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Medicare Cost Plan Changes

Important Changes Coming for Minnesota Prime Solution (Cost) Plan Members

A new federal law will limit the availability of Medicare Cost plans beginning January 1, 2019. This legislation requires that health insurance companies discontinue Cost plans in 66 counties in Minnesota. If you live in one of these impacted counties, you will need to choose a new plan during the upcoming Annual Election Period (AEP).

What Does This Mean for You?

If you live in one of the impacted 66 counties in Minnesota, and are currently enrolled in a Medica Prime Solution (Cost) plan, your coverage will end December 31, 2018. That means you will need to explore alternative Medicare coverage options and make a decision about your 2019 coverage.

There will be a lot of changes in the Minnesota marketplace for Medicare beneficiaries. You will likely see many new plan types and options from insurance companies you already know, and from companies that are new to Minnesota. This can be very confusing and you will want to carefully evaluate your personal needs so that you make the best decision for your situation.

What Happens Next?

First, rest assured that your current coverage through Medica’s Prime Solution (Cost) plan will remain in effect through December 31, 2018. You’ll continue to have your current health plan coverage as long as you continue to pay your plan premiums.

Next, prepare for the upcoming change. One of the best places to start is to get educated about alternative Medicare private insurance types. Medicare Advantage plans and Medicare Supplement plans are the two most commonly offered coverage types. In addition, you’ll need to consider whether you need to change your Medicare Part D coverage—either bundled with a Medicare Advantage plan, or purchase a stand-alone prescription drug plan (PDP). Take a look at the Q&A section on this page for specific questions about how these types of plans differ from a Cost plan.

Finding Your Best Match

The more you know about Medicare plan types, the more confident you can be that you have made the right decision about your coverage for 2019. You will want to be sure that the plan you select is the best match for your needs, health, lifestyle and budget.

A finger pointing at an info icon

Use our 3-Step Guide to evaluate your options, including fictional scenarios that illustrate common enrollment challenges and how plan choices could be made.

my best match Download “Choosing The Right Medicare Plan For You” (PDF) brochure. It provides an explanation of various plan types, and important considerations when evaluating which might be the best for you. 

New Plan Options from Medica

With all of the changes happening with Cost plan availability in Minnesota, Medica has been working hard to develop a new portfolio of Medicare plan options for 2019 to meet the diverse needs of our members.

Minnesota 2019

Medica Signature SolutionSM | Medicare Supplement (Medigap) Plans
Available Statewide in Minnesota

Currently, Medica offers two Medicare Supplement plan options in all 87 counties in Minnesota. For 2019, we are adding two new plan options to provide a broader range of coverage and premium options to meet your personal needs. Starting October 1, you can shop and compare our 2019 Signature Solution plan offerings.

MN Advantage Solution 2019 

Medica Advantage Solution® (HMO-POS) (PPO) | Medicare Advantage Plans
Available in 29 Minnesota Counties 

Medica is expanding availability of Medicare Advantage plans from nine to 29 counties including the greater Twin Cities metro area (13 counties) and 16 counties in southeast Minnesota. This portfolio will include a choice of PPO or HMO-POS plan options. Starting October 1, you can shop and compare our 2019 Advantage Solution plan offerings.

We're Here to Help

Ensuring that you have access to the information and support you need is our first priority. Be sure to take advantage of one or more of these resources to help you compare options and make a decision about your 2019 coverage.

Special Member Meetings in October scheduled at convenient locations and times - over 130 sessions available for our members. Watch for your meeting invitation in early September or call (after September 5th) 1-855-235-6030 to reserve your spot.
Customer service One-on-One Telephone Appointment. You will receive a mailing from Medica that includes the date and time of a pre-scheduled telephonic appointment with a Medicare Advisor to discuss your needs, evaluate plan options, and make an enrollment decision for 2019. Be sure to take advantage of this opportunity.
phone Special Cost Plan Member Hotline. You can call 1-833-779-2881 (TTY:711) for assistance. Medicare Advisors are ready to take your call. Oct. 1-Mar. 31, 8 a.m. to 8 p.m. Central, 7 days a week.
Work with Your Broker or Agent. Contact your agent to assist in 2019 plan selection.

