Open Enrollment for Medicare: October 15 through December 7. For information on special enrollment periods, visit the Medicare website
Medicare is a health insurance plan sponsored by the federal government. To qualify, people must be one of the following:
Age 65 or older and a U.S. citizen or a permanent legal resident of the U.S. for at least five continuous years;
Under age 65 with certain disabilities; or
Any age with End-Stage Renal Disease.
Medicare Part A covers inpatient hospital, skilled nursing facility, home health care and hospice care.
Medicare Part B covers almost all reasonable and necessary medical services, including doctors’ services, laboratory and x-ray services, durable medical equipment (wheelchairs, hospital beds, etc.), ambulance services, outpatient hospital care, home health care, blood and medical supplies.
Medicare Part C is called “Medicare Advantage” (or MA) and is an optional plan that is offered by private insurance companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits. Medicare Advantage combines the benefits of Medicare Parts A and B, as well as, in some cases, prescription drug coverage provided by Part D, and may provide some additional benefits.
Medicare Part D is the optional prescription drug coverage offered by private insurance companies and available to all people with Medicare.
A Medicare Cost Plan is a type of Medicare health plan that has been popular with Minnesota seniors for many years. Like Medicare Advantage, it is offered by private insurance companies approved by Medicare. A Cost Plan includes Medicare Part A and B coverage, but with greater flexibility in seeing non-network providers. A Cost Plan may also include the option of separate Part D prescription drug coverage.
A Medicare Supplement policy (sometimes known as Medigap or MedSupp) is a private insurance policy designed to supplement Original Medicare Parts A and B by covering out-of-pocket costs such as deductibles, copayments and coinsurance.
Minnesota Senior LinkAge Line®
The Senior LinkAge Line® is the federally designated State Health Insurance Assistance Program (SHIP) for Minnesota and provides free, objective, comprehensive help with Medicare.
Minnesota Commerce Department
651-539-1600 or 1-800-657-3602 (Greater Minnesota)
The Commerce Department is the state regulator of insurance companies and insurance brokers/agents. The Department’s Consumer Services Center provides assistance to Minnesotans with concerns or problems regarding an insurance policy, insurance broker/agent or insurance company.
Due to a change in federal law, many Minnesota seniors with a specific type of Medicare plan, known as a “Cost Plan,” may need to enroll in new Medicare coverage for 2019.
What you need to know
What is a Medicare Cost Plan?
A Cost Plan is a type of Medicare plan that has been popular with Minnesota seniors for many years.
In Minnesota, Cost Plans are currently offered by just three insurers:
Blue Cross and Blue Shield of Minnesota
Their Cost Plans have various brand names. A list can be found at the bottom of this page.
How do I tell if I have a Cost Plan?
Most Minnesota seniors do NOT have Medicare Cost Plans.
Of the one million Minnesota seniors currently enrolled in Medicare, about 370,000 have Cost Plans.
You can confirm whether you have a Medicare Cost Plan by calling the number on the back of your health plan member card.
What should Minnesota seniors with Medicare Cost Plans do now?
For now, seniors with Medicare Cost Plans do NOT need to take any action.
All current Medicare Cost Plan coverage remains in effect until December 31, 2018.
Later this summer and into the fall, seniors will receive information about how to obtain new Medicare coverage for 2019.
What is the Minnesota Department of Commerce doing to protect seniors with Medicare Cost Plans?
The Commerce Department is helping to ensure a smooth transition in Medicare coverage for Minnesota seniors. We are coordinating with the Centers for Medicare & Medicaid Services (CMS), other state agencies, the Minnesota Board on Aging Senior LinkAge Line®, insurance companies and health plans, insurance brokers/agents and many partner organizations that serve and work with seniors.
How will Minnesota seniors with Medicare Cost Plans be affected for 2019?
Not all seniors with Cost Plans will be affected in the same way.
Seniors in 21 Minnesota counties will be able to remain with their current Cost Plans because of the limited availability of other Medicare options.
Many seniors with Cost Plans may be automatically transitioned into a Medicare Advantage plan for 2019 with their same company, as long as CMS determines the new plan is similar in benefits to their current Cost Plan.
Seniors will still be able to opt out and select a different Medicare Advantage plan or Medicare Supplement policy.
It is estimated that about 200,000 Minnesota seniors will need to take action this fall to replace their existing Medicare Cost Plan and enroll in a new Medicare Advantage plan or purchase a Medicare Supplement policy for coverage beginning January 1, 2019.
August 15 - September 1, 2018
Minnesota seniors whose Cost Plans are ending and who will not be automatically transitioned into a Medicare Advantage plan will receive letters from Medicare informing them of the change and their options.
August 15 - September 15, 2018
Minnesota seniors who will be automatically transitioned from their Cost Plan to a Medicare Advantage plan will be notified by their current insurer.
October 1, 2018 This is when seniors can begin to compare plans for 2019.
