Medicare Plan Options
The first step to choosing a plan is to understand how Medicare is structured. You may be satisfied with Original Medicare — with or without an add-on Medigap and Part D prescription drug plan. Or, you may wish to select a single plan through Minnesota’s Medicare Advantage program. When shopping for a plan, consider how often you use particular services and compare the premiums, deductibles, and copays charged by different providers.
When you first sign up for Medicare, you receive Original Medicare unless you choose other coverage. Original Medicare is run through the federal government and covers medically necessary health care services. Part A helps pay for inpatient stays in hospitals, skilled nursing facilities, and hospice care, when recommended by a doctor. It also covers some home health services. Part B helps pay for a wide range of essential services, such as wellness checks, blood tests, EKGs, emergency department visits, cardiovascular rehab, and chemotherapy treatment. You’re responsible for paying deductibles and copays, and there are no limits on out-of-pocket costs. Original Medicare doesn’t include benefits, such as prescription drugs, vision, and dental.
Medicare Advantage Plans
Minnesota residents who want an alternative to Original Medicare can choose a Medicare Advantage Plan offered by private insurance companies. Also known as Medicare Part C, these plans are required by law to cover Part A and Part B services and may offer extra benefits, such as prescription drugs, gym memberships, eyeglasses, dental care, hearing aids and transportation to medical appointments. There are four main types of Medicare Advantage Plans — HMO, PPO, PPFS, and SNP — and each has specific policies regarding the health care providers you can see. Similar to Original Medicare, you pay premiums, deductibles, and copays, but these plans put an annual limit on out-of-pocket costs.
Medicare Prescription Drug Coverage Plans
You can receive Medicare drug coverage in two ways: adding a Part D prescription drug plan onto Original Medicare or choosing a Medicare Advantage Plan that offers prescription drug benefits. Drug coverage isn’t required, but if you don’t sign up when you first enroll in Medicare, you may face a late enrollment fee later in the form of a permanent monthly penalty. Medicare drug plans are offered through private insurers and cover generic and brand-name drugs. If you take regular medication, check the plan’s formulary to see if it’s covered. In most cases, a similar drug should be available if it’s not.
Medicare Supplement Insurance Plans
Medicare Supplement Insurance Plans, or Medigap, can be added onto Original Medicare to pay some of your out-of-pocket costs. When you have both plans, Original Medicare contributes its portion of approved expenses, and then Medigap pays its share. In Minnesota, you can choose from a Basic or Extended Basic Medigap plan. Some costs, such as Part A and B coinsurance and cost-sharing for hospice, are included in both plans. The Extended Basic plan includes some additional costs, such as the Part A hospital deductible, travel outside of the United States, and more days of skilled nursing facility coinsurance. You can’t join Medigap and Medicare Advantage at the same time.
Medicare in Minnesota by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|536,822||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Minnesota
Whether you’re looking for your first Medicare plan or changing coverage, finding the right mix of benefits for your health needs is essential. You’ll also want to search for the most cost-effective solution. If you need assistance in understanding the choices available to you, reach out to one of the following organizations.
Senior LinkAge Line
This free service provides counseling to help seniors and caregivers in Minnesota make informed choices about Medicare coverage. Funded by the federal government, the Senior LinkAge phone line helps residents understand and navigate the Medicare system. You can call the toll-free line to ask questions about navigating Medicare, comparing plan options, purchasing a policy, and finding new coverage.
Contact Information: Website | 800-333-2433
Trellis is the Area Agency on Aging for the Twin Cities metro area. Minnesota residents in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties can book appointments for free, one-hour Medicare counseling. During the session, a trained counselor answers your questions about Medicare and helps you compare plans if needed. Visit the Trellis website to book your counseling session or to register for free online presentations about Medicare.
Contact Information: Website | 800-333-2433
Minnesota Department of Human Services (DHS)
The DHS administers Medical Assistance, which is Minnesota’s Medicaid program to help low-income seniors pay for health insurance. In some cases, you can enroll in both Medicare and Medical Assistance. The DHS can answer questions about your eligibility for state assistance to pay for premiums, deductibles, copays, and expenses that Medicare doesn’t cover.
Contact Information: Website | 800-657-3739
Learn More From Our Sources
- Medicare | What Part A covers | Last accessed May 2021
- Medicare | Medicare and You | Last accessed May 2021
- Medicare | Medicare Advantage Plans | Last accessed May 2021
- Medicare | Medicare Advantage Plans cover all Medicare services | Last accessed May 2021
- Medicare | Drug coverage (Part D) | Last accessed May 2021
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed May 2021
- Medicare | Medigap in Minnesota | Last accessed May 2021