Health Care Choices For Minnesotans On Medicare - Metropolitan ...

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Health Care Choices for Minnesotans on MedicareAn important note about loss of Medicaresupplemental policy coverageIn Minnesota, if you lose your supplemental coveragethrough no fault of your own, you can purchase a BasicMedicare supplement policy with up to three additionalriders, or you can purchase a Medicare SELECT policy.• You must apply for the new policy within 63 days oflosing coverage to ensure that your health status will notaffect your ability to get a new policy.Common situations where you could lose yoursupplemental insurance coverage:• You are enrolled in an employer’s group health plan thatsupplements Medicare and the plan terminates or stopsproviding Medicare supplement benefits.• You voluntarily leave the employer plan.• You are enrolled in a Medicare Advantage plan, otherMedicare plan, or a Medicare SELECT plan, but areno longer eligible because you moved out of the plan’sservice area.II. Medicare Supplement Policies, MedicareAdvantage Plans, Other Medicare Plans, andStand Alone Prescription Drug PlansIf you join a Medicare Advantage plan or other Medicareplan for the first time, and you do not want to staywith the plan, you have special rights to buy a Medicaresupplement policy if you return to Original Medicarewithin 12 months of enrolling in the Medicare Advantageor Other Medicare plan.• If you had a Medicare supplement policy before youjoined the plan, you may be able to get the same planback if the company still sells it in Minnesota.• Medicare supplement policies can no longer includeprescription drug coverage, even if you had it before,but you may be able to join a Stand Alone MedicarePrescription Drug Plan.• If you joined a Medicare Advantage plan or OtherMedicare plan when you were first eligible for Medicare,you can choose from any Medicare supplement policysold in Minnesota.• This also applies if you purchase a Medicare SELECTpolicy and decide you do not want to stay with it. Youcan switch to a Basic Medicare supplement policy within12 months of purchasing the Medicare SELECT policy.III. Minnesota Comprehensive Health Association(MCHA)Since 1976, Minnesota has provided an option for peopleto get health insurance coverage who have been deniedcoverage by the private market because of a pre-existinghealth condition. MCHA is also referred to as Minnesota’shigh risk pool for health insurance. MCHA is regulatedby the Minnesota Department of Commerce andadministered by Medica.MCHA offers• Individual deductible health insurance policies for peoplewithout Medicare• Basic Medicare supplement policynExtended Basic Medicare supplement is no longeravailable through MCHA.You may be eligible for MCHA Basic Medicaresupplement policy if:• You are enrolled in both Part A and B of Medicare.• You have been a resident of Minnesota for the six monthsimmediately preceding your application for MCHAcoverage.• You have been rejected for other health coverage or havea preexisting condition limitation.• You have been the “holder” of a policy or certificateof Medicare supplement coverage which has beenterminated by an insurer for reason other thannonpayment of premium.• You have been treated within the last three years for oneof the special “presumptive conditions”.Examples of the 47 presumptive conditions include,but are not limited to:nInsulin dependent diabetesnStrokenAlzheimer’s diseasenMultiple SclerosisnParkinson’s diseaseCall MCHA Customer Service at 1-800-325-3540for more information.34
A publication of the Minnesota Board on Aging Senior LinkAge Line ®In Minnesota, there are 2 types of Medicare supplements–Basic and Extended Basic. For most policies sold,Minnesota does not use the alphabet policy systemof naming Medicare supplements A through M.All Medicare supplemental policies sold in Minnesotaexceed the benefits required by the federal governmentMN now has policies K, L, M and N (refer below).Information about the specific companies that may be sellingthese policies was not available.There are currently 24 companies selling Medicaresupplements in Minnesota.All Medicare supplemental policies sold in Minnesotato Medicare beneficiaries age 65 and older must also besold to Medicare beneficiaries under age 65 enrolled inMedicare. This is not required in most states.All Medicare supplemental policies sold in Minnesotaare “community rated”. This means that you cannot becharged a higher premium based just on your age or healthstatus. Everyone with the policy, regardless of age or healthstatus, pays the same premium. There are 2 exceptions–higher premium can be charged if you are a smoker andpremiums may differ between rural and urban areas ofMinnesota.Policy K Policy L Policy M Policy NHigh Deductible Policy High Deductible Policy Covers 50% of the MedicarePart A deductibleCovers 100% of the MedicarePart A deductibleIn 2010, the out-ofpocketlimit is $4,620In 2010, the out-ofpocketlimit is $2,310Covers 100% MedicarePart B co-insuranceCovers 100% of the MedicarePart B co-insurance exceptup to a $20 office visit copayand up to $50 co-pay foremergency roomCovers the skilled nursingfacility co-insuranceCovers the skilled nursingfacility co-insuranceCovers foreign travelemergencyCovers foreign travelemergency35
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