Read through this Minnesota Medicare guide to learn everything you need to know about enrolling in Medicare, choosing additional Medicare insurance, and getting financial assistance.
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There are over one million Minnesota Medicare beneficiaries, making up 19% of the state’s total population. Most Minnesota residents age into Medicare when they turn 65, but about 11% are on Medicare due to disability. 13% of Medicare enrollees also receive Medicaid benefits to help them pay for some or all of their healthcare costs.
Medicare beneficiaries have options and can either stay on Original Medicare or switch to a Medicare Advantage plan. In Minnesota, 48% choose to remain on Original Medicare and 52% enroll in a Medicare Advantage plan. We’ll explain more about the pros and cons of Medicare Advantage later on.
All US citizens have the same Medicare eligibility requirements. If you’re 65 or older, you’re eligible. You also may be eligible if you have certain disabilities, including ALS and End-Stage Kidney Disease.
To start Medicare, you’ll first enroll in Original Medicare, which is made up of Part A and Part B. If you’re already receiving Social Security benefits, you’ll be enrolled automatically. Otherwise, you’ll need to notify Social Security that you’d like to enroll during your Initial Enrollment Period (IEP). Your IEP is a seven-month window that starts three months before the month you turn 65 and ends three months after. In some cases, people choose to delay Part B enrollment because they’re still working. If you choose to do this, just be sure you’ll be eligible for a Part B Special Enrollment Period, or you may incur a late enrollment penalty!
Like we said before, Medicare beneficiaries have options. The main decision you need to make is: Original Medicare or Medicare Advantage? If you choose to stay on Original Medicare, you also have the option to enroll in a Medicare Supplement (also called Medigap) plan and/or a Part D (prescription drug) plan. We’ll explain more about how these options differ in the following sections.
The right combination of Medicare insurance isn’t the same for everyone! That’s why we specialize in helping people understand their Medicare options and pick the best coverage for their unique needs. Schedule a free consultation with a licensed Minnesota Medicare Advisor or call us at (888) 604-0055 to get personalized advice!
Choosing the right coverage is crucial to ensure you get the best value from Medicare, but the true value comes from using your coverage. Make sure to schedule covered, preventive appointments, like your annual wellness visit. You should also share your new drug coverage information with your pharmacy to ensure you get the best price when you fill your next prescription.
We also recommend that you review your coverage each year during the Medicare Open Enrollment Period, which lasts from October 15 - December 7. Medicare Advantage and Part D plans can change each year—and so can your healthcare needs! In many cases, we find Medicare beneficiaries are still on the best plan for their needs, but in other cases, we’re able to help people save thousands by changing their Medicare coverage.
There are 78 Medicare Advantage plans in Minnesota, but the specific plans available to you depends on the county you live in. For example, Hennepin County has 47 Medicare Advantage plans from 8 different insurance carriers. Saint Louis County has 41 plans from 7 insurance carriers.
Medicare Advantage plans are an alternative to Original Medicare, and by law they must cover at least the same amount. In most cases, these plans provide more coverage and benefits. Most plans provide prescription drug coverage in addition to other benefits, like:
Medicare Advantage plans are popular because they offer more coverage and benefits, generally for low or no additional premium (Medicare Advantage enrollees still pay their Original Medicare premiums). But Medicare Advantage plans have their downsides, including:
Prior authorization requirements
Higher out-of-pocket costs (compared to Original Medicare + Medicare Supplement)
Reach out to our licensed Minnesota Medicare Advisors to discuss specific Medicare Advantage plans that meet your healthcare needs.
Alone, Original Medicare doesn’t cover about 20% of the costs for covered services. This is why many Medicare beneficiaries choose to add a Medicare Supplement (also called Medigap) plan. Minnesota residents have two main Medigap plan types available to them: Basic and Extended Basic. Including all the variations of these plans, there are eight different options.
These plans provide different coverage for the following:
Part A inpatient hospital deductible
Part A skilled nursing facility coinsurance
Part B deductible
Foreign travel emergency care
Outpatient mental health
Usual and customary fees
Medicare-covered preventive care
Coverage while in a foreign country
State-mandated benefits (diabetic equipment and supplies, routine cancer screening, reconstructive surgery, and immunizations)
Compared to Medicare Advantage plans, Medigap has some big benefits that improve your access to care:
You can see any doctor who accepts Medicare (90% of doctors nationwide)
You won’t need to get prior authorization for covered services
Your out-of-pocket costs are much lower
When you enroll in a Medigap plan matters! The Medigap Open Enrollment Period lasts for the first six months that you have Part B coverage. During this time you are guaranteed acceptance into any Medigap plan from any insurance company. Outside of this time and a handful of other guaranteed issue periods, insurance companies may ask you questions about your health history and may charge you more or deny your application.
Most Medicare Advantage plans provide prescription coverage. If you’re on Original Medicare, you should get a standalone Part D (prescription drug) plan. There are 24 stand-alone drug plans in Minnesota. Like with Medicare Advantage, specific plan pricing and availability depends on which county you live in.
Even if you don't have any prescriptions when you first enroll in Medicare, we recommend enrolling in a low-cost Part D plan to avoid paying a Medicare penalty later on!
If you have questions about Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Minnesota Medicare Advisors or give us a call at (888) 604-0055.
There are three government programs that can help Minnesota Medicare beneficiaries with low incomes and resources pay for medical expenses.
Medicaid is a joint federal and state program, and each program is run by the state. Minnesota Medicaid is handled by the Minnesota Department of Human Services.
Minnesota expects its 65+ population to grow, much like the rest of the US and has multiple programs to help its residents, whether they want to age in place or join a community for seniors.
Minnesota Medicaid also has Medicare Savings Programs to help Medicare beneficiaries with low incomes and resources. These programs help pay for Medicare premiums, deductibles, and coinsurance. Eligibility requirements and benefits vary by program.
The Qualified Medicare Beneficiaries (QMB) Program helps pay for Part A and B premiums, deductibles, coinsurance, and copays.
The Service Limited Medicare Beneficiaries (SLMB) Program helps pay for Part B premiums.
The Qualified Individuals (QI-1) Program helps pay Medicare Part B premiums.
The Qualified Working Disabled Individual (QWD) Program helps pay for the Part A premium.
To apply for one of these programs, fill out this form and turn it into your county or tribal office. If you need assistance determining if you’re eligible, applying, or accessing your benefits, reach out to our Minnesota Medicare advisors at (888) 604-0055.
Extra Help is a federal program that helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance. It’s also commonly called the Part D Low-Income Subsidy (LIS).
You automatically qualify for Extra Help if you:
Receive full Medicaid coverage from Minnesota
Minnesota pays your Part B premium
Are eligible for Supplemental Security Income (SSI)
If you don’t automatically qualify for Extra Help, you can learn more about the program here or talk to one of our licensed Minnesota Medicare Advisors to get free support with your application.
Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:
You are 65 and older, blind, or have a disability
You have limited income and limited resources