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Medicare offers healthcare coverage to Minnesota residents age 65 or older, or to those Minnesota residents that suffer from certain medical disabilities. In 2016, 882,000 people are enrolled in Medicare in Minnesota, accounting for 16.2% of the population in Minnesota. In 2009 an average of about $8,941 was spent per Medicare enrollee in Minnesota, approximately 13.74% lower than the national average of $10,365. Between 2015 to 2030 the number of seniors in Minnesota is expected to rise by an estimated 54.07% according to calculations based off of the 2000 Census. Thus, the number of Medicare enrollees in the state is also projected to grow.

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.
“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.”
The annual open enrollment period for people selecting a Medicare health plan ends Friday, but that doesn’t mean the shopping season is over for more than 300,000 Minnesotans who are losing their Medicare Cost coverage next year. Beginning Saturday, people losing Cost plans will be eligible for a special enrollment period where they have until month’s end to buy replacement coverage that takes effect Jan. 1, and enrollment options that stretch into 2019. (Snowbeck, 12/6)
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.
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.
In addition, both Minnesota Medigap plans and Medicare plans usually come with a package of membership benefits. These extra benefits may help members save money on such non-Medicare expenses as memberships to fitness clubs, dental care, glasses, and even over-the-counter vitamins and medicine. These membership benefits aren’t insurance, but they may offer the same sort of discounts that people enjoy when they have to pay for in-network services with insurance.
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 believe you are eligible for medical assistance benefits, you can begin the process of applying for Medicaid at any time. There are number of simple Medicaid application methods currently available in Minnesota; individuals and families are free to choose any of the methods to apply. It may take up to a month to be approved. You can learn about coverage and costs, eligibility, and all of the application options on our site. Please feel free to review the comprehensive information we have provided.

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. 

But be aware that your benefits and premium could change from one year to the next. So even if you’re confident that you want to keep your current coverage for the following year, it’s important to make sure you understand any changes that may apply, and that you’ve double checked to make sure that your current plan is still the best available option. The available plans and what they cover changes from one year to the next, so even if the plan you have now was the best option when you shopped last year, it’s important to verify that again before you lock yourself in for another year.
Medicare Advantage (also called "Part C") and Medicare Cost plans are ways to get a single combined plan including Parts A, B, and D through a private company. With Medicare Advantage plans, you may have less flexibility, but your costs could be lower. With Medicare Cost plans, you have more flexibility, because you can still use Original Medicare to pay for out-of-network providers.
Between January 1 and March 31 each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to Original Medicare, and buy a Part D prescription drug plan to supplement your Original Medicare. Starting in 2019, you also have the option to switch to a different Medicare Advantage plan during this time. From 2011 through 2018, there wasn’t an option to switch to a different Medicare Advantage plan outside of the fall open enrollment period unless you had a circumstance that allowed you a Special Enrollment Period. But the 21st Century Cures Act (Section 17005) expanded the timeframe of the window (from one and a half months to three months) starting in 2019, and allows people to switch from one Medicare Advantage plan to another.
Medicare Part D is optional prescription drug coverage. If you have Original Medicare, you can get this coverage through a Medicare Prescription Drug Plan, offered through private Medicare-approved insurance companies. These plans offer stand-alone prescription drug coverage that work alongside Original Medicare, Part A and Part B. A Medicare Advantage Prescription Drug plan also provides the Medicare Part D benefit, covering all Medicare benefits under a single plan.
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.
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.
The legislation that introduced Medicare Advantage also created a competition clause that banned Medicare Cost plans from operating in areas where they faced substantial competition from Medicare Advantage plans, but the implementation of the competition clause was delayed for many years. In 2015, legislation (MACRA) called for the competition clause to be implemented as of 2019.
One of the reasons Medicare Cost has been so popular in Minnesota is that the state has a large population of “snowbirds” — retirees who live in Minnesota during the summer, but head south to warmer climes in the winter. With Medicare Cost plans, the enrollee still has Original Medicare — including the large nationwide network of providers who work with Medicare — in addition to the Medicare Cost coverage. Medicare Advantage plans, in contrast, tend to have localized networks that might not be suitable for a senior who lives in two different states during the year. A Medigap plan plus Original Medicare will allow a person in that situation to have access to health providers in both locations, although Medigap tends to be more expensive than Medicare Advantage. There are pros and cons to both options, and no one-size-fits-all solution.
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.
But a Star Tribune review of January enrollment data shows zero-premium plans have been much less popular in Minnesota, with only about 5 percent of state residents who enrolled in a Medicare health plan opting for the coverage. Greiner said her group's analysis of federal data came to the same conclusion; the relatively low interest in zero-premium plans showed up again in recently released figures for February, she said.
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)
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.
A Special Needs Plan is a type of Medicare Advantage plan limited to people with certain chronic conditions and  other specific characteristics. Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.
Only one switch during this time frame is allowed each year — you can change your mind multiple times during the enrollment period in the fall, but can only switch to a different Medicare Advantage plan (or back to Original Medicare) once in the first quarter of the new year. But if you sign up for a Medicare Advantage plan in the fall and then decide you don’t like it once it takes effect in January, you have until the end of March to make a change.

You’re eligible for Medicare if you’re age 65 or older, receiving disability benefits, or have certain conditions, like end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease). You must be either a United States citizen or a legal permanent resident of at least five years. In some instances, you may not have to take any action in order to enroll. This may happen if you’re turning 65 and already receive Social Security benefits or Railroad Retirement Board benefits.


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. 

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.
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.
Original Medicare does not limit out-of-pocket costs, so most enrollees maintain some form of supplemental coverage. Nationwide, more than half of Original Medicare beneficiaries get their supplemental coverage through an employer-sponsored plan or Medicaid. But for those who don’t, Medigap plans (also known as Medicare supplement plans, or MedSupp) will pay some or all of the out-of-pocket costs they would otherwise have to pay if they had only Original Medicare.
Medicare is a federal program that helps seniors in Minnesota and all over the country pay for their medical expenses. It is a program that is split into two main parts. Part A is a program that covers your hospital care and rehabilitation in case you get injured or sick. Part B will help pay for outpatient care, preventive care, and other forms of health care. If you ever get sick in Minnesota, this federal program will help you pay for it and for some of your medication. But this program will not pay for everything.
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.
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