If you’re shopping for Medicare plans in Minnesota, it’s easy to feel overloaded with information. That’s actually good news because it means you have a lot of options.
Medicare is a national health insurance program for adults over age 65 and people of any age who meet certain health criteria. Over the years, the program has expanded to give you a lot of choices when it comes to selecting Medicare healthcare coverage.
Medicare isn’t just a single health plan. There are various parts, some of which you get from the government and others that you can purchase from private insurance companies. Parts A and B make up what’s known as original Medicare, which comes directly from the government.
You can think of Part A as hospital insurance. It helps pay a portion of the costs for any inpatient health care services you receive while in a hospital, for a limited time at a skilled nursing facility, or when you’re in hospice care.
It also offers coverage for some home health services. Part A is funded through a payroll tax. So, if you or your spouse worked for at least 10 years, you’ve probably already paid for it and won’t need to pay a premium.
Part B helps pay for basic outpatient health care services, medical supplies, and preventive care you get at the doctor’s office or outpatient clinic. You do pay a premium for Part B. The amount varies depending on factors such as your income.
Part D plans are a specific type of supplemental coverage for prescription drugs. They add coverage to help you pay for medications.
Medicare supplement plans, sometimes called Medigap plans, were developed to help cover the gaps. Medicare supplement plans are available from private insurance companies and can complement your original Medicare.
These plans may help pay some out-of-pocket expenses, as well as add coverage for dental or other types of care.
Medicare Advantage (Part C) plans offer an “all-in-one” alternative to purchasing original Medicare plus supplemental coverage. Medicare Advantage plans cover all of the same benefits as original Medicare, plus a lot of the benefits you might get from Medicare supplement plans.
Instead of having separate plans to cover your benefits, you get it all from a single plan you purchase from a private insurance company.
A number of private insurance companies offer Medicare Advantage plans in Minnesota, including:
- Allina Health Aetna Medicare
- Blue Cross and Blue Shield of Minnesota
- Lasso Healthcare
These companies offer plans in many counties in Minnesota. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
While we often think of Medicare as health insurance for individuals age 65 and older, it’s open to people with some serious health circumstances, as well. Medicare is available to U.S. residents who:
You can begin the process of enrolling in Medicare three months before your 65th birthday. This is when your initial enrollment period begins. It then continues for three months after you turn 65. It usually makes sense to enroll in at least Part A at this time, assuming you qualify for Part A without paying a premium, even if you or your spouse continue to qualify for health insurance through an employer.
If you choose not to enroll in Part B during this time, you’ll be able to enroll in a special enrollment period later on.
Additionally, there’s an open enrollment period each year, during which you can enroll in Medicare for the first time or switch plans if you want to adjust your coverage.
General enrollment for Medicare Advantage plans runs from January 1 to March 31 each year, and an open enrollment runs from October 15 through December 7 each year.
In addition to these enrollment times, you may also enroll during a special enrollment period if you have had a major life change such as a loss of employee-sponsored insurance, a move to a new coverage area, or if your plan is dropped by Medicare.
Medicare Advantage plans aren’t one size fits all. While federal law requires them to cover the same benefits as original Medicare, they often vary in how that coverage works and what it may cost.
For instance, some plans may be Health Maintenance Organization (HMO) plans, which require you to designate a primary care provider who oversees your care. Others may be Preferred Provider Organization (PPO) plans, which offer a network of providers you must use.
When choosing a plan that’s best for you, you need to consider your own situation and preferences. Consider the following:
- How much will this plan cost me, both in premiums and when I seek care?
- How extensive is the provider network? Does it include doctors and hospitals convenient to me?
- What do current members have to say about their coverage? Are there online reviews, or do you know someone who is a member who might offer their opinion of the plan?
- Does the plan offer special programs that are especially useful for you? For instance, if you or your spouse have diabetes, it might make sense to look for a plan that offers a diabetes management program.
Take advantage of the following resources to learn more about your Medicare options in Minnesota:
When you’re ready to make the next move toward Medicare enrollment, here are some actions you can take:
- Do some research on specific plans available in your area. You can use the list above as a starting point or consider working with an agent who has experience with Medicare plans.
- Access the online Medicare application on the Social Security Administration website. If enrollment is currently open to you, you should be able to complete the application in as little as 10 minutes.
This article was updated on October 2, 2020 to reflect 2021 Medicare information.
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