Medicare Advantage Plans in Minnesota

There are many people today wanting to learn more about Medicare Advantage Plans in Minnesota. Original Medicare consists of Medicare Part A, which covers hospitalization expenses, and Medicare Part B, which covers outpatient costs. Congress later amended the Medicare plans by adding Medicare Part D, which provides prescription drug coverage. However, many seniors noticed that even with original Medicare plus Part D, they were paying a lot of their health expenses in out-of-pocket costs because there are copays, coinsurance, deductibles, and limits to coverage.

Two efforts have been made to fill in these gaps that occur in Medicare plans. Seniors can opt to stay with original Medicare plus Part D and purchase one of the Medicare Supplement plans (also known as a Medigap plan) that will help cover the gaps, limitations, and out-of-pocket expenses of the classic Medicare plans.

The other option is to switch from original Medicare to a Medicare Advantage plan (sometimes referred to as Medicare Part C). A Medicare Advantage plan is an insurance policy purchased from a private insurance company. These plans are required by Congress to cover everything that original Medicare Part A and Part B cover. In addition, most Medicare Advantage plans provide all of the coverage provided by a Medicare Supplement plan and also provide prescription drug benefits.

There are two major advantages of a Medicare Advantage plan over Original Medicare. The first is that it is much simpler. Instead of juggling Part A, Part B, Part D, and Medigap, the beneficiary has one plan that covers everything, including prescription drug benefits. The other advantage is that original Medicare does not cover the following:

• Dental care (checkups, fillings, cleanings)
• Vision care (eyeglasses, contacts)
• Hearing care (checkups, hearing aids)

Most Medicare Advantage plans provide coverage of these three important aspects of healthcare; in addition, many of these health plans also provide free gym memberships and other perks intended to encourage seniors to be active.

Overview of Medicare Advantage Plans in Minnesota

CMS (the central government agency that runs Medicare) gives a star rating from one to five to each Medicare Advantage plan every year. The rating is based on the following factors:

• Does the plan cover preventative health care services (vaccines, checkups, screenings)?
• Do most beneficiaries of the plan utilize preventative health care services?
• Does the plan cover chronic health conditions, including testing and checkups necessary to manage the health condition successfully?
• How satisfied are beneficiaries with the plan?
• Have there been any problems with the plan reported to CMS?

The five-star-rated plans, which are the best Medicare Advantage plans in Minnesota, are:

• Aetna Medicare Discover
• HealthPartners Minnesota

In addition, Blue Cross Blue Shield of Minnesota, United Healthcare, and Humana’s Medicare Advantage plans are all rated a 4.5 by CMS.

U.S. News evaluated the available plans using a combination of the CMS star rating and other sources of information, and concluded that the best Medicare Advantage plans in Minnesota in 2020 were:

• Senior Preferred
• HealthPartners
• Blue Cross Blue Shield of Minnesota
• Blue Plus
• Primewest Health
• South Country Health Alliance
• United Healthcare

Popular Kinds of Medicare Advantage Plans in Minnesota

Although there are technically six types of Medicare Advantage plans, listed and explained below, the best Medicare Advantage plans in Minnesota are HMO plans, with PPO plans coming in a distant second in popularity. The six types of plans available are:

• HMO. A Health Management Organization is an insurance plan that restricts beneficiaries to using in-network healthcare providers only.
• PPO. A Preferred Provider Organization is similar to an HMO, with a provider network, except it does allow beneficiaries to use out-of-network providers if they are willing to pay some of the cost out of pocket.
• HMOPOS. An HMO Point of Service plan is an HMO plan that charges additional fees but does cover part of the costs of using out-of-network providers.
• PFFS. A Private Fee For Service plan reimburses the healthcare providers that you get care from. These plans vary; some have in-network requirements and others don’t. Some healthcare providers may refuse to treat patients with a PFFS plan.
• SNP. A Special Needs Plan covers the unique, specific needs of individuals with a severe chronic illness who need a lot of healthcare.
• MSA. A Medical Savings Account plan combines a high deductible insurance plan with a special savings account into which Medicare deposits a certain amount of money (the amount is based on the typical Medicare cost plans). After you meet your high deductible out of pocket every year, you can use the money in your savings account to cover the Medicare cost and your health care expenses.

