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Medicare in Minnesota: How to Apply, Costs, & More

March 21, 2022

Medicare in Minnesota: How to Apply, Costs, & More

Health insurance can help you pay for part or all of your medical expenses from doctors, specialists, hospital visits, and prescriptions. Since health insurance options are always changing, it's a good idea to learn more about health insurance choices and which ones offer the most benefits while helping you save money.

Medicare is a type of health insurance program offered by the government for American citizens over the age of 65 and younger citizens with certain disabilities. For eligible residents in Minnesota, Medicare can provide health insurance benefits that complement your existing health insurance plan, or be used to provide full coverage. There are over four million Medicare Advantage beneficiaries in Minnesota and more than three million residents with a Prescription Drug Plan.

Learning more about the application process and the cost of Medicare in Minnesota can help you determine if it's the right choice for you.

How do I Apply for Medicare in Minnesota?

The first step for applying for Medicare in Minnesota is to determine whether you are eligible to apply. As in all other states, residents in Minnesota must meet one of the following requirements to qualify:

  • 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.

If you meet any of the requirements for qualification, there are a few different ways you can apply for Medicare in Minnesota.

Like other states, Medicare in Minnesota consists of four basic parts:

Medicare Part A and Part B combine to form Original Medicare

Medicare Part C (also known as Medicare Advantage) includes the benefits of Original Medicare and may also include other benefits. Part C is available from private insurance providers

Medicare Part D covers prescription medications and may be included in a Medicare Advantage plan or purchased separately to supplement original Medicare

Some counties in Minnesota also offer Medicare Cost Plans from private insurance providers. How you apply for Medicare in Minnesota will depend on your situation and the plan you choose.

Some people are automatically enrolled in Medicare Part A and Part B. Automatic enrollment usually only applies to people who already receive Social Security benefits, those who are disabled and have been receiving SSI for 24 months, and retirees from the Railroad Retirement Board. If you're automatically enrolled, you'll receive a "Welcome to Medicare" packet in the mail three months before you turn 65.

If you're not automatically enrolled in Medicare, there is a seven month initial enrollment period during which you can enroll in Medicare. Your initial enrollment period begins three months before the month of your 65th birthday and extends through three months after your birthday month. To enroll in Medicare during your initial enrollment period, you can enroll online at the Social Security Administration website, or call Social Security at 1-800-772-1213. Alternatively, you may be able to visit your local social security office to enroll.

If you choose to delay Medicare Part B enrollment, you have an eight-month special enrollment period to enroll in Part B. This period begins when active employment or your employer group coverage ends (whichever is first). Failing to apply for Medicare within the special enrollment period can lead to penalty fees for as long as you receive Medicare.

If you're already enrolled in Medicare and wish to make changes to your plan, there is an annual enrollment period (AEP) that will allow you to change from original Medicare to Medicare Advantage, choose a new Medicare Advantage plan, or make other coverage changes. Medicare AEP runs from October 15 to December 7th each year.

How Much Does Medicare Cost in MN?

Medicare costs in Minnesota come from several different sources and will depend on the plan you choose. For eligible beneficiaries, there is no monthly cost for Medicare Part A (hospital coverage). The premiums can vary for the other parts of Medicare. Check out this guide to learn more about updated Medicare premium and deductible costs.

What is a Medicare Cost Plan in Minnesota?

A Medicare Cost Plan is a type of Medicare plan offered by private insurance companies. Like Medicare Advantage, these plans include Medicare Part A and Part B coverage. Some plans also include prescription drug coverage and other benefits not covered by Original Medicare.

Is Minnesota Care Medicare?

No. Minnesota Care is a health care program for uninsured, working Minnesota residents. The program is designed to help working Minnesotans with low incomes. For eligible families, Minnesota Care pays for a variety of services like doctor visits. prescriptions, and hospital stays. Coverage may be different for children, pregnant women, and some other adults. Most families pay a monthly premium based on the family's income.

Is Medicare Advantage Available in Minnesota?

Yes, 100% of people with Medicare in Minnesota have access to a Medicare Advantage plan. Medicare Advantage plans are provided by private insurers, but they are overseen by the federal government.

There are four different types of Medicare Advantage plans available in Minnesota:

  • HMO Point-of-Service (HMO POS): Participants are required to choose a primary care provider who refers patients to specialists within a specific network. Extra costs may be incurred for services provided by out-of-network providers.
  • Preferred Provider Organization (PPO): These plans have provider networks that allow you to see any provider (including specialists) within the network. Out-of-network providers typically require you to pay more.
  • Private Fee-for-Service (PFFS): Participants are typically allowed to go to any provider that accepts the plan's payment terms. Your specific plan will determine payment terms.
  • Special Needs Plans (SNP): These plans provide focused and specialized health care for specific groups of people like seniors with both Medicare and Medicaid, or non-seniors with disabilities. Learn more about Special Needs Plans.

For many Medicare enrollees, Medicare Advantage plans provide a way to get complete health insurance benefits from a single plan. The cost of monthly premiums and out-of-pocket costs will depend on the plan you choose. Unlike Original Medicare plans, Medicare Advantage plans have a maximum out-of-pocket cost to prevent beneficiaries from paying too much each year.

Learn More About Medicare in Minnesota

Your medical needs are always changing. The plans offered by Medicare and the costs associated with these plans routinely change as well. Navigating all these changes and finding the information you need to choose a plan can be difficult. Our licensed agents can help you choose a Medicare plan based on the coverage features that are most important to you. Whether you want to browse plans in your area, get assistance choosing a plan online, or speak with a Medicare advisor on the phone, our experts are here to help you navigate the process of choosing a Medicare plan that fits your needs and budget.

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