We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Part B also helps with durable medical equipment (DME), including but not limited to canes, walkers, lift chairs, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use are also covered.[44]
Medicare also has an important role driving changes in the entire health care system. Because Medicare pays for a huge share of health care in every region of the country, it has a great deal of power to set delivery and payment policies. For example, Medicare promoted the adaptation of prospective payments based on DRG's, which prevents unscrupulous providers from setting their own exorbitant prices.[80] Meanwhile, the Patient Protection and Affordable Care Act has given Medicare the mandate to promote cost-containment throughout the health care system, for example, by promoting the creation of accountable care organizations or by replacing fee-for-service payments with bundled payments.[81]
If you decide to sign up for a Medigap policy, a good time to do so is during the Medigap Open Enrollment Period, a six-month period that typically starts the month you turn 65 and have Medicare Part B. If you enroll in a Medigap plan during this period, you can’t be turned down or charged more because of any health conditions. But if you apply for a Medigap plan later on, you may be subject to medical underwriting; your acceptance into a plan isn’t guaranteed.

Payment for physician services under Medicare has evolved since the program was created in 1965. Initially, Medicare compensated physicians based on the physician's charges, and allowed physicians to bill Medicare beneficiaries the amount in excess of Medicare's reimbursement. In 1975, annual increases in physician fees were limited by the Medicare Economic Index (MEI). The MEI was designed to measure changes in costs of physician's time and operating expenses, adjusted for changes in physician productivity. From 1984 to 1991, the yearly change in fees was determined by legislation. This was done because physician fees were rising faster than projected.

The 2003 payment formulas succeeded in increasing the percentage of rural and inner city poor that could take advantage of the OOP limit and lower co-pays and deductibles—as well as the coordinated medical care—associated with Part C plans. In practice however, one set of Medicare beneficiaries received more benefits than others. The MedPAC Congressional advisory group found in one year the comparative difference for "like beneficiaries" was as high as 14% and have tended to average about 2% higher.[47] The word "like" in the previous sentence is key. MedPAC does not include all beneficiaries in its comparisons and MedPAC will not define what it means by "like" but it apparently includes people who are only on Part A, which severely skews its percentage comparisons—see January 2017 MedPAC meeting presentations. The differences caused by the 2003-law payment formulas were almost completely eliminated by PPACA and have been almost totally phased out according to the 2018 MedPAC annual report, March 2018. One remaining special-payment-formula program—designed primarily for unions wishing to sponsor a Part C plan—is being phased out beginning in 2017. In 2013 and since, on average a Part C beneficiary cost the Medicare Trust Funds 2%-5% less than a beneficiary on traditional fee for service Medicare, completely reversing the situation in 2006-2009 right after implementation of the 2003 law and restoring the capitated fee vs fee for service funding balance to its original intended parity level.
Remember, Medicare Advantage plans may offer additional benefits that are not offered in Original Medicare coverage. Beneficiaries who need prescription drug coverage may prefer the convenience of having all of their Medicare coverage included under a single plan, instead of enrolling in a stand-alone Medicare Prescription Drug Plan for Medicare Part D coverage. However, every person’s situation is different, so it’s a good idea to review your specific health needs, and compare Medicare Advantage plans in your area to find a plan option that best suits your needs.
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a “guaranteed issue” basis. Later, insurance companies can ask questions about a senior’s health status and deny coverage depending on the answers, said Greiner of the Minnesota Board on Aging.
Nearly one in three dollars spent on Medicare flows through one of several cost-reduction programs.[20] Cost reduction is influenced by factors including reduction in inappropriate and unnecessary care by evaluating evidence-based practices as well as reducing the amount of unnecessary, duplicative, and inappropriate care. Cost reduction may also be effected by reducing medical errors, investment in healthcare information technology, improving transparency of cost and quality data, increasing administrative efficiency, and by developing both clinical/non-clinical guidelines and quality standards.[21]

This concept is basically how public Medicare Part C already works (but with a much more complicated competitive bidding process that drives up costs for the Trustees, but is very advantageous to the beneficiaries). Given that only about 1% of people on Medicare got premium support when Aaron and Reischauer first wrote their proposal in 1995 and the percentage is now 35% on the way to 50% by 2040 according to the Trustees, perhaps no further reform is needed.

Original Medicare, Part A and B, pays for many of your health-care services and supplies, but it doesn’t pay for everything. That’s why you may want to consider getting a Medicare Supplement plan, also called Medigap. Unlike Original Medicare, a Medicare Supplement plan is offered through private insurance companies. These Medigap plans help pay some of the hospital and medical costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and yearly deductibles.


