More Medicare beneficiaries than ever are signing up for a Medicare Advantage plan in Minnesota. Also known as Medicare Part C, Medicare Advantage plans are administered by private health insurance companies. They offer all the benefits of Original Medicare plus high-value additional coverage contained in one plan for simplicity and convenience. A Medicare Advantage plan in Minnesota for 2022 can provide peace of mind for many beneficiaries.
What is Medicare Advantage in Minnesota?
Minnesota residents eligible for Medicare coverage will first enroll in Original Medicare, which consist of Medicare Part A and Part B. That program is administered by the Centers for Medicare and Medicaid Services and provides a red, white, and blue card that is presented to healthcare providers for basic inpatient and outpatient services.
Beneficiaries then have the option of selecting a Minnesota Medicare Advantage plan for 2022 to extend their Medicare coverage. These plans are administered by private insurance companies and may include coverage not offered by Medicare Supplement plans or Original Medicare, including:
- Medicare Advantage prescription drug plans, also known as MAPD, allow beneficiaries to pay one monthly premium for prescription drug coverage and basic healthcare.
- Many Advantage plans include additional wellness benefits like coverage for dental, vision, and hearing services.
- Premiums are often lower for Medicare Part C than Medigap, but there are more out of pocket expenses like the Part B premium.
An insurance agent can help beneficiaries select the right Advantage plan while assisting with the enrollment process.
What is the Best Medicare Advantage plan in Minnesota in 2022?
Best for network freedom: Medicare Advantage PPO
- PPO health plans offer larger networks than most HMOs.
- Many plans allow out-of-network service providers with higher out of pocket costs.
- In most cases, referrals are not required to see specialists.
- PPO premiums can go up to $100 per month, but there are $0 premium plans in many service areas.
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
- HMO plans reduce costs by limiting beneficiaries to service providers willing to accept payment terms arranged by the plan. There are fewer out of pocket costs, but out-of-network providers are generally not covered, excepts in emergencies.
- Many plans have no monthly premium.
Best for low income or health conditions: Medicare Advantage D-SNIP
- Enrollment is limited to those with select chronic health conditions or limited income.
- Many Minnesota beneficiaries combine Medicare and Medicaid to ensure coverage for copayments, coinsurance, deductibles, and other expenses not covered by SNP insurance plans.
What Medicare Advantage plans are available in Minnesota?
From 2020 to 2021, the number of Advantage plans offered in Minnesota increased from 85 to 91. That increase represents increasing demand for Part C plans within the state and across the country. All beneficiaries in the state have access to Advantage plans, including $0 premium plans.
The most popular Advantage plans in Minnesota include:
- Local PPO
- Local HMO
- Regional PPO
How much does Medicare Advantage cost in 2022?
In 2020, the average cost of a Minnesota Medicare Advantage plan was $64.66. As of 2022, all beneficiaries in the state have access to $0 premium plans. Those plans are mostly HMOs, but there are some no-premium PPOs in select areas. Rates vary by insurance company and county.
When can I make changes to my Medicare Advantage plan?
There are two opportunities to change your Medicare Advantage plan in Minnesota if you don’t qualify for a special enrollment period:
1. Annual Election Period – October 15 – December 7
Also known as the Medicare General Election Period, this is the best time to switch to a new Minnesota Medicare Advantage plan or go back to Original Medicare. The changes you make will take effect January 1.
2. Advantage Open Enrollment Period – January 1 – March 31
You can make a one-time plan change during this period. Your options are to move to a different Advantage plan or go back to Original Medicare. You will also have eligibility for a Medicare Part D prescription drug plan if you switch back to Original Medicare.
When can you enroll in a Minnesota Medicare Advantage plan for 2022?
Initial Enrollment Period
Your first opportunity to enroll in a Minnesota Advantage plan is your seven-month initial enrollment period. It starts three months prior to your 65th birthday month and ends three months after.
If your application is approved prior to the first day of the month you turn 65, your coverage will take effect the first day of your birthday month. If your application is approved during or after your birthday month, it will take effect the first day of the following month.
Open Enrollment Period – AKA Annual Election Period
The Medicare Open Enrollment Period takes place from October 15 to December 7 every year. It gives beneficiaries a chance to make the following changes:
- Join a Minnesota Advantage plan
- Switch Medicare Advantage plans
- Switch from an Advantage plan to Original Medicare
Plan changes take effect on January 1 the following year.
Medicare Advantage Open Enrollment Period
This open enrollment period is reserved for beneficiaries already enrolled in an Advantage plan. The following change options are permitted from January 1 to March 31 each year:
- Switch to a different Advantage plan
- Move back to Original Medicare with or without a Part D plan
Special Enrollment Periods – Special Circumstances
Some Minnesota beneficiaries will have the opportunity to enroll in an advantage plan outside of the official enrollment periods. Some of the most common qualifications for special enrollment include:
- Moving to a new service area
- Losing insurance coverage from an employer or other source
5-star Special Enrollment Period
From December 8 to November 30, Medicare beneficiaries have the option of moving to an Advantage plan that has a 5-star rating. This is a one-time change open only to beneficiaries already enrolled in an Advantage plan. Star ratings are assigned by the federal Medicare program and can change over time.
