Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare Advantage takes the coverage of Medicare Part A and Medicare Part B and places it in one plan from a private insurance company. These types of plans in Minnesota are sometimes called Medicare Part C. Many retirees find them appealing because they often offer more coverage than what the federal plans cover, with additional benefits like dental, vision care or senior-focused wellness plans. One exception is hospice, which is only offered through Medicare Part A.
Because most Medicare Advantage Plans cover prescription medications, and some even cover over-the-counter medications, seniors will not need a prescription drug supplemental plan with these, as they often do with Original Medicare. The plan providers can also set their own costs for out-of-pocket expenses, networks and eligibility criteria, but they do have to follow the rules set by the Centers for Medicare & Medicaid Services. Because of these varied options, these plans are quite popular in the state. Minnesota has over 1 million Medicare beneficiaries, and Medicare Advantage accounts for 496,113 of those people, compared to 543,888 who have Original Medicare, based on the data from 2020. That number means that nearly 48% of the population of the state is on Medicare Advantage Plans, compared to the national average of 42%.
This guide offers an overview of Minnesota’s Medicare Advantage Plans, with information about the top plan options, eligibility and how to enroll in one of these plans.
The Top 10 Medicare Advantage Plans in Minnesota
Minnesota has multiple companies that have Medicare Advantage plans available. One of the reasons many beneficiaries choose Medicare Advantage over Original Medicare is because of these varied plan options. The ability to shop around gives the beneficiaries more choices for their coverage.
The top 10 most popular Medicare Advantage providers based on the number of enrollees are listed in the table below. It outlines the range of prices across the various plans the company offers, with data as of April 2022, and it states the Medicare star rating. The best place to get the most current information about available Medicare Advantage plans is Medicare.gov.
Blue Cross Blue Shield of Minnesota
HMO, PPO, PFFS
Allina Health Aetna Medicare
Blue Cross Blue Shield Minnesota
How Medicare Advantage Plans Work in Minnesota
Medicare Advantage plans in Minnesota may be health maintenance organization (HMO) or paid provider organization (PPO) plans, or they may take another structure. The structure is set by the insurance company that offers the plan, which is why they vary, and different insurance providers may offer more than one plan that falls under the Medicare Advantage umbrella. In addition, these plans will have different rules for eligibility, copayments, deductibles and coverage. For this reason, applicants need to carefully read the plans to find one that fits their needs best.
What Medicare Advantage Plans Cover in Minnesota
All Medicare Advantage plans in Minnesota cover the same things covered in Medicare Parts A and B, except for hospice. Hospice is only provided under Medicare Part A. Because these plans come from private insurers they often have additional coverage, like vision, hearing aids and medications. Each plan will vary, but the table below outlines some coverage seniors may find under Medicare Advantage Plans.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Durable Medical Equipment
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Minnesota
Before qualifying to receive Medicare Advantage, a senior must already be a Medicare Part A and Medicare Part B beneficiary. These plans also require that the applicant live within the service area and meet the eligibility requirements of Original Medicare. This means they must be either qualified immigrants or U.S. citizens. To apply, seniors must also be age 65 or older or have a disability that qualifies them to receive Medicare.
The enrollment periods are also important to understand because seniors who do not enroll during these periods will either not be able to enroll or will pay penalties. The timing of the enrollment process is explained in greater detail below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
Medicare Advantage Open Enrollment Period
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Minnesota
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
The Minnesota Board on Aging operates the statewide MN SHIP program that provides advice, assistance and direct application support for health care resources to Minnesotans aged 60 and over. Program assistance includes discount pharmaceutical programs, Extra Help benefits for Part D premiums and other Medicare issues. MN SHIP case workers also provide preadmission screening for seniors moving into long-term care and fraud prevention and reporting hotlines. Eligible seniors must meet income and asset limits for some means-tested programs.
