Guide to Minnesota Medicare

Did you know there are more than one million beneficiaries enrolled in Minnesota Medicare? Your health is unique and you may need different coverage than your neighbor. With the abundance of available information, you can get easily overwhelmed. Fortunately, Medicare Plan Finder makes understanding Medicare, Medicare Advantage, Medicare Supplements, and Part D plans easy.

Click below to learn more about Minnesota Medicare:

• Minnesota Medicare Eligibility
• What Does Minnesota Medicare Cover?
• Types of MN Medicare Plans
• Minnesota Medicare Supplement Plans
• Medicare Advantage Minnesota
• Medicare in Minnesota Costs
• Can I Have Medicaid and Medicare in MN?
• Senior Resources in MN
• How to Enroll in Minnesota Medicare

Minnesota Medicare Eligibility

The most common way to qualify for Medicare is by turning 65. However, reaching your 65th birthday is not the only way to become eligible. If you have ESRD (end-stand renal disease) or ALS (Lou Gehrig’s Disease), you may qualify even if you’re under 65. Plus, if you have been receiving SSDI (Social Security Disability Insurance), you will be automatically enrolled in Medicare during your 25th-month of SSDI benefits. If you have a question regarding your eligibility, fill out this form or give us a call at 844-431-1832.

What Does Minnesota Medicare Cover?

Minnesota Medicare starts with Original Medicare (Part A and B). Part A covers services like hospital stays, nursing homes, hospice, and home health services. Part B is medical insurance and helps cover services like ambulance travel, medical equipment, mental health, partial hospitalization, lab tests, and x-rays. Once you are enrolled in parts A and B, you can start exploring other plan options like Medicare Advantage, Medicare Supplements, and Part D.

Types of MN Medicare Plans

Original Medicare (Part A and B) is regulated through the federal government. This means that your coverage is the same regardless of which state you live in. Once you are enrolled in Part A and B, you should consider enrolling in some type of prescription drug coverage. If you do not enroll in drug coverage, you may face a late-enrollment penalty down the road. You can purchase prescription drug coverage through a stand-alone Part D plan. Plus, many Medicare Advantage plans offer prescription coverage.

Minnesota Medicare Supplement Plans

Most states have eight Medigap plans organized by letter (A, B, D, G, K, L, M, N). Three states (Massachusetts, Minnesota, and Wisconsin), however, operate differently!

While you can technically get modified versions of plans K, L, M, and N in Minnesota, the state also offers two unique plans: The “Basic Plan,” and the “Extended Basic Plan.”

Regardless of your age or health problems, everyone who applies for Minnesota Medicare Supplement Plans can have these basic benefits: 

• Part A coinsurance for inpatient hospital care
• Part B coinsurance for medical costs
• First three pints of blood each year
• Part A hospice and respite cost-sharing
• Parts A and B home health cost-sharing

If you wait until you’re older to enroll, underwriting for preexisting conditions may apply, resulting in higher costs. However, if you return to work or if you drop Part B in favor of your employer’s health plan, you’ll get a 6-month Medigap enrollment period (where age and preexisting conditions do not apply).

The “Basic Plan” then offers (in addition to the basic benefits):

• Preventive care
• 100 days of Part A skilled nursing facility coinsurance
• 80% of foreign travel emergency
• 50% of outpatient mental health
• 20% of physical therapy
• State-mandated benefits:
  • Diabetic equipment
  • Routine cancer screenings
  • Reconstructive surgery
  • Immunizations

The “Extended Basic Plan” adds on:

• Part A deductible for inpatient hospital stays
• 120 days of Part A skilled nursing facility coinsurance
• Part B deductible (no longer available in 2020)
• 50% of outpatient mental health
• 20% of physical therapy
• 80% of foreign travel emergency, then 100% after you spend $1,000 per year out-of-pocket
• 80% of “usual and customary fees,” then 100% after you spend $1,000 per year out-of-pocket

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Medicare Advantage Minnesota

Medicare Advantage plans are great if you are looking for additional health benefits beyond Original Medicare. Legally, they must provide the same benefits as Original Medicare, but many plans offer additional benefits like prescription drug coverage, vision, dental, and hearing coverage, OTC pharmacy allowances, non-emergency transportation, group fitness classes like SilverSneakers, and so much more! These plans have grown in popularity every year and more than 56% of Minnesota Medicare beneficiaries are enrolled in Medicare Advantage. Our licensed agents can show you all the plans that are available in your area and help you enroll in the plan with the benefits you want at the price you need. Fill out this form or give us a call at 844-431-1832.

Medicare in Minnesota Costs

If you were employed and paid Medicare taxes for at least 39 quarters, you will not have a premium for Part A. If you only paid Medicare taxes for 30-39 quarters, you’ll pay $240/month in 2019. If you did not pay Medicare taxes for at least 30 quarters, you’ll pay $437/month in 2019.

The standard Part B premium is $135.50/month in 2019, but this can change based on your income. Since Medicare Advantage, Medicare Supplements, and Part D plans are sold through private insurance companies, plan costs will vary based on carrier, location, and benefits.

Can I Have Medicaid and Medicare in MN?

Medicaid and Medicare are often easily confused because they both provide health benefits and are regulated by the federal government. However, they were designed for two entirely different groups of people. Medicare was intended for older adults over 65 and people with specific disabilities whereas Medicaid was intended for low-income individuals and families regardless of age and health conditions.

You can qualify for both programs. In fact, more than 17% of Minnesota Medicare beneficiaries are eligible for both Medicare and Medicaid. If you qualify for both programs, you are eligible for a Dual Eligible Special Needs Plan (DSNP). DSNPs are a special type of Medicare Advantage plan that provides extra benefits at lower costs. If you qualify for a DSNP, you may qualify for a Special Enrollment Period (SEP) too. SEPs allow you to enroll year-around without the need to wait for the Annual Enrollment Period. This means you can get extra benefits at lower costs as soon as possible. Plus, if you qualify for a DSNP, you may be eligible for other programs like Medicare’s prescription drug program Extra Help, or other Medicare Savings Programs. To find out if you are eligible, contact one of our licensed agents by filling out this form or calling us at 844-431-1832.

Senior Resources in MN

The Department of Aging in Minnesota helps provide resources and programs to seniors, family members, and caregivers. These programs include:

Adult Day Services: The Department of Aging in MN offers several adult day services that focus on providing emotional and physical health benefits in and outside of the home.

Caregiver Support: The Caregiver Support Program recognizes caregivers and helps them develop new ways of support.

Rent Assistance: The Rent Assistance Program help provide financial assistance for a senior’s rent or mortgage in emergency situations.

Transportation: Getting around gets harder with age, and transportation is a large factor. The Department of Aging offers several transportation programs to help seniors get around.

Ombudsman: The  Ombudsman Program helps resolve issues from those who are living in long-term settings like nursing homes or assisted living facilities. This program helps educate residents on their rights and advocate for those who may not be able to.

Protective Services: The Minnesota Elder Abuse Hotline helps protect seniors against physical, emotional, and financial abuse. If you think you or a loved one is being abused, called the statewide abuse hotline 1-844-880-1574.

How to Enroll in Minnesota Medicare

You can apply for Minnesota Medicare through Social Security. There are three main places where you can apply. You can go to www.SocialSecurity.gov, call 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday from 7 AM to 7 PM, or apply in person at your local Social Security office.

If you are interested in enrolling in a Medicare Advantage, Medicare Supplement, or Part D plan, we can help! Our agents can talk to you about plans from all the major carriers, so there is no bias. Fill out this form or give us a call at 844-431-1832.