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.
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.  
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Are you tired of paying for all of your healthcare costs? Even if you are under certain Medicare Advantage plans, you can still be on the hook for a lot of costs. Luckily, we can help you find the best Medicare Advantage plans in Minnesota for 2019 that will help you pay for these expenses. Then, you can enjoy retirement instead of worrying so much about money concerning your healthcare.

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.

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.
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.
Prior to 2014, Medical Assistance in Minnesota was available to parents with dependent children if their household income was up to 100 percent of poverty, and to adults without dependent children if their household income was up to 75 percent of poverty. Minnesota was already very progressive in providing Medicaid access for most of the state’s low-income population – in many states there was no coverage at all for childless non-disabled adults prior to 2014, and in states that haven’t expanded Medicaid under the ACA, there still isn’t.

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.
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.
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.
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.
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.

One of the Medicare Savings Programs (MSPs) is for Qualified Medicare Beneficiaries (QMB). The QMB program covers the premiums for Medicare Part A and Part B. The deductibles, copays, and coinsurance costs are covered as well. An individual can qualify for this program with an income of no more than $1,032 a month. A married couple can also qualify with a combined income of less than $1,392 a month.
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.
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.
One of the Medicare Savings Programs (MSPs) is for Qualified Medicare Beneficiaries (QMB). The QMB program covers the premiums for Medicare Part A and Part B. The deductibles, copays, and coinsurance costs are covered as well. An individual can qualify for this program with an income of no more than $1,032 a month. A married couple can also qualify with a combined income of less than $1,392 a month.
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.
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.

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. 

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.
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.
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.
Original Medicare, on the other hand, provides wider access to doctors and hospitals and gives people a choice of Part D coverage from a variety of companies. While Medicare itself only covers 80 percent of costs in many cases, people who use the government program in tandem with Medigap and Part D coverage can see lower copayments for doctor and hospital care than with MA plans.
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.
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.
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Medicare beneficiaries and their caregivers in Minnesota can receive free, confidential, and unbiased one-on-one health insurance counseling through the State Health Insurance and Assistance Program (SHIP). Senior Medicare Patrol (SMP) is another program which aims to empower seniors to identify, help prevent, and report instances of Medicare waste, fraud and/or abuse.
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.
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.
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.

“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.
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.
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.
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