Medicare in Minnesota

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Overview of Medicare in Minnesota

In 2015, more than 905,770 residents of Minnesota received Medicare coverage, according to the Centers for Medicare & Medicaid Services (CMS). As a Minnesota resident and Medicare beneficiary, you may have several choices for your Medicare coverage, as described below.

Original Medicare is the government health insurance program for eligible American citizens, and permanent legal residents of at least five continuous years, aged 65 and older as well as younger beneficiaries who qualify by disability. In Minnesota, as in all states, Original Medicare includes Part A and Part B.

  • Part A covers inpatient hospital, skilled nursing facility, and hospice care, as well as some home health visits in limited situations.
  • Part B helps pay for physician, outpatient, and some home health and preventive medical services.

You typically pay a deductible, copayment, and/or coinsurance for covered Medicare Part A and Part B services. Most people pay a Medicare Part B premium

Original Medicare does not pay for some services that you may need. For instance, Original Medicare doesn’t cover:

  • Prescription drugs in most situations
  • Custodial long-term services and support, either at home or in a nursing home or assisted living facility.
  • Routine dental care and dentures or routine vision care.

Medigap (Medicare Supplement) plans are also offered by private insurance companies and can help you pay your out-of-pocket costs for services covered under Original Medicare.

A Medicare Part D Prescription Drug Plan (PDP) can help pay your prescription drug costs. Designed to work alongside Original Medicare coverage, Medicare Prescription Drug Plans are available from private insurance companies approved by Medicare and doing business in Minnesota. You can also enroll in a Medicare Prescription Drug Plan if you enroll in a Medicare Advantage plan that does not include Part D prescription drug coverage in its benefits.

As an alternative to obtaining Original Medicare coverage directly from the government, you may want to consider Medicare Advantage (sometimes referred to as Medicare Part C) in Minnesota. Medicare Advantage plans are offered by private insurance companies that contract with CMS to provide all Original Medicare benefits except hospice care, which is paid by Medicare Part A. Many Medicare Advantage plans also include extra benefits such as routine dental and vision care.

Some plans also include prescription drug coverage; these are called Medicare Advantage Prescription Drug plans, and they deliver all your Medicare medical and prescription drug benefits through a single plan. Medicare Advantage plans are required to limit beneficiaries’ out-of-pocket spending for services covered under Medicare Part A and Part B.

To sign up for a Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B, and live in the Medicare Advantage plan’s service area. You need to continue paying your Medicare Part B premium to Medicare, and pay any Medicare Advantage premium directly to your plan.

To review the various plans available to you, visit the Medicare Plan Finder on this page, and enter your home zip code.

Medicare resources in Minnesota

The Minnesota Board on Aging (MBA) may be helpful for seniors seeking a wide range of information. The office provides education in a broad range of areas, including health-care coverage and Medicare plans. The office was first established in 1956. Since that time, seniors have been able to turn to the Minnesota Board of Aging for a variety of programs, including:

  • The Office of Ombudsman for Long-Term Care – this office works with Minnesotans and government agencies to help you find long-term care appropriate to your needs.
  • Health insurance counseling – Also called the Minnesota State Health Insurance Assistance Program (SHIP), this service offers information, counseling, and other types of assistance to beneficiaries in the state. The program is primarily staffed through volunteers that have received certification from the Minnesota Board on Aging.
  • Medicare Rx Coverage – This branch of the Minnesota Board on Aging provides information about prescription drug coverage, also known as a Medicare Part D Prescription Drug Plan. This program offers assistance and counseling for those interested in enrolling in coverage for their medications.

The Minnesota Department of Health offers information about Medicare plans in Minnesota. The agency serves as a resource for those who need help paying their Medicare premiums and those interested in obtaining prescription drug coverage. The office also offers guidelines for handling complaints about health-care coverage and providers. Information on other types of health-care coverage are also covered by this website, including long-term care insurance. Downloads of publications on specific topics are also available, as well as links to additional resources available through state and federal offices.

The Minnesota Department of Commerce: provides beneficiaries with information about Medicare Part D Prescription Drug Plans and other insurance options available to them. The office is a resource for information about protection from Medicare fraud and how to report fraud. Additional links are included for federal offices that deal with Medicare and brochures that explain how to enroll in Part D Prescription Drug Plans. This government office also offers downloads of premium guides for supplemental plans available to current Medicare beneficiaries in Minnesota.

Medicare statistical trends in Minnesota

Here are some interesting facts from CMS about Medicare coverage in Minnesota in 2015 that may be of interest as you consider your Medicare coverage options.

  • 905,779 Minnesotans received Medicare coverage in 2015.
  • More than half (489,099) of these Medicare beneficiaries were enrolled in Medicare Advantage plans.
  • 416,680 individuals were enrolled in Original Medicare Part A and/or Part B.
  • More than 677,500 Medicare beneficiaries in Minnesota elected to have Part D prescription drug coverage either from stand-alone Medicare Prescription Drug Plans (391,006 people) or from Medicare Advantage Prescription Drug plans ( 286,560 people).
  • Over 150,500 Minnesotans with Original Medicare received at least one preventive service with no cost-sharing (out-of-pocket expense).

CMS reports (published in 2015) project the following for 2016:

  • All Medicare beneficiaries in Minnesota will have access to Medicare Advantage plans.
  • 23% of people with Medicare Part D are eligible to receive may qualify for Extra Help (also called the low-income subsidy, or LIS).
  • 77% of people with Medicare Part D coverage have access to a plan with a lower premium than what they paid in 2015
  • $18.40 is estimated to be the lowest monthly premium for a Medicare Prescription Drug Plan (premiums may be lower for individuals who qualify for Extra Help, or higher for those who pay a Part D late-enrollment penalty).

Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015; and “2016 MA Part D Landscape State-by-State Fact Sheet” as of September 21, 2015.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.


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