Enrollment Statistics for Medicare Advantage Plans in Minnesota

Slightly more than half of Medicare enrollees in Minnesota have opted to enroll in Medicare Advantage plans, and among these, 56% opted to enroll in a Medicare Advantage plan that provided prescription drug benefits.

The median monthly premium in 2020 for the best Medicare Advantage plans in Minnesota was around $90. Many of the best Medicare Advantage plans in Minnesota have a $0 monthly premium, meaning that enrollees in the plan only have to pay their monthly Medicare Part B premium of $144. Of course, most of the plans available also have copays and coinsurance costs, some have deductibles, and they all have out-of-pocket limits. The details of each plan vary, so it is important to look at the fine print before selecting a plan to enroll in.

Prescription Drug Plans in Minnesota

Many of the Medicare Advantage programs available in Minnesota come with prescription drug benefits. If you are enrolled in a Medicare Advantage plan that doesn’t provide prescription drug benefits you can purchase a Part D prescription drug plan, also called a stand-alone prescription drug plan, to supplement your Medicare Advantage plan. Most of these stand-alone prescription drug plans can be purchased from the same insurance company that you obtained your Medicare Advantage plan from.

Although the monthly premiums vary for stand-alone prescription drug plans in Minnesota, most are under $20 a month. The yearly deductible is set by CMS and is $435 in 2020. The copays and other details of each plan vary by plan. In addition, they all provide better coverage for generic and “preferred” drugs and medications. The list of “preferred” drugs and medications can be obtained from the insurance company. If you need to take several expensive medications, it is a good idea to confirm all of these medications are included on the “preferred” list before purchasing a particular stand-alone prescription drug plan.

Network Restrictions for a Medicare Advantage Plan in Minnesota

The Medicare Advantage plans available in Minnesota vary by geographical location; for example, there are 47 different plans available in Hennepin County but only 15 in Cottonwood County. Overall, across the entire state, there are a total of 85 plans available in 2020.

The reason for the differences by location is that most Medicare Advantage policies, including all of the best Medicare Advantage plans in Minnesota, are HMOs or PPOs that have a restricted service area. An HMO restricts beneficiaries to using in-network healthcare providers, while a PPO allows beneficiaries to use out-of-network healthcare providers but requires the beneficiary to pay more out of pocket when using an out-of-network provider. Healthcare providers based in specific areas can sign up to be part of an insurance plan’s network.

Comparing Other Medicare Advantage Plan Benefits

As mentioned briefly above, most Medicare Advantage plans available in Minnesota provide benefits that are not available through regular Medicare coverage. These benefits include dental care, routine vision care, coverage of eyeglasses and hearing aids, and health-promoting wellness programs.

The details of each specific plan’s benefits vary, but it is a good idea to shop for a Medicare Advantage plan that provides these benefits. Even healthy seniors with 20/20 vision should get an eye checkup every six months to confirm their eyes are healthy, and dental care costs can really add up. Because the details of these insurance plans vary so much, it is a good idea to consult with an experienced insurance agent about your current needs and possible future needs before selecting one of the best Medicare Advantage plans in Minnesota.

While some seniors might scoff at the idea of participating in a wellness plan, these plans can provide significant health benefits. Many studies have shown that seniors who engage in physical exercise programs are less likely to develop chronic health conditions, less likely to suffer from falls, and more likely to remain independent throughout life. In addition, engaging in exercise in a social setting, such as regularly attending a dance class, can dramatically reduce the risk of developing dementia.

Additional Resources

The star ratings of each Medicare Advantage plan, including the best Medicare Advantage plans in Minnesota, are available here.

The U.S. News list of the best Medicare Advantage plans in Minnesota, including links to the specific plans, is available here.

The Minnesota Board of Aging provides assistance, information, and counseling to seniors. It has a specific office dedicated to handling health insurance issues and information called SHIP.

You can also visit medicare.gov for more information.