs, better known as PMAP Medicaid benefits.
If you make a change, it will take effect on the first day of the following month. You’ll have to wait for the next period to make another change. You can’t use this Special Enrollment Period from October–December. However, all people with Medicare can make changes to their coverage from October 15–December 7, and the changes will take effect on January 1.
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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!
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.
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.
Medicare2019.com is a privately owned website and is not associated, endorsed or authorized by the Center for Medicare and Medicaid Services or any other government entity. This site contains basic information about Medicare, services related to Medicare, private medicare, Medigap and services for people with Medicare. If you would like to find more information about the Government Medicare program please visit the Official US Government Site: at www.medicare.gov
Each year, most Medicare beneficiaries should receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by Sept. 30. CMS makes information available to the public on Medicare.gov in October. The Medicare website is also a tremendous asset for individuals with questions about Medicare rules, timelines, Medicare Part D, etc.
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.

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.
The program for Qualified Individuals (QI) also pays for Part B premiums, though the application approval and benefits are on a “first come, first served” basis. This is sometimes due to limited funding. For an individual to qualify for the QI program, their income must be less than $1,386 a month. The combined income limit for a married couple is $1,872.
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.
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.
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.
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.
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.
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.
Minnesota made history for kick-starting the Basic Health Program before any other state in the nation. People who are curious about “what are the Medicaid application guidelines?” will be interested to learn that prior to expansion, the process of learning how to qualify for Medicaid in MN was much more generous than it is now. The Medicaid benefits eligibility rules for adults with dependent children used to be up to 100 percent of poverty or 75 percent for adults without dependents.
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.
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.

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.


As is the case nationwide, enrollment in private Medicare plans grew in Minnesota in 2018. As of December 2018, there were 581,822 Minnesota Medicare beneficiaries with private Medicare coverage, which amounts to nearly 58 percent of the state’s Medicare population. Nationwide, most people with private Medicare plans are enrolled in Medicare Advantage plans, but Medicare Cost plans are another type of private Medicare coverage, and as of 2018, Minnesota residents accounted for two-thirds of the national total enrollment in Medicare Cost plans.

Each year, most Medicare beneficiaries should receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by Sept. 30. CMS makes information available to the public on Medicare.gov in October. The Medicare website is also a tremendous asset for individuals with questions about Medicare rules, timelines, Medicare Part D, etc.

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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.
You have eight months to take action. Your SEP begins when your employer coverage ends or when your employment ends, whichever is first. Contact Social Security or your employer for more information. If you are age 65 and have COBRA through a previous employer, you should enroll in Medicare Part B. You will not get an SEP when COBRA ends.Be sure to enroll in Part B during the first eight months of your COBRA coverage to avoid the late enrollment penalty.
Original Medicare does not provide coverage for outpatient prescription drugs. More than half of Original Medicare beneficiaries nationwide have supplemental coverage via an employer-sponsored plan (from a current or former employer or spouse’s employer) or Medicaid, and these plans often include prescription coverage. Some Medigap plans that were sold prior to 2006 included coverage for prescription drugs, but sales of those plans ceased as of 2006, when Medicare Part D became available. Part D was created under the Medicare Modernization Act of 2003, which was signed into law by President George W. Bush.
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.

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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