Detailed Medicare plan offerings for 2019 will be available on the www.Medicare.gov Plan Finder tool, including information on cost, coverage and other benefits.
In addition, the Minnesota Board on Aging’s 2019 edition of Health Care Choices for Minnesotans on Medicare will be available at this time. The publication provides information on all Minnesota Medicare options for 2019. To get a free copy, call the Senior LinkAge Line® at 1-800-333-2433.
October 15 – December 7, 2018
The Medicare Annual Enrollment Period is when all seniors can choose to enroll or switch to a new Medicare plan for 2019, including a Medicare Advantage plan or Medicare Part D prescription drug plan.
November 2, 2018 – March 4, 2019
This is the period when seniors who lost their Cost Plan and returned to Original Medicare Part A and B can purchase a Medicare Supplement policy without any health screening (underwriting).
December 8, 2018 – February 28, 2019
This is a Special Enrollment Period for seniors who lost their Cost Plans. They can enroll in a different Medicare Advantage Plan or Medicare Part D prescription drug plan for 2019 than the one they selected during the Annual Enrollment Period (October 15-December 7, 2018).
January 1, 2019 – March 31, 2019
This is a new Medicare Advantage enrollment period for all seniors enrolled in a Medicare Advantage plan. They can switch to a different Medicare Advantage plan or return to Original Medicare Part A and B.
What are the brand names of Medicare Cost Plans in Minnesota?
Blue Cross and Blue Shield of Minnesota
Platinum Blue Choice
Platinum Blue Choice with Rx
Platinum Blue Complete
Platinum Blue Complete with Rx
Platinum Blue Core
Platinum Blue Core with Rx
Freedom Active with Rx
Freedom Balance with Rx
Freedom Ultimate with Rx
Freedom Ultimate with Enhanced Rx
Freedom Vital with Rx
Prime Solution Basic
Prime Solution Basic with Rx
Prime Solution Basic with Rx 2
Prime Solution Enhanced
Prime Solution Enhanced with Rx
Prime Solution Enhanced with Rx 2
Prime Solution Thrift
Prime Solution Thrift with Rx
Medica Prime Solution Value
Medica Prime Solution Value with Rx
Medica Prime Solution Value with Rx 2
Medicare Part D plans, which provide prescription drug coverage, are offered by private insurance companies with a Medicare contract. (It is also possible to receive prescription drug coverage through a Medicare Advantage Plan or a Medicare Cost Plan that offers prescription drug coverage)
Medicare Part D is an optional benefit. However, if you do not enroll when you are first eligible and do not have existing equivalent drug coverage, you may have to pay a premium penalty if you enroll at a later time.
Each Part D plan is different. Each can cover different drugs and have different costs.
Medicare Plan D providers have to follow Medicare rules that limit how they promote their plans.
Unfortunately, some plan representatives may break the rules and use high-pressure sales tactics or false promises to try to enroll you in a plan that may not cover the drugs you take. Or scammers may pretend to be Part D providers in order to get your personal information — such as your Medicare number — to commit identity theft.
To protect consumers, the law is very specific about what Medicare Plan D providers may and may not do. For example:
Medicare Part D plan representatives may not market through unsolicited contact, including:
Telemarketing calls, including voice mail messages
Emails or texts
Door-to-door solicitations, including leaflets or flyers at your home or car
Approaching you in common areas, like parking lots, hallways, lobbies and sidewalks.
Medicare Part D plan representatives may enroll you on the phone only if YOU call them. You can be on the safe side by calling Medicare first (toll-free at 1-800-633-4227) to verify the legitimacy of any provider you may be tempted to call. Medicare doesn't recommend any particular prescription drug plan; it simply verifies that a provider is legitimate.
Providers may come to your home only if you have invited them to do so.
Providers may ask you how you want to pay your premiums, but they may not ask you for payment on the phone or through the internet.
You may set up a direct payment plan if you want to, but the provider first has to mail you the information to do so.
Legitimate providers will not charge you any fees to enroll in a plan.
You will never be called by Medicare, the Commerce Department or The Senior LinkAge Line® to get you to sign up for a Part D plan. If you receive such a call, it is a scam.
Report scams and suspicious activity to Medicare by calling 1-800-MEDICARE (1-800-633-4227). You can also call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-772-3379. The MEDIC helps prevent inappropriate activity and fights fraud, waste, and abuse in Medicare plans.
A Medicare Supplement policy (also known as Medigap or MedSupp) is health insurance that:
Is sold by private companies to supplement Original Medicare.
Helps to pay your share of the costs of Medicare-covered services (coinsurance, copayments and deductibles).
May cover certain costs not covered by Original Medicare such as medical care needed while traveling outside of the U.S.
Medicare Supplement policies sold in Minnesota must be reviewed and approved by the Minnesota Commerce Department.
Multiple types of Medicare Supplement policies are available in Minnesota:
You must have Original Medicare Part A and Part B to buy a policy.