Key Dates for Transitioning Cost Plan Members

  • In early September, you will also receive an invitation to attend a special member meeting at a location near you.
  • Watch your mailbox for a Medica informational packet that will include a personalized pre-scheduled date and time for a telephonic appointment with a Medica Medicare Advisor.
  • Window shopping begins October 1 for new 2019 Medicare plan options.
  • Plan to attend a member meeting in October where you can conveniently learn and enroll in a new plan for 2019.
  • Take advantage of a one-on-one telephonic appointment with a Medicare Advisor.
October 15 – December 7
  • The Annual Election Period (AEP) begins October 15. This is the period of time when you can select and enroll in a new plan for 2019.
December 8 – February 28
  • A one-time Special Election Period (SEP) is available for transitioning Cost plan members. You may change plans or disenroll in coverage.


Have More Questions?

Do you have additional questions or feel like your questions weren't answered above? Here's all the current information about the Medicare Cost plan changes in an easy Q&A format.

Many people in Minnesota who are currently enrolled in a Medicare Cost plan will need to change their health insurance coverage for 2019. This impacts residents in 66 Minnesota counties and includes any type of Cost plan offered by all health insurance companies.

Effective January 1, 2019, due to a change in federal law, health insurance companies that currently offer Medicare Cost plans in Minnesota will no longer be able to sell or renew these types of Medicare private insurance plans in impacted counties.

This change impacts 66 counties in Minnesota. Please refer to the Minnesota county map found in the fact sheet. If you are a resident in one of these counties, your Prime Solution Cost plan will no longer be available after December 31, 2018.

View Cost plan change fact sheet (PDF)

Yes. Medicare Cost plans will continue to be available to residents in 21 Minnesota counties including: Aitkin, Carlton, Cook, Goodhue, Itasca, Kanabec, Koochiching, Lake, Le Sueur, McLeod, Meeker, Mille Lacs, Pine, Pipestone, Rice, Rock, St. Louis, Sibley, Stevens, Traverse and Yellow Medicine. Please refer to the Minnesota county map.

First, rest assured that your Medica Prime Solution (Cost) plan coverage will continue to be in effect through December 31, 2018.

During the upcoming Annual Election Period (AEP), October 15-December 7, 2018, you will need to select and enroll in a new plan for 2019. It is a good idea to plan ahead and explore different Medicare plan types so that you will be ready to take action this fall.

No. The limitation of Cost plan availability in these service area of North Dakota, South Dakota and Wisconsin is not impacted by the change in federal law. 

We intend to offer a variety of Medicare health insurance plans for 2019. There are regulations about what we can share with you until the new plans are approved by the Centers for Medicare and Medicaid Services (CMS) later this summer. Window shopping for 2019 plans begins October 1, 2018, when you can shop and compare benefits. Watch your mailbox for important mailings this fall.

This fall, we'll be contacting impacted members through important mailings. Be sure to keep an eye out for this information and take advantage of the many options we'll have available for support and guidance.

With a Cost plan, you keep your Original Medicare benefits (Part A and Part B). Your health insurer covers your Part B services plus any additional benefits that your plan option may include.

When you enroll in a Medicare Advantage plan, you get all of your Part A and Part B benefits through your private insurance plan, not through Original Medicare. Medicare Advantage plans may also bundle Part D prescription drug benefits together with your medical coverage – giving you the convenience of one ID card, one monthly premium, one insurance plan.

There are a range of Medicare Advantage plan types including HMO, HMO-POS and PPO plans. All plan types have a provider network that you will want to access for care to lower your out-of-pocket expenses. Be sure you are familiar with the doctors and hospitals included in the provider network, out-of-network benefits, and any requirements for referrals to specialists or other health care services.

There are a range of Medicare Supplement plans with varying levels of coverage options and premiums. Medicare Supplement plans cover what Original Medicare does not. Unlike Cost plans, where your benefits can change from year to year, Medicare Supplement benefits are standardized and will never change as long as you pay your monthly premium.

There is no provider network, giving you the freedom to travel or live anywhere in the U.S. You can receive covered benefits from any provider that accepts Medicare.

Medicare Supplement plans do not include Part D prescription drug coverage. You will need to select and enroll in a stand-alone prescription drug plan (PDP) if you need Part D.  

Medica is a Cost, HMO-POS and PPO plan with a Medicare contract. Enrollment in Medica depends on contract renewal.

Last updated - 8/2018

Date: 12/9/2018 8:16:08 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CMSWEB01