In all but three states, Medigap plans are standardized under federal rules. But Minnesota is one of three states that have federal waivers that allow the state to do its own Medigap standardization. So instead of the ten Medigap plans (A through N) that are marketed in most states, Minnesota Medigap plans include Basic, Basic with riders, Extended Basic, and Medigap plans F, K, L, M, and N. There are also Medicare Select Medigap plans in Minnesota, just as there are in other states.
As is the case nationwide, enrollment in private Medicare plans grew in Minnesota in 2018. As of December 2018, there were 581,822 Minnesota Medicare beneficiaries with private Medicare coverage, which amounts to nearly 58 percent of the state’s Medicare population. Nationwide, most people with private Medicare plans are enrolled in Medicare Advantage plans, but Medicare Cost plans are another type of private Medicare coverage, and as of 2018, Minnesota residents accounted for two-thirds of the national total enrollment in Medicare Cost plans.
The legislation that introduced Medicare Advantage also created a competition clause that banned Medicare Cost plans from operating in areas where they faced substantial competition from Medicare Advantage plans, but the implementation of the competition clause was delayed for many years. In 2015, legislation (MACRA) called for the competition clause to be implemented as of 2019.
A Medicare Part D Prescription Drug Plan (PDP) can help pay your prescription drug costs. Designed to work alongside Original Medicare coverage, Medicare Prescription Drug Plans are available from private insurance companies approved by Medicare and doing business in Minnesota. You can also enroll in a Medicare Prescription Drug Plan if you enroll in a Medicare Advantage plan that does not include Part D prescription drug coverage in its benefits.
A “Welcome to Medicare” packet is mailed out a few months before you turn 65. If you are not yet 65 but receive disability benefits from the Social Security Administration, or receive certain disability benefits from the Railroad Retirement Board, then you become eligible for Medicare as soon as you enter into the 25th straight month of receiving those benefits.
The Minnesota Department of Health offers information about Medicare plans in Minnesota. The agency serves as a resource for those who need help paying their Medicare premiums and those interested in obtaining prescription drug coverage. The office also offers guidelines for handling complaints about health-care coverage and providers. Information on other types of health-care coverage are also covered by this website, including long-term care insurance. Downloads of publications on specific topics are also available, as well as links to additional resources available through state and federal offices.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
Original Medicare does not provide coverage for outpatient prescription drugs. More than half of Original Medicare beneficiaries nationwide have supplemental coverage via an employer-sponsored plan (from a current or former employer or spouse’s employer) or Medicaid, and these plans often include prescription coverage. Some Medigap plans that were sold prior to 2006 included coverage for prescription drugs, but sales of those plans ceased as of 2006, when Medicare Part D became available. Part D was created under the Medicare Modernization Act of 2003, which was signed into law by President George W. Bush.
As an alternative to obtaining Original Medicare coverage directly from the government, you may want to consider Medicare Advantage (sometimes referred to as Medicare Part C) in Minnesota. Medicare Advantage plans are offered by private insurance companies that contract with CMS to provide all Original Medicare benefits except hospice care, which is paid by Medicare Part A. Many Medicare Advantage plans also include extra benefits such as routine dental and vision care.
People who aren’t yet 65 can enroll in Medicare if they’re disabled and have been receiving disability benefits for at least two years, and 13 percent of Minnesota Medicare beneficiaries are under age 65. Federal rules do not guarantee access to Medigap plans for people who are under 65, but the majority of the states — including Minnesota — have implemented rules to ensure that disabled Medicare beneficiaries have at least some access to Medigap plans. Minnesota law grants a six-month open enrollment period to anyone who enrolls in Medicare Part B, regardless of age (federal rules only grant this window to people who enroll in Part B and are also at least 65 years old).