You will pay a premium to the insurance company (in addition to Medicare Part B).
Policies are sold by insurance companies and licensed insurance agents.
Policies are guaranteed renewable, even if you have health problems in the future. The insurance company cannot cancel your policy as long as you pay your premiums.
If you move out of state, your coverage can continue as long as you pay your premiums.
It is best to enroll during your initial six-month Medicare Supplement Open Enrollment Period.
This period begins on the first day of the month you are enrolled in Medicare Part B and ends six months later.
If you enroll during this period, you have guaranteed issue rights, meaning the insurance company is required by law to sell or offer a policy to you.
If you apply for a policy outside this period, you will likely be asked to complete a health questionnaire by the insurance company and your application may be denied.
How to Purchase a Policy
Contact the licensed insurance company or agent selling the policy you want to purchase.
The insurance company must provide you with an outline of coverage.
You can return the policy within 30 days of receipt and receive a full refund.
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private insurance companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits.
You must be eligible for Medicare Parts A and B and live in the plan’s service area to be eligible to enroll. People with End-Stage Renal Disease (permanent kidney failure) generally cannot join a Medicare Advantage Plan.
A Medicare Advantage Plan will provide all of your Medicare Part A and Part B coverage. This is different than a Medicare Supplement (Medigap) policy, which helps cover Part A and Part B out-of-pocket costs such as deductibles, copayments and coinsurance.
A Medicare Advantage Plan may require you to use certain health care providers (the provider network). Seeing providers outside the network can significantly increase your out-of-pocket costs.
Many Medicare Advantage Plans offer extra benefits such as vision, dental or wellness coverage.
Most Medicare Advantage Plans offer Part D prescription drug benefits.
In addition to your Medicare Part B premium, you usually pay one monthly premium for the services included in a Medicare Advantage Plan. Different Medicare Advantage Plans have different costs and benefits, which can also change from year to year. It is important to compare plans and understand these different costs and benefits before you enroll.
There are different types of Medicare Advantage Plans available in Minnesota:
HMO Point-of-Service (HMO POS) plans typically require you to choose a primary care doctor and to get a referral from this primary doctor to see a specialist. You may also be required you to use only the plan’s provider network (except in an emergency), otherwise you pay extra costs.Some plans may include a self-referral option that allows some flexibility to go to out-of-network providers.
Preferred Provider Organization (PPO) plans have provider networks, but you are allowed to see any provider that accepts Medicare (usually for a higher cost). You do not need a referral to see a specialist, but you may pay more if you go outside the plan’s network.
Private Fee-for-Service (PFFS) plans generally allow you to go to any provider as long as they accept the plan’s payment terms. The plan determines how much it will pay providers and how much you must pay when you get care. Medicare Part D prescription drug coverage may or may not be provided, but you can enroll in a standalone Part D plan if coverage is not provided.
Special Needs Plans (SNPs) provide focused and specialized health care for specific groups of people, such as seniors who have both Medicare and Medicaid, or non-seniors with disabilities who have Medical Assistance.
Minnesota seniors will be receiving new Medicare cards beginning the summer of 2018.
To help protect your identity, Medicare is removing Social Security numbers from Medicare cards. Instead, the new cards will have a unique Medicare Number. This will happen automatically. You don’t need to do anything or pay anyone to get your new card.
Medicare will mail your card, at no cost, to the address you have on file with the Social Security Administration. If you need to update your official mailing address, visit your online Social Security account or call 1-800-772-1213. When you get your new card, your Medicare coverage and benefits will stay the same.
When you get your new card, be sure to destroy your old card. Don’t just toss it in the trash. Shred it. If you have a separate Medicare Advantage or other health insurance card, keep that because you will still need it for treatment.
As the new Medicare cards start being mailed, be on the lookout for Medicare scams. Here are some tips:
You do not have to pay for your new Medicare card. Medicare is mailing new cards at no charge. If anyone contacts you claiming to represent Medicare or another government agency and is trying to make you pay for a new card, it is a scam.
Do not give your Medicare number to an untrusted source. Scammers call pretending to be from Medicare or another government agency asking for personal information in exchange for your new card. Cards are being shipped automatically and do not require you to share your Medicare number to receive one. Only share your Medicare number with doctors or trusted people who work with Medicare.
Never share financial information with someone you don’t know. If someone contacts you asking for your bank or credit card information with the promise of a rebate or bonus because of your new Medicare card, it is a scam.
Do not believe anyone who threatens to cancel your Medicare if you don’t give them your Medicare number. Your eligibility and access to Medicare services are not affected by the new Medicare cards.
Destroy your old card. Once you receive your new Medicare card, the old one is not needed. Destroy your old Medicare card by shredding it—remember: it has your Social Security number on it!
Guard your new card. Even though the new Medicare card doesn’t have your Social Security number on it, you should safeguard the card just as you would any other important records or credit cards.