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.
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.
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.
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. 

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.
Unlike Medical Assistance, MNCare has a small monthly premium that ranges as high as $80, but calculated on a sliding scale and not applicable to some enrollees. The preferred enrollment method is through MNsure. Like Medical Assistance, enrollment in MinnesotaCare is open year-round. By September 2016, average monthly enrollment in MinnesotaCare was a little over 100,000. As of 2015, a quarter of the insureds were new enrollees, while the rest were already on MinnesotaCare in 2014.
You may qualify for a special enrollment period if you delayed Part B because you or your spouse had medical coverage through an employer or union, or if you cancelled Part B coverage because you went back to work with group medical coverage. The special enrollment period lasts eight months (it begins when your employer coverage ends, or when your employment ends – whichever is first). Request a form from your employer to begin your special enrollment period, and then send the form with your Part B Enrollment form to Social Security. If you continue your employer coverage through COBRA, you should enroll in Medicare Part B during the first three months of your COBRA coverage to avoid the late enrollment penalty.
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.
The table below presents the most recent, point-in-time count of total Medicaid and CHIP enrollment in   for the last day of the indicated month, and is not solely a count of those newly enrolled during the reporting period. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces, and (b) national counts and change statistics for the same period.
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.
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.
Medigap coverage can be priced in one of three ways: community rating, issue-age rating, or attained-age rating. As of 2018, eight states (Arkansas, Connecticut, Massachusetts, Maine, Minnesota, New York, Vermont, and Washington) require carriers to use community rating. The remaining states were simply listed as not requiring community rating, thus leaving it up to the insurer to allow for any rating type, including issue-age or attained-age.
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.
MA plans often include dental, vision and health-club benefits that aren’t part of many supplements. Yet people who buy a supplement have the option of buying “stand-alone” Part D prescription drug coverage from any one of several insurers — a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.

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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.
The Minnesota Medicaid program is for people with low income and is known as Medical Assistance (MA). Low income residents of Minnesota who meet Medicaid eligibility requirements get health care through various health plan providers serving different counties. Minnesota residents that do not get health care through a health plan receive care on a fee-to-service basis. With this option, the health plan providers bill the state directly for the services they offer. Medical Assistance (MA) is Minnesota’s largest Medicaid health care program. The program serves pregnant women, children, adults that do not have children, families, the elderly, the blind and residents with disabilities. Are curious about where to apply for Medicaid? Or are you interested in reviewing the Medicaid application form before attempting to apply? 

It’s important to note that not every Medicare Prescription Drug Plan covers the same list of medications. Each plan lists covered medications in formulary. Formularies may vary among plans. So, when you’re shopping for a plan in Minnesota, you can make a list of your medications and compare it to the plan’s formulary to make sure the plan will suit your needs. The formulary may change at any time. You will receive notice from your plan when necessary.
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).
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)
More than 44 million individuals in the U.S. are enrolled in Medicare, and Medicare eligibility in Minnesota is high, with more than 746,500 people receiving Medicare benefits. That means approximately 14 percent of the state’s total population is eligible for Medicare, with over 237,000 individuals enrolled in a Medicare Advantage plan and 753,000 people receiving Medicare Part D to help cover the cost of their prescriptions.
The Minnesota Medicaid program is for people with low income and is known as Medical Assistance (MA). Low income residents of Minnesota who meet Medicaid eligibility requirements get health care through various health plan providers serving different counties. Minnesota residents that do not get health care through a health plan receive care on a fee-to-service basis. With this option, the health plan providers bill the state directly for the services they offer. Medical Assistance (MA) is Minnesota’s largest Medicaid health care program. The program serves pregnant women, children, adults that do not have children, families, the elderly, the blind and residents with disabilities. Are curious about where to apply for Medicaid? Or are you interested in reviewing the Medicaid application form before attempting to apply?
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.

What are the income requirements for Medicaid? In the event that an adult’s income exceeds the 135 percent Federal Poverty Level, he or she may sign up for a different kind of care in Minnesota, called MNCare. State tax from Minnesota hospitals and health care providers fund this program, which includes basic health services for people who do not exceed the income requirement for Medicaid in Minnesota.
For some services, you pay a deductible, copayment, or co-insurance before Medicare begins to help pay for that service. For Medicare Part B or Part D, or for Medicare Advantage or Medicare Cost plans, you may have to pay a monthly premium, unless you qualify to get help paying for your Medicare premiums, copayments, and deductibles through MA, a Medicare Savings Program (MSP), or the Low Income Subsidy (LIS).
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.
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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.
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.
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.
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.
“It’s important for consumers to review their Medicare coverage  and make sure the plan is both affordable and provides access to doctors, clinics, hospitals and pharmacies they want and need,” said Kari Benson, executive director of the Minnesota Board on Aging, which operates the Senior LinkAge Line. “Line specialists can help by providing comprehensive, unbiased Medicare counseling.” 

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.
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.

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.

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.
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.
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.
MA plans often include dental, vision and health-club benefits that aren’t part of many supplements. Yet people who buy a supplement have the option of buying “stand-alone” Part D prescription drug coverage from any one of several insurers — a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.
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.
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.
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.
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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.
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.
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.
Medigap is the only form of private coverage for Medicare beneficiaries that has no federally mandated annual open enrollment period. Medigap coverage is guaranteed issue for six months, starting when you’re at least 65 and enrolled in Medicare Part B. During that time, enrollees can select any Medigap plan available in their area, with no medical underwriting.
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. 

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.
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