**NY: In New York, the Excess Charge is limited to 5%; PA and OH: Under Pennsylvania and Ohio law, a physician may not charge or collect fees from Medicare patients which exceed the Medicare-approved Part B charge. Plans F and G pay benefits for excess charges when services are rendered in a jurisdiction not having a balance billing law; TX: In Texas, the amount cannot exceed 15% over the Medicare approved amount or any other charge limitation established by the Medicare program or state law. Note that the limiting charge applies only to certain services and does not apply to some supplies and durable medical equipment; VT: Vermont law generally prohibits a physician from charging more than the Medicare approved amount. However, there are exceptions and this prohibition may not apply if you receive services out of state.
Another wrinkle is that people who want a supplement might have a better chance of getting into the coverage during the transition out of their Medicare Cost plan, when the supplement is provided on a “guaranteed issue” basis. Later, insurance companies can ask questions about a senior’s health status and deny coverage depending on the answers, said Greiner of the Minnesota Board on Aging.

****Medically Necessary Emergency Care in a Foreign Country: coverage to the extent not covered by Medicare for 80 percent of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States, subject to a calendar year deductible of $250, and a lifetime maximum benefit of $50,000. For purposes of this benefit, “emergency care” shall mean care needed immediately because of an injury or an illness of sudden and unexpected onset.


*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
Enrollment in public Part C health plans, including Medicare Advantage plans, grew from about 1% of total Medicare enrollment in 1997 when the law was passed (the 1% representing people on pre-law demonstration programs) to about 36% in 2018. Of course the absolute number of beneficiaries on Part C has increased even more dramatically on a percentage basis because of the large increase of people on Original Medicare since 1997. Almost all Medicare beneficiaries have access to at least two public Medicare Part C plans; most have access to three or more.
Blue Cross plans on sending letters in early July notifying about 200,000 subscribers who stand to lose their Medicare Cost plans. Minnetonka-based Medica, which started sending letters last week, expects that about 66,000 members will need to select a new plan. Officials with Bloomington-based HealthPartners say the insurer sent letters to about 34,000 enrollees this month explaining the change.

If you are a Minnesota beneficiary and considering enrollment in a Medicare Advantage plan, it is important to compare and evaluate the Medicare plan options available to you. While similar Medicare Advantage plans may be offered throughout the state, the cost for premiums may vary depending on your county of residence. You should also take note that some Medicare Advantage plans in Minnesota may offer monthly premiums as low as $0. If your service area offers a Medicare Advantage plan with a $0 premium, keep in mind that the plan may still include other costs besides the premium, such as copayments, coinsurance, and deductibles. In addition, you must still pay your Medicare Part B premium.
The Patient Protection and Affordable Care Act ("PPACA") of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. The most substantial provisions slowed the growth rate of payments to hospitals and skilled nursing facilities under Parts A of Medicare, through a variety of methods (e.g., arbitrary percentage cuts, penalties for readmissions).

Part B also helps with durable medical equipment (DME), including but not limited to canes, walkers, lift chairs, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use are also covered.[44]


There are 33 Medicare Advantage Plans available in Hennepin County MN from 8 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. Hennepin County Minnesota residents can also pick from 6 Medicare Special Needs Plans. The highest rated plan available in Hennepin County received a 4.5 overall star rating from CMS and the lowest rated plan is 4 stars

More limited income-relation of premiums only raises limited revenue. Currently, only 5 percent of Medicare enrollees pay an income-related premium, and most only pay 35 percent of their total premium, compared to the 25 percent most people pay. Only a negligible number of enrollees fall into the higher income brackets required to bear a more substantial share of their costs—roughly half a percent of individuals and less than three percent of married couples currently pay more than 35 percent of their total Part B costs.[149]
Medicare supplement Plan F has also been the #1 seller with Baby Boomers for many years. According to a report from America’s Health Insurance professionals, about 57% of all Medigap policies in force were a premium Medicare Plan F policy. (In recent years, Plan G has been the second most popular Medicare supplement plan, and you can read more on that below.)
Humana is a Fortune 500 company offering several health insurance plans, including Medicare supplement plans. It services over 13 million customers and has won numerous awards from the National Business Group on Health, American Heart Association, Military Times and other organizations for the company’s insurance products and responsible business practices.

