As a Medicare beneficiary in Minnesota, you have multiple options when it comes to how you want to receive your coverage. Your choices will depend on whether you get your coverage through Original Medicare or Medicare Advantage. If you decide to enroll in a private Medicare Advantage plan, your options will depend on which plans are available in your area.
Original Medicare is a federal program that provides health coverage for individuals over 65 and some individuals with qualifying disabilities. In terms of costs and benefits, Original Medicare coverage in Minnesota works the same way as it does in other states. Under Original Medicare, you’re not limited to using providers in a certain network and can use any provider that accepts Medicare patients.
Original Medicare comes in two parts, Part A and Part B.
Part A covers hospital services, including:
Part B covers medical services, including:
To be eligible for the Medicare program, you must be 65 years and older and either a U.S. citizen or a permanent resident for five consecutive years. As long as you’ve worked at least 10 years, you usually don’t pay a premium for Medicare Part A. However, most people pay a monthly premium for Part B. There are other cost-sharing requirements in Original Medicare, including deductibles, copayments, and coinsurance.
Original Medicare doesn’t cover everything. Prescription drugs, routine vision and dental care, hearing aids, and dentures aren’t covered. You can get coverage for some of these things through a private Medicare Advantage plan.
Most people enroll in Medicare when they’re first eligible at age 65. You can sign up during your Initial Enrollment Period, which begins three months before you turn 65, includes the month you turn 65, and ends three months later. You may qualify before 65 if you receive disability benefits or have certain conditions, such as Lou Gehrig’s disease or end-stage renal disease.
If you’re still working or have coverage through a group plan, you may choose to delay Part B enrollment to avoid paying an extra premium for benefits you don’t need. You can sign up for Part B later when your coverage ends or you stop working, using a Special Enrollment Period (SEP). You won’t have to pay a Part B penalty if you had health coverage based on current employment (either your own or through your spouse’s employer).
If you miss your IEP or don’t qualify for an SEP, you can still enroll in Medicare Part A and/or Part B during the General Enrollment Period (GEP). This enrollment period runs from January 1 to March 31 every year. You might have to pay a higher premium for Part A and/or Part B if you didn’t sign up when you were first eligible.
Like other states, Minnesota residents can sign up for Medicare in the following ways:
Beneficiaries in Minnesota can also choose to get Medicare coverage through private insurance companies. The specific plans and benefits available to you will depend on where you live, since not all plans are offered in every location. If you are looking for private Medicare plans in Minnesota, always make sure to input your zip code when comparing plans.
Medicare Part C, more commonly known as Medicare Advantage, is another way to receive your Original Medicare benefits. These plans are required to cover at least the same benefits as Original Medicare, but may have other benefits as well. If you have Medicare Advantage, you’re still in the Medicare program, but would have a separate membership card, pay another plan premium (if applicable), and submit claims directly to the private insurance company. You’d still pay a monthly premium for Part B.
To be eligible to join a Medicare Advantage plan, you must have Medicare Part A and Part B and live in the service area of the plan you wish to join. You cannot have end-stage renal disease (ESRD).
Medicare Advantage plans may come with prescription drug coverage (also known as MA-PD). Medicare Advantage plans that include drug coverage let beneficiaries get all of their health and drug benefits under one plan.
Medicare Part D is optional prescription drug coverage you can purchase. This coverage is only available through private insurers and doesn’t automatically come with Original Medicare. If you have Original Medicare, you can add on this coverage by joining a stand-alone Medicare Prescription Drug Plan. You’d pay a separate plan premium for this drug plan, as well as additional costs like copayments and deductibles. If you have Medicare Advantage and want drug coverage, you must enroll in an MAPD plan. You can’t join a Medicare Prescription Drug Plan if you have Medicare Advantage, or you’ll be automatically disenrolled from Medicare Advantage.
To enroll in Part D, you must have Part A and/or Part B and live in the service area of a plan that provides drug coverage. It’s important to sign up for Part D as soon as you’re eligible. Similar to Part B, there is a late enrollment penalty for Part D if you sign up later.
Original Medicare doesn’t cover everything and can come with many out-of-pocket costs. To help offset some of these expenses, many beneficiaries with Original Medicare purchase a Medicare Supplement (Medigap) plan. Medigap plans cover cost-sharing expenses like deductibles, copayments, and coinsurance. Some plans also cover benefits not included in Original Medicare, such as overseas coverage and Part B excess charges (the difference between what Medicare pays for and what your provider charges).
Keep in mind that Medicare Supplement plans can only be used to pay for costs in Original Medicare. Medigap won’t cover costs associated with Medicare Advantage.
Learn more about how Medicare plans work in Minnesota, including: