“What is Medicaid eligibility?” This question may be on your mind if you are new to the program. MN Medicaid eligibility is generally determined by the income level of the individual or household applying for Medical Assistance (MA). Individuals and families that fall within the allowable income range are eligible to receive benefits. In order to qualify for the program all applicants must meet all income and any other requirements.
As of 2018, there were 370,000 Medicare Cost plan enrollees in Minnesota, but most of them had to switch to new plans (either Medicare Advantage or Original Medicare) for 2019. This is described in more detail below, but Minnesota’s enrollment in private Medicare plans could end up fluctuating significantly for 2019, depending on how many of those enrollees opted to have coverage under Original Medicare versus Medicare Advantage.
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.
Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. However, this page is focused on Medicaid eligibility for Minnesota elderly residents, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, in an adult foster care home, or in an assisted living facility.

And although 16 percent of Medicare beneficiaries are under 65 and eligible for Medicare due to a disability (including ALS and kidney failure), federal rules do not guarantee access to Medigap plans for enrollees who are under age 65. The majority of the states have implemented regulations to ensure access to at least some Medigap plans for people in this situation, although it varies considerably from one state to another.


Among those losing Cost plans, about 142,000 people are being automatically enrolled in new MA plans from their current insurer, although they are free to make a different choice. Some of those being automatically enrolled in an MA plan are finding their doctor is not in the new health plan’s network, Greiner said, and there are cases where the new MA plan’s drug coverage brings much higher copayment requirements.

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.


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.
A couple of major insurers have already announced new plans to replace Minnesota Cost Plans in certain counties. Typically, these new plans offer broader network coverage within an HMO. One major carrier expects about 200,000 of their Minnesota customers to lose access to a Cost Plan. On the other hand, this change may open opportunities for other companies to expand their own market shares with Minnesota Medicare Advantage plans that can offer greater flexibility, such as PPOs with nationwide networks.
The Minnesota Medicaid program is for people with low income and is known as Medical Assistance (MA). Low income residents of Minnesota that qualify for Medicaid 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… Read More
If you’re automatically enrolled in Medicare Part B, but do not wish to keep it you have a few options to drop the coverage. If your Medicare coverage hasn’t started yet and you were sent a red, white, and blue Medicare card, you can follow the instructions that come with your card and send the card back. If you keep the Medicare card, you keep Part B and will need to pay Part B premiums. If you signed up for Medicare through Social Security, then you will need to contact them to drop Part B coverage. If your Medicare coverage has started and you want to drop Part B, contact Social Security for instructions on how to submit a signed request. Your coverage will end the first day of the month after Social Security gets your request.
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.
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.  
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.
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.

Medigap plans are standardized, which means that a Plan F in Vermont provides the same benefits as a Plan F in Florida. But in 2010, average premiums for plan F (the most popular choice among Medigap enrollees) ranged from $139/month in Hawaii to $226/month in New York. A Business Insider analysis of average 2016 Medigap Plan F premiums for 65-year-old enrollees found a variation from $109/month in Hawaii to $162/month in Massachusetts.
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a “guaranteed issue” basis. Later, insurance companies can ask questions about a senior’s health status and deny coverage depending on the answers, said Greiner of the Minnesota Board on Aging.
Medicare Supplement insurance plans (or Medigap) are voluntary, additional coverage that helps fills the gaps in coverage for Original Medicare. The best time to enroll in a Medicare Supplement insurance plan is during your individual Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month you turn 65 and have Medicare Part B. If you decide to delay your enrollment in Medicare Part B for certain reasons such as having health coverage based on current employment, your Medigap Open Enrollment Period will not begin until you sign up for Part B.

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.

With changes brought about to the healthcare system from the passage of the Affordable Care Act, more people are wondering about Medicare Eligibility. Minnesota HealthMarkets agents can help explain Medicare eligibility in Minnesota, and help you understand whether or not you may qualify. HealthMarkets Insurance Agency can help you determine whether or not you are eligible for Medicare, as well as answer any questions you may have concerning the healthcare marketplace. Our agents can also help you pick out the perfect plan that meets your individual health and financial needs. We can also assist you in enrolling in a plan once you have one selected if you are Medicare eligible.

For people who are under 65 and eligible for Medicare due to a disability, Medigap availability depends entirely on state regulations, as there is no federal regulation requiring a guaranteed issue Medigap enrollment period for under-65 enrollees. The majority of the states have established regulations regarding access to Medigap coverage for this population, although they vary considerably in scope (click on a state on the map above to see how access to Medigap is handled in the state).
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.
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.
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.

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.


How much does Medicaid cost in Minnesota? Full Medicaid coverage is granted to certain qualified patients, while others may be required to pay fees in the forms of deductibles or co-pays for certain Medicaid services. And, while what is covered by Medicaid means little-to-no-cost for beneficiaries, there are some medical services that are considered what is not covered by Medicaid in MN. How much is Medicaid when a health service is not handled by the government? Medicaid cost estimates vary depending on the patient and types of Medicaid insurance… Read More
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.
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.

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. 

Among those losing Cost plans, about 142,000 people are being automatically enrolled in new MA plans from their current insurer, although they are free to make a different choice. Some of those being automatically enrolled in an MA plan are finding their doctor is not in the new health plan’s network, Greiner said, and there are cases where the new MA plan’s drug coverage brings much higher copayment requirements.
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.

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.
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.
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.

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.
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.

See whether you would prefer a Medicare Advantage plan. Medicare Advantage plans have to offer at least the basic benefits that Original Medicare offers, but some Medicare Advantage plans might also offer coverage for things that Original Medicare doesn’t cover. Use the Medicare Plan Finder to see if there’s a Medicare Advantage plan that meets your needs.
In order to find the best supplemental Medicare insurance quote, you will want to take your time. There will be a lot of information presented when you search for the different quotes for Minnesota Medicare supplemental insurance. You need to make sure you look through all of the information that is provided so you can be sure to find the best policy for you. Make sure you get enough Minnesota Medicare supplemental insurance so you will be able to afford to pay for those medical expenses and procedures. You will also want to make sure you can afford your monthly payments for your Minnesota Medicare supplemental insurance.
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.

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).
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a “guaranteed issue” basis. Later, insurance companies can ask questions about a senior’s health status and deny coverage depending on the answers, said Greiner of the Minnesota Board on Aging.
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.

See whether you would prefer a Medicare Advantage plan. Medicare Advantage plans have to offer at least the basic benefits that Original Medicare offers, but some Medicare Advantage plans might also offer coverage for things that Original Medicare doesn’t cover. Use the Medicare Plan Finder to see if there’s a Medicare Advantage plan that meets your needs.
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.
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