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As of 2016, 11 policies are currently sold—though few are available in all states, and some are not available at all in Massachusetts, Minnesota and Wisconsin. These plans are standardized with a base and a series of riders. These are Plan A, Plan B, Plan C, Plan D, Plan F, High Deductible Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies in the same state. Unlike public Part C Medicare health Plans, Medigap plans have no networks, and any provider who accepts Original Medicare must also accept Medigap.
If you decide to sign up for a Medigap policy, a good time to do so is during the Medigap Open Enrollment Period, a six-month period that typically starts the month you turn 65 and have Medicare Part B. If you enroll in a Medigap plan during this period, you can’t be turned down or charged more because of any health conditions. But if you apply for a Medigap plan later on, you may be subject to medical underwriting; your acceptance into a plan isn’t guaranteed.
MA plans often include dental, vision and health-club benefits that aren’t part of many supplements. Yet people who buy a supplement have the option of buying “stand-alone” Part D prescription drug coverage from any one of several insurers — a feature touted as one of the selling points for Cost plans, too. People in MA plans, by contrast, are limited to Part D plans sold by their MA carrier, Christenson said.
Helpfulness: The company takes as much guesswork as possible out of your quest for supplemental insurance. For example, you can answer a couple health questions in an online quiz that’ll match you with potential plans that may work for you. Company representatives are also available by phone seven days a week. The AARP website has a search tool to find plans in your ZIP code and a link to schedule in-person info meetings in your area if you’d rather have a face-to-face meeting.
Most Medicare enrollees do not pay a monthly Part A premium, because they (or a spouse) have had 40 or more 3-month quarters in which they paid Federal Insurance Contributions Act taxes. The benefit is the same no matter how much or how little the beneficiary paid as long as the minimum number of quarters is reached. Medicare-eligible persons who do not have 40 or more quarters of Medicare-covered employment may buy into Part A for an annual adjusted monthly premium of:

In most states, Medigap insurance plans have the same standardized benefits for each letter category. This means that the basic benefits for a Plan A, for example, is the same across every insurance company that sells Plan A, regardless of location. This makes it easy to compare Medicare Supplement insurance plans because the main difference between plans of the same letter category will be the premium cost.
In 2018, Medicare spending was over $740 billion, about 3.7% of U.S. gross domestic product and over 15% of total US federal spending.[19] Because of the two Trust funds and their differing revenue sources (one dedicated and one not), the Trustees analyze Medicare spending as a percent of GDP rather than versus the Federal budget. According to the 2019 Trustees Report, "The Trustees are issuing a determination of projected excess general revenue Medicare funding in this report because the difference between Medicare’s total outlays and its dedicated financing sources6 is projected to exceed 45 percent of outlays within 7 years. Since this determination was made last year (2018) as well, this year’s determination triggers a Medicare funding warning, which (i) requires the President to submit to Congress proposed legislation to respond to the warning within 15 days after the submission of the Fiscal Year 2021 Budget and (ii) requires Congress to consider the legislation on an expedited basis. This is the third consecutive year that a determination of excess general revenue Medicare funding has been issued, and the second consecutive year that a Medicare funding warning has been issued."
CMS projections in 2018 estimated that the average basic premium for a Medicare Part D prescription drug plan will fall to $32.50 per month this year from its $33.59 last year. But you need to look beyond the premiums to determine your total costs: Make a list of your prescription medications, then check out your plan’s formularies to make sure your drugs are covered and to learn which tier your drugs are in. (The higher the tier, the higher your copay.) And look at the costs of deductibles and coinsurance, especially if you’re taking expensive specialty drugs.
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The Congressional Budget Office (CBO) wrote in 2008 that "future growth in spending per beneficiary for Medicare and Medicaid—the federal government's major health care programs—will be the most important determinant of long-term trends in federal spending. Changing those programs in ways that reduce the growth of costs—which will be difficult, in part because of the complexity of health policy choices—is ultimately the nation's central long-term challenge in setting federal fiscal policy."[84]
Many experts have suggested that establishing mechanisms to coordinate care for the dual-eligibles could yield substantial savings in the Medicare program, mostly by reducing hospitalizations. Such programs would connect patients with primary care, create an individualized health plan, assist enrollees in receiving social and human services as well as medical care, reconcile medications prescribed by different doctors to ensure they do not undermine one another, and oversee behavior to improve health.[142] The general ethos of these proposals is to "treat the patient, not the condition,"[136] and maintain health while avoiding costly treatments.
For doctors and medical procedures (Part B) at the hospital and at home: The patient would pay 20 percent of all costs after meeting the $185 deductible. Unlike many other health insurance policies, there is no cap or maximum out-of-pocket amount on what a person could owe. The American Heart Association says that the minimum cost of bypass heart surgery is $85,891, in which case, the Part B copay would be over $17,000.
Part A Late Enrollment Penalty If you are not eligible for premium-free Part A, and you don't buy a premium-based Part A when you're first eligible, your monthly premium may go up 10%. You must pay the higher premium for twice the number of years you could have had Part A, but didn't sign-up. For example, if you were eligible for Part A for 2 years but didn't sign-up, you must pay the higher premium for 4 years. Usually, you don't have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a Special Enrollment Period.
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