Medicare Advantage Plans in Minnesota
If you live in Minnesota, you can choose to enroll in a Medicare Advantage plan. First, you must have Original Medicare (Part A and Part B). Medicare Advantage (Part C) plans are required to give you at least the same level of coverage as Original Medicare. And most Medicare Advantage plans include additional coverage, such as prescription drug benefits.
Original Medicare is the federal government program. Medicare Advantage is offered by Medicare-approved private insurance companies.
More Benefits: Medicare Advantage plans are a way of getting your medical and hospital coverage all in one plan, with one card. Many Medicare Advantage plans also give you more benefits, like prescription drugs. This might be a convenient option for you, so be sure to ask when you are comparing plans.
Limited Costs: Medicare Advantage plans have a yearly limit (or “cap”) on your out-of-pocket costs. After you reach this yearly limit, you won't have to pay anything for covered services. Yearly limits vary by plan so be sure you know before you enroll. Original Medicare does not have a yearly limit.
Overview of Medicare Advantage benefits
Keep in mind that the benefits and costs may vary depending on the plan, insurance company, and the county in Minnesota where you live.
Medicare Advantage plans cover:
- Hospital services (Medicare Part A)
- Medical services (Medicare Part B) – including preventive care
Most Medicare Advantage plans may also cover:
- Prescription drugs (Medicare Part D)
- Routine vision, hearing and dental care
- Health, fitness and wellness programs
Medicare Advantage options in Minnesota
It's good to know your options. Compare the plans to find which one works best for you.
- Health Maintenance Organization (HMO) plans: HMOs cover your health care through their network of doctors, specialists and hospitals. You select a primary care doctor from the network, and this doctor will coordinate your care and refer you to specialists if needed. For medical emergencies, you will be covered even outside the network
- Preferred Provider Organization (PPO) plans: PPOs are different than HMOs in a few key ways. With a PPO plan, you won't choose a primary care doctor. Also, you don't need referrals when seeing a specialist. Your share of costs is usually lowest if you see doctors in the network. You also can visit providers outside of the network – you just may have to pay higher copays and/or coinsurance.
- Private Fee-for-Service (PFFS) plans: Generally you can get covered care from any doctor, specialist or hospital as long as they contract with the PFFS plan. Check first to make sure they accept the plan's payment terms. Read more about PFFS plans here.
- Medicare Savings Account (MSA): You may also choose this high-deductible plan that includes a medical savings account. You use the savings account for your covered costs until you reach your deductible. Read more about MSA plans here.
- Special Needs Plans (SNPs): These Medicare Advantage plans are for people who have chronic conditions or special health needs, this also includes someone living in an institution. The benefits, providers and covered prescription drugs are carefully chosen for these unique needs. Read about SNPs here.
Hospital, Medical and Prescription Drug coverage all in one plan
Many Medicare Advantage plans combine prescription drug coverage along with hospital and medical benefits. These are called Medicare Advantage Prescription Drug plans. This may be an easy option because you can get all your Medicare benefits through just one plan.
Keep in mind that if you decide to enroll in Medicare Part C and want prescription drug benefits, you should get them through a Medicare Advantage Prescription Drug plan, not a separate stand-alone Medicare Prescription Drug plan (Part D).
Comparing Medicare Advantage plans in Minnesota
When you are comparing plans, look for your ideal balance of benefits and costs. In Minnesota, Medicare Advantage costs like monthly premiums vary depending on the county you live in. For example, your area might offer Medicare Advantage plans with monthly premiums as low as $0. Remember that these plans may still require you to pay deductibles, copays and coinsurance.
It's important to know that all Medicare Advantage plans have a yearly limit on your out-of-pocket costs. (Original Medicare does not.) To find the most convenient plan for your health and budget, read your enrollment materials, and talk with a Medicare expert.
Your Medicare Advantage plan choices may depend on your county or ZIP code.
Enrolling in Medicare Advantage in Minnesota
You can enroll in a Medicare Advantage plan during the Initial Enrollment Period and the Open Enrollment Period. Remember you must have Original Medicare, Part A and Part B, in order to enroll in a Medicare Advantage plan.
Initial Enrollment Period: If you're not automatically enrolled in Original Medicare, you can first enroll during the 7-month Initial Enrollment Period. This begins three months before you turn 65, your birthday month, and three months after you turn 65. This is also the same time you can enroll in a Medicare Advantage plan.
Open Enrollment Period: You can also join, change or leave your Medicare Advantage plan during the Open Enrollment Period. This happens every year starting on October 15 and ends on December 7.
Things to remember:
- Benefits and costs vary by the plan you choose and where you live.
- With any Medicare Advantage plan, you must continue to pay your Original Medicare Part B premium.
- Hospice care is covered by Part A
- Review the information and talk with a Medicare specialist
How to sign up for a Medicare Advantage plan
- Visit Medicare.gov
- Search the plans you want, choose one and enroll on their website
- Call the plan you're interested in for a paper form to fill out
- Call 1-800-MEDICARE (1-800-633-4227) (TTY: 711)