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.
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.
If you don’t want Medicare Advantage, think about a Medigap policy (Medicare Supplement Insurance). If you get Original Medicare, you can pay an extra monthly premium to get a private Medigap policy that covers some of the expenses that Medicare Parts A and B won’t cover, such as co-insurance, copayments, and deductibles. Medigap policies do not cover prescription drugs (you need Part D for that). Learn more about Medigap policies or find one in your area.
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.
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.
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!
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.
Residents may still qualify to receive MA benefits even if they already have other private insurance. When applying for Medicaid, they simply must state in their application that they have other insurance or could get insurance through an employer or military service. Often, MA can pay the cost of the other insurance, allowing the candidate to keep the same coverage.
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.
Senior LinkAge Line, at (800) 333-2433, is a free statewide service of the Minnesota Board on Aging in partnership with Minnesota’s Area Agencies on Aging. Senior LinkAge Line provides help to older Minnesotans, their families and friends, helping them connect to local services, find answers and get the help they need. The Senior LinkAge Line does not sell or market any Medicare or insurance product.
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.
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.
Senior LinkAge Line, at 1-800-333-2433, is a free statewide service of the Minnesota Board on Aging in partnership with Minnesota’s Area Agencies on Aging. Senior LinkAge Line provides help to older Minnesotans, their families and friends, helping them connect to local services, find answers and get the help they need. The Senior LinkAge Line does not sell or market any Medicare or insurance product.
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
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.
MA plans feature a network of doctors and hospitals that enrollees must use to get the maximum payment, whereas supplements tend to provide access to a broader set of health care providers, said Shawnee Christenson, an insurance agent with Crosstown Insurance in New Hope. While that might sound good to beneficiaries, supplements can come with significantly higher premiums, Christenson said.
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.
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.
People in a Medicare health or prescription drug plan should always review the materials their plans send them, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). If their plans are changing, they should make sure their plans will still meet their needs for the following year. If they’re satisfied that their current plans will meet their needs for next year and it’s still being offered, they don’t need to do anything.
Minnesota’s Medicaid program has utilized estate recovery (required under state and federal law) since 1967 as a means of recouping Medicaid costs after an enrollee dies. The estate recovery program applies to people who were 55 or older at the time they incurred Medicaid claims, and the program allowed the state to place leins against the enrollees’ estates, so that some or all of the money would be paid back to the state.Prior to the ACA, it was
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.
Numerous improvements were made to MNCare effective January 1, 2014. The program no longer has a $1,000 copay for hospitalization, or a $10,000 cap on inpatient benefits. The asset test has been eliminated just as it was for Medicaid, and premiums have been significantly reduced. It used to be available only to applicants who had been uninsured for at least four months, but that provision was eliminated in 2014.
Now that you have an idea of the type of Medicare plan options for Minnesotans, would you like some assistance looking for a plan that fits? I’d be happy to help, and you can click on the “View profile” link below to view my profile if you’d like. How about setting up a phone call with me, or having me send you some information by email? You can click on the links below to do that. Some folks prefer to research plans on their own; you can do that easily by clicking on the Compare Plans option on the right.
It’s important to note that Minnesota has a Medicaid Look-Back Period. This is a period of 60 months (5 years) that dates back from one’s Medicaid application date. During this time frame, Medicaid checks to ensure no assets were sold or given away under fair market value. If one is found to be in violation of the look-back period, a period of Medicaid ineligibility will ensue.
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.
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.
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
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.
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:
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.