Medicare is a health insurance plan sponsored by the federal government. To qualify, people must be one of the following:
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.
Click on the images to open/view/download the fact sheets.
Medicare Cost Plan Transition, Infographic
Changes in Medicare for 2019, Infographic
Counties Where Cost Plans Will Continue in 2019
Changes in Medicare for 2019, Cost Plan and Timeline
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 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:
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?
What should Minnesota seniors with Medicare Cost Plans do now?
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.
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.
October 15, 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.
Blue Cross and Blue Shield of Minnesota
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.
More details on Part D plans in Minnesota can be found in Health Care Choices for Minnesotans on Medicare – an annual publication by the Minnesota Board on Aging and Senior LinkAge Line® that outlines Medicare options in Minnesota.
To find and compare Part D plans, you can also use the Medicare Prescription Drug Plan Finder at Medicare.gov.
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.
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:
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:
More details on these policies can be found in Health Care Choices for Minnesotans on Medicare – an annual publication by the Minnesota Board on Aging and Senior LinkAge Line® that outlines Medicare options in Minnesota.
You must have Original Medicare Part A and Part B to buy a policy.
It is best to enroll during your initial six-month Medicare Supplement Open Enrollment Period.
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.
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.
More details about Medicare Advantage plans can be found in Health Care Choices for Minnesotans on Medicare – an annual publication by the Minnesota Board on Aging and Senior LinkAge Line® that outlines Medicare options in Minnesota.
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:
For more information about changes to your Medicare card, go to medicare.gov/newcard/
If you believe you have been contacted by a scammer, report the incident to 1-800-MEDICARE (1-800-633-4227).
Not sure if Medicare will cover your medical test or service? There’s now an app for that!
The Centers for Medicare & Medicaid Services (CMS) has launched a smartphone app that gives consumers direct, convenient access to some of the most-used content on Medicare.gov, including accurate cost and coverage information.
You can use your mobile device to get accurate, consistent Original Medicare coverage information while at your doctor’s office, the hospital or the comfort of your own home.
The “What’s Covered” app lets you (or your caregiver) quickly see whether Medicare covers a specific medical item or service. The app delivers general cost, coverage and eligibility details for items and services covered by Medicare Part A and Part B. (If you have Medicare Advantage, this app will NOT have information about your specific plan.)
Search or browse to learn what’s covered and not covered; how and when to get covered benefits; and basic cost information. You can also get a list of covered preventive services.