Original Medicare

Part A (Hospital Insurance)

 Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

Part B (Medical Insurance)

 Helps cover:

• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
• Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)

You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also buy supplemental coverage, like Medicare Supplement Insurance (Medigap).

A Medicare Supplement policy (also known as Medigap or MedSupp) is health insurance that:

• Is sold by private insurance companies to supplement Original Medicare.
• Helps to pay your share of the costs of Medicare-covered services (coinsurance, copayments and deductibles as applicable to the plan coverage).
• May cover certain costs not covered by Original Medicare such as medical care needed while traveling outside of the U.S.
• Covers Minnesota state-mandated benefits 

Multiple types of Medicare Supplement policies are available in Minnesota:

• Basic
• Basic with riders
• Medicare SELECT
• Extended Basic
• Supplement Plan with 50 percent coverage
• Supplement Plan with 75 percent coverage
• Supplement Plan with 50 percent Part A deductible coverage
• Supplement Plan with $20 AND $50 Co-payment Medicare Part B coverage
• Supplement Plan with high deductible coverage

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private insurance companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits. 

You must be eligible for Medicare Parts A and B and live in the plan’s service area to be eligible to enroll. People with End-Stage Renal Disease (permanent kidney failure) generally cannot join a Medicare Advantage Plan.

Policy Basics

• A Medicare Advantage Plan will provide all of your Medicare Part A and Part B coverage. This is different than a Medicare Supplement (Medigap) policy, which helps cover Part A and Part B out-of-pocket costs such as deductibles, copayments and coinsurance.
• A Medicare Advantage Plan may require you to use certain health care providers (the provider network). Seeing providers outside the network can significantly increase your out-of-pocket costs.
• Many Medicare Advantage Plans offer extra benefits such as vision, dental or wellness coverage.
• Most Medicare Advantage Plans offer Part D prescription drug benefits.

In addition to your Medicare Part B premium, you usually pay one monthly premium for the services included in a Medicare Advantage Plan. 

A Medicare Cost Plan is a type of Medicare health plan that has been popular with Minnesota seniors for many years. Like Medicare Advantage, it is offered by private insurance companies approved by Medicare. A Cost Plan includes Medicare Part A and B coverage, but with greater flexibility in seeing non-network providers. A Cost Plan may also include the option of separate Part D prescription drug coverage.

Due to Federal legislation, most  Medicare Cost plans were mandated to sunset at the end of 2018.  However, as of 2022, they are still available in some Minnesota counties. 

Medicare Part D plans which provide prescription drug coverage are offered by private insurance companies. 

Medicare Part D is an optional benefit. However, if you do not enroll when you are first eligible and do not have existing equivalent drug coverage, you may have to pay a premium penalty if you enroll at a later time.

Each Part D plan is different. Each can cover different drugs and have different costs.