Special Enrollment Periods if you get “Extra Help”
Minnesota beneficiaries eligible for Medicare and Medicaid can join an Advantage plan or switch to a new plan one time during each of the following periods:
- January – March
- April – June
- July – September
Beneficiaries who have a standalone Part D prescription drug plan and qualify for Extra Help can make changes to their drug coverage one time during each of those periods.
Are Medicare Advantage plans in Minnesota “bad”?
Many beneficiaries decide that a Medicare Advantage plan in Minnesota for 2022 is the best option for their health care and wellness needs. While some prefer to minimize out of pocket expenses with a Medigap policy or stick with the basic benefits offered by Medicare Part A and Part B, there is a trend of increasing interest in Advantage plans nationwide.
In 2019, 43% of Minnesota beneficiaries were enrolled in Medicare Advantage plans. In 2021, that percentage rose to 48%. The number of plans offered in the state increased as well, and those trends of growth are expected to continue in years to come.
Advantage plans do offer great coverage options for beneficiaries interested in simplifying their medical benefits. They allow beneficiaries to include wellness and prescription drug benefits in one monthly premium with their general health coverage.
Frequently Asked Questions about Medicare Advantage in Minnesota
What's the downside to Medicare Advantage plans?
- Medicare Advantage plans aren’t as effective at eliminating gaps in Medicare Part A and Medicare Part B coverage as Medigap policies. That means beneficiaries may pay more expenses out of pocket, which works against the lower monthly premiums to some extent.
- Beneficiaries enrolled in an Advantage plan are required to select a primary care physician and secure a referral before seeing specialists.
- There are network restrictions with all Medicare Part C plans. Beneficiaries are required to see network providers with HMO plans while PPO plans have larger networks and may allow out-of-network service with higher out of pocket expenses.
- Beneficiaries must do more to maintain Advantage plans because the benefit terms can change every year along with premium rates.
What are 4 types of Medicare Advantage plans in Minnesota?
1. Health Maintenance Organization (HMO)
HMOs are popular because most beneficiaries have access to a $0-premium policy in their service area. They do have the most restrictive networks and typically won’t allow out-of-network services providers. Referrals are required, and beneficiaries must select a primary care physician to manage their care.
2. Preferred Provider Organization (PPO)
PPOs have larger networks that allow greater choice in providers, and they may give beneficiaries the freedom to see out-of-network providers at greater cost.
3. Private Fee-for-Service (PFFS)
A PFFS allows beneficiaries to select their medical providers as long as those providers agree to the payment terms established by the plan. In some cases, the plan will have a network of providers who have already agreed to the terms, but beneficiaries are typically not required to stick only to that list of providers.
4. Special Needs Plans (SNP)
Special needs plans are reserved only for those with very low income or chronic health conditions. Each plan is dedicated to a different income range or chronic condition. For instance, someone with end-stage renal disease may join an SNP that providers specialized care for beneficiaries with that medical condition.
What are the top 3 Medicare Advantage plans?
The following list reveals the most popular Advantage plan insurance companies in 2020, along with their share of the market:
- United Healthcare – 26%
- Humana – 18%
- Blue Cross Blue Shield – 15%
Those are the leading insurers offering Medicare Advantage plans in Minnesota as well, but plan selection is a personal adventure. Monthly premiums and benefits packages vary as well as out of pocket expenses like copays, coinsurance, and deductibles. No plan perfectly meets the needs of all beneficiaries.
What Are Medicare Special Needs Plans?
Special needs Medicare Advantage plans cater to beneficiaries with shared healthcare or financial needs. Some plans are dedicated to low-income beneficiaries while others provide extra benefits that are of value to people with a specific chronic condition like End-Stage Renal Disease, diabetes, or cancer.
These plans often decide everything from prescription drug formularies to network providers with the select health or financial needs of the participants in mind. Low-income beneficiaries may end up with fewer copays and other out of pocket expenses while those with medical needs receive extra care for their conditions.
Does Medicare Advantage cover drugs?
Many Medicare Advantage plans include prescription drug plans, eliminating the need for a standalone Part D drug plan. Policies that include this coverage are designated as Medicare Advantage Prescription Drug Plans or MAPD.
Do Medicare Advantage plans use the SilverSneakers program in Minnesota?
SilverSneakers memberships are offered by some Advantage plans in Minnesota. Some insurance companies may also offer similar gym memberships for all beneficiaries enrolled in their Advantage plans.
Minnesota Medicare Resources
Minnesota State Links
Minnesota Medicare Plan Statistics
Minnesota’s nearly 5.5 million residents live in 87 counties. The five largest are:
- In 2015, 905,779 residents were eligible for Medicare Part A and Part B.
- Among Minnesota Medicare beneficiaries, 53 percent had Medicare Advantage plans.
- Medicare Advantage enrollment grew by 6 percent between 2015 and 2016.
- In 2016, 23 percent were in an HMO.
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