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How Do Medicare Advantage Plans Work in Minnesota?



Minneapolis, Minnesota
Minneapolis, Minnesota
Until recently, there was only one way to go when it came to Medicare coverage.  First you would acquire Medicare coverage.  You would then supplement your coverage by purchasing a Medicare Supplement plan.  A stand-alone Medicare plan contains "gaps" in coverage that can lead to significant out-of-pocket costs for several possible medical circumstances.  There are a variety of Medicare supplement health plan options that provide different levels of supplement protection.  The various plan types are designated by letters of the alphabet (A-N).  Generally, the more comprehensive the coverage, the higher the cost of the supplement plan.

Good to know:  Each insurance provider has a formulary or list of medicines covered by the plan.  If a medicine is not on the formulary it may not be covered and you may have to endure a potential nightmare attempting to find an alternative medication.  The list of covered medicines is also often divided into tiers, which determines how much of a copay or coinsurance you may have to pay.  Make a list of your current medicines and compare it to the plan's formulary to make sure your medicines are covered and you understand the out-of-pocket costs that may be associated with them.

In Minnesota, Medicare Advantage Plans are an "all in one" alternative to the Original Medicare / Medicare Supplement plan arrangement.  These plans are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare.  These "all in one" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans cover all services covered by original Medicare.  In addition, Advantage plans are required to offer at least the same level of coverage as the Original Medicare Part A and Part B coverage.  In almost every case, Advantage plans feature several attractive additional benefits that are not covered by original Medicare.  Dependent upon which Minnesota advantage plan you choose, these benefits may include coverage for vision care, hearing aids, dental care, prescription drug coverage, transportation to and from medical facilities, and even fitness center membership.  The end result is a very comprehensive medical insurance plan.

Improvements for 2020

What's new?  Beginning in 2020, Medicare Advantage plans will have the option of covering several items that you would not expect to be covered by any health insurance plan.  Such as for example, a person with diabetes could receive transportation to a doctor's appointment, to a diabetes education program, or to a meeting with a nutritionist.  Some Medicare Advantage plans will even pay for cooking classes as part of improving someone's eating habits!  For someone with heart disease, a Medicare Advantage plan could provide heart-healthy produce or other foods that promote heart health.  For asthma, the plan could cover air cleaners or even pay to shampoo a subscriber's carpet to remove the irritants that often trigger asthma attacks.  Astoundingly, plans may even pay for improvements to a member's home, such as permanent ramps or wider hallways and doors to accommodate wheelchairs.  2020 will see a host of new, attractive, Medicare Advantage Plan Benefits.

Good to know:  Talk to an independent agent.  An independent insurance agent is an essential resource when purchasing insurance.  An independent agent works with multiple different carriers, which is different from captive agents who can only sell insurance from the carrier they work for.  Working with an independent agent can help make sure that you are getting the best coverage, for the best price.

If you enroll in a Medicare Advantage plan, you continue to pay your Medicare Part B premium.  The private insurer determines what the Medicare Advantage plan premium will be.  This premium amount will vary from one plan style to another.

Medicare Advantage plans tend to be significantly less expensive than Medicare Supplement coverage.  Some Medicare Advantage plans may have premiums as low as $0.

Copay costs may also be less with a Medicare Advantage plan.  For, example, if you visit a primary care physician under a Medicare Advantage plan, you may pay a copayment of $10.  However, if you visit a primary care physician under Original Medicare, you may have a coinsurance of 20%, which could be significantly more than $10.

A Medicare Advantage plan will limit your maximum out-of-pocket expense.  Once you have spent that maximum, you pay nothing for covered medical services for the remainder of the year.

Medicare Advantage Rules and Guidelines

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans.  In turn, these companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different Out-of-pocket costs.  They can also have different rules for how you get services – for example:

  • Whether you need a referral to see a specialist.
  • What shared medical costs you are responsible for.


Which Medicare Avantage Plan Carriers Are Available in Minnesota?

Following is a list of some of the insurance companies that offer Medicare Advantage plans in Minnesota:

  • Medica Health Plans. (Several plan variations)
  • Allina Health Aetna Medicare - Minnesota. (Several plan variations)
  • Blue Cross and Blue Shield of Minnesota. (Several plan variations)
  • UCare. (Several plan variations)
  • HumanaChoice. (Several plan variations)
  • UnitedHealthcare. (Several plan variations)
  • AARP. (Several plan variations)
  • Medica Health Plans. (Several plan variations)

Good to know:  Make an effort to understand insurance terms and lingo.  Understanding what various health insurance, or alternative health plan terms mean, is truly invaluable when it comes to choosing a quality health care plan.  Don't even attempt to shop for coverage until you have a good understanding of terms like copay, coinsurance, deductibles, and lifetime maximums.
For more information concerning Medicare Advantage, Medicare Supplement or Medicare Prescription Drug Plans, please give us a call.


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