The federal government paid the full cost of covering the newly-eligible Medicaid population through 2016. Starting in 2017, the state began paying a portion of the cost, but the state’s share will never exceed 10 percent. A few weeks prior to passage, an amendment had been added to HF9 that would allow Medicaid expansion to expire if the federal government ever defaults on its promise to always pay at least 90 percent of the cost of covering the newly-eligible population. But that amendment was removed from the bill prior to passage.

But once that window closes, enrollees often find themselves locked into the plan they have – regardless of how the premium changes – because in most states, switching to another plan can be impossible or prohibitively expensive due to medical underwriting. (Under federal guidelines, there are seven limited circumstances when you can get a new Medigap plan without medical underwriting.)


In addition to Medical Assistance Medicaid, the state also provides Minnesota Care (MNCare) for residents with incomes above 138 percent of poverty, up to 200 percent of poverty. MNCare has existed in Minnesota since 1992, but it became a much more robust program in 2014. And as of January 2015, MinnesotaCare transitioned to a Basic Health Program under the ACA. BHPs are a provision of the ACA that any state can implement, but Minnesota was the only state to do so for 2015. New York has now also established a BHP, effective January 2016.

1. This table reflects the principal but not all MAGI coverage groups. All income standards are expressed as a percentage of the federal poverty level (FPL). For the eligibility groups reflected in the table, an individual’s income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income standards identified in this table to determine if they are income eligible for Medicaid or CHIP. The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to 5% FPL disregard. Other eligibility criteria also apply, for example, with respect to citizenship, immigration status and residency.

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.
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.
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.
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.
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.
If you are not eligible for retirement benefits from Social Security or the RRB, you will not be automatically enrolled into Original Medicare. However, you can still sign up for Medicare Part A and/or Part B during your IEP. You may not be able to get premium-free Medicare Part A, and the cost of your monthly Part A premium will depend on how long you worked and paid Medicare taxes. You will still have to pay a Medicare Part B premium.
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.
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).
In the fall of 2013, prior to the launch of the ACA’s exchanges, Minnesota’s total Medicaid/CHIP enrollment stood at 873,040. There were 144,481 new Medicaid enrollments through MNsure, the state-run exchange, from October 2013 through April 2014, and total enrollment in Minnesota’s Medicaid program had grown to 1,066,787 by August 2014, an increase of more than 22 percent over the enrollment total prior to October 2013. Many of these enrollees were already eligible prior to 2014, but were not aware of their eligibility.
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.
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.  
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.
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)
You become eligible to sign up for Medicare during a seven-month period called the Initial Enrollment Period (IEP). This covers the three months before you turn 65, the month you turn 65, and three months after you turn 65. During IEP, you’re eligible to enroll in Medicare Part A, Medicare Part B, Medicare Advantage (Part C) or a Part D prescription drug plan. If you want your coverage to start the month of your 65th birthday, you must enroll at least one month before your birthday month. If you don’t enroll in Medicare Part B or Part D when you first become eligible, you may have to pay a premium penalty if you enroll later.
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.
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.
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?
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.
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.
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.
If you have this concern, you may be in luck, though. When you are shopping for Minnesota Medicare supplemental insurance, look for plans that do not require you to have any type of medical exam before you make your purchase. There are many different policies out there, and there are plenty that will be able to offer you coverage without the hassle of first getting a medical exam. You will be able to save yourself time, the hassle, and money if you can find this type of policy to purchase.
“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.”
You may be worried that in order to purchase a Minnesota Medicare supplemental insurance policy that you will have to have a medical exam before you purchase one. This could be a serious issue if you have any preexisting medical issues that you feel your medical supplements will not be able to cover. You could be denied coverage or have to spend more money on your coverage than you were originally planning on spending. These are both serious concerns for any person looking for medical coverage and ones that you should worry about when you are shopping for supplements.
We have worked with two of Minnesota’s most respected health care companies to bring you two new Medicare Advantage plan options for 2019. Our new plans are set up in an accountable care model: an extra level of coordination between these insurers and our health system to ensure quality coverage, great value, and an exceptional experience. Both plans offer two coverage options to give consumers more choice. Learn more about these plans: 

We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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.
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
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.
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.
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

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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