Seniors in Minnesota who would like to contact the Board on Aging for any of the services it offers, or for referrals to affiliated programs, can call the main program center, known as the Senior LinkAge Line, at 1-800-333-2433. Email inquiries may be submitted to [email protected]. Correspondence, including paper applications for services, is accepted at the Minnesota Board on Aging’s main office.
The Minnesota Commerce Department provides free information about health insurance, costs of care and Medicare coverage on its website. Information provided includes up-to-date changes to Medicare legislation, Medicare Advantage plan changes and available Part D benefits. Further information and advice about benefits includes the end of Minnesota Medicare Cost plans and other variations on Medicare benefits in the state. Fraud, waste and abuse reporting is also available through the department.
Contact the Minnesota Commerce Department by phone via the main line at 1-800-657-3602. Emails may be sent to [email protected]. Correspondence with the department may be mailed to the Minnesota Department of Commerce at its headquarters in Saint Paul.
The Minnesota Senior Health Options (MSHO) program focuses assistance on the 35,000 Minnesotans who are eligible for both Medicare and Medicaid. People in this category are usually seniors who have reached eligibility for Medicare, while having income and assets that fall below the state Medicaid threshold. MSHO coordinates care between these two services, helping to ensure seniors who are dual-eligible get full coverage of their health needs with minimal to nonexistent gaps in coverage. Program counselors can explain both programs to beneficiaries, assist with initial applications for coverage and help manage denials of service. Other program services include publishing educational materials for beneficiaries and their caregivers about benefits and assistance locating additional resources.
Contact the MSHO program by calling 1-800-366-5411. Email inquiries may be submitted at [email protected]. Seniors can send mail inquiries to MSHO at its office in the Elmer L. Andersen Human Services Building in Saint Paul.
HealthFinders Collaborative Medication Assistance Program – Faribault
The HealthFinders Collaborative (HFC) Medication Assistance Program (MAP) -Faribault is part of a statewide medication assistance program that helps seniors find Part D benefits and co-payment assistance for prescription drugs. The program offers no-cost prescription medications to all uninsured Rice County residents. Working with Sterling Drug as a local partner, Faribault MAP provides medication assistance to patients at its own clinic and at local hospitals and emergency departments. Prescriptions may be delivered to seniors with limited ability to travel to a pharmacy. The MAP staff includes MNsure-approved navigators, who act as certified benefits counselors for seniors seeking coverage under Original Medicare and Medicare Advantage. Navigators help seniors aged 60 and over understand and apply for benefits, as well as identify other benefits they may be eligible for. Program counselors can also assist beneficiaries apply for private insurance, including Medicare supplements and Extra Help, the federal assistance program for Part D co-payments.
Both clinical and counseling services offered by HealthFinders are available by appointment only. Call 507-323-8100 to speak with an intake worker to schedule a visit. The state program may be reached with inquiries via email at [email protected]. Applications, inquiries and written requests for assistance may be mailed to the program’s Faribault office.
Land of the Dancing Sky Area Agency on Aging is the regional branch of this Minnesota Board on Aging’s senior resource program. Through the AAA, seniors can receive no-cost counseling about their health insurance options, including Medicare, and available prescription drug programs. The AAA also provides SHIP and Senior Medicare Patrol assistance and acts as the local Aging and Disability Resource Center (ADRC).
Seniors in the AAA’s service area can contact the Senior LinkAge line at 1-800-333-2433 for information and assistance. Mail, including completed application packets, may be sent to the agency’s address in Warren.
County Human Services Offices
Every county in Minnesota has a Department of Human Services office so seniors can receive assistance and services in the area where they live. Case workers in these DHS offices can assist Minnesota seniors with signing up for benefit programs they may be eligible for, as well as provide impartial advice regarding Original Medicare, Medicare Advantage and Medicaid benefits.
Seniors can contact their local DHS office to schedule an appointment with a case worker. A list of contact information for each county office, as well as tribal offices and other health counseling agencies, can be found here.