Medicare in Minnesota: Plans and Coverage (2026)

Medicare in Minnesota runs on federal rules, but the state adds its own layer: free Aging Pathways counseling, DHS-administered savings programs, and a distinct Medigap framework.1,2

This guide covers Medicare in Minnesota for 2026: what each part costs, the plan choices available to you, and how to get help paying.

It walks through every part of Medicare for Minnesota residents, the 2026 costs that apply statewide, the plan types and what makes the state's options distinct, and the programs that can lower your bill significantly.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Minnesota (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Minnesota
• Help Paying for Medicare in Minnesota
• Medicare Enrollment Periods
• Free Medicare Help: Minnesota Aging Pathways
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1; CMS announced them on November 14, 2025.3 Medicare costs change every year, so check medicare.gov for the current year's figures. To talk to a person about your own coverage, call 1-800-MEDICARE at 1-800-633-4227 (TTY 1-877-486-2048), staffed 24 hours a day, 7 days a week except some federal holidays.6 For answers about Minnesota options, call Minnesota Aging Pathways at 1-800-333-2433, Monday through Friday, 8 a.m. to 4:30 p.m.1

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government and has two parts. The costs are the same in Minnesota as in every other state.3

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

The 2026 hospital deductible of $1,736 rose $60 from 2025. A benefit period begins the day you're admitted and ends once you've gone 60 days in a row without inpatient hospital care or skilled care in a nursing facility. Get readmitted after that gap, and the deductible resets.3

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and most mental health care. Part B does not cover routine dental, vision, or hearing.7 Most Medicare Advantage plans offer routine dental, vision, and hearing benefits instead, so check what a specific plan actually covers before you count on it.8

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 individual or $218,000 married, under the income-related adjustment)3
• Annual deductible: $2833
• After the deductible: you pay 20% of the Medicare-approved amount for most services3

Delaying Part B past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program triggers a permanent penalty: 10% added to the standard premium for every full 12-month period you could have had it, and the penalty lasts as long as you keep Part B.9

Medicare Advantage in Minnesota (Part C)

Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare. They must cover everything Parts A and B do (except hospice, which stays with Original Medicare), and most include Part D drug coverage along with extras like dental, vision, and hearing.8

Plan availability in Minnesota varies by geography. The Twin Cities metro area (Minneapolis, St. Paul, and surrounding suburbs) has a wide selection of Medicare Advantage options from multiple carriers. Greater Minnesota, particularly rural counties in the north and central parts of the state, typically has fewer plans and narrower networks. What's available at your specific address can differ from a neighboring county, so check the Medicare Plan Finder by ZIP code before comparing.

Minnesota Senior Health Options (MSHO)

Minnesota operates a specialized Medicare Advantage program for residents who have both Medicare and Medicaid. Called the Minnesota Senior Health Options (MSHO), it is an integrated Dual Eligible Special Needs Plan (D-SNP) that coordinates coverage across both programs. Qualifying Minnesota residents who have both Medicare and Medicaid may be able to get their coverage coordinated through MSHO rather than managing the two programs separately. Contact Minnesota DHS Medicare Savings Programs or Minnesota Aging Pathways to learn whether MSHO is an option for your situation.

How Medicare Advantage Plans Work

• You keep paying your Part B premium ($202.90 a month in 2026) in addition to any plan premium, though CMS says some plans may help pay all or part of it.3 The CMS estimate for the average Medicare Advantage premium in 2026 is about $14 a month, and many plans charge nothing extra.8
• Plans run on networks (HMO or PPO). Confirm your doctors and preferred hospitals are in-network before enrolling.
• Plans typically require prior authorization for certain services, which Original Medicare generally does not.8
• Every plan caps your annual in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap. CMS puts it this way: there is no yearly limit on what you pay out of pocket unless you have supplemental coverage like Medigap, Medicaid, employer, retiree, or union coverage. With none of those, your exposure is open-ended.8

Minnesota Aging Pathways' Open Enrollment page points to the same Plan Finder to check which plans best cover the medications you're on and which providers participate, and says you can contact Aging Pathways by chat or at 1-800-333-2433, Monday through Friday, 8 a.m. to 4:30 p.m.1

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can enroll in a standalone Part D plan paired with Original Medicare, or get drug coverage built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, so the donut hole is gone.4 Part D now moves through three phases:

1. Deductible: you pay full drug prices until you meet your plan's deductible (up to the federal maximum of $615 in 2026; some plans charge less or nothing).10
2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
3. Catastrophic: once your out-of-pocket spending hits $2,100, you pay $0 for covered drugs for the rest of the year.4

That $2,100 cap is the number that matters most. It was $2,000 in 2025 and adjusts each year with drug-spending growth.4 The Part D national base beneficiary premium for 2026 is $38.99, and the average standalone plan runs roughly $34.50 a month, though plan premiums vary widely.3

Every Part D plan must also offer the Medicare Prescription Payment Plan, which lets you spread your annual out-of-pocket drug costs into capped monthly installments instead of paying in full at the pharmacy.4 People who qualify for Extra Help often pay far less, sometimes nothing.

For a deeper look, see our guide to Medicare Part D drug coverage.

Medigap in Minnesota

Medigap policies, sold by private insurers, fill the cost-sharing gaps in Original Medicare: deductibles, coinsurance, and copays. They work only alongside Original Medicare, never with Medicare Advantage.11

Minnesota is one of only three states (along with Massachusetts and Wisconsin) that does not use the standard federal Medigap plan letters A through N.5 Instead, under Minnesota statute (Minn. Stat. 62A.31), every Medicare supplement policy must carry a designation specifying whether it is a Basic Plan or the more comprehensive Extended Basic Plan.5 This means the plan-choice mechanics in Minnesota differ from what you'd read in a generic national Medigap guide.

You then customize a base plan by adding optional riders. Medicare lists four for Minnesota: the Part A inpatient hospital deductible, the Part B deductible (for those eligible for Medicare before January 1, 2020), usual and customary fees, and preventive care Medicare doesn't cover. Foreign travel emergency care is not a Minnesota rider, because both base plans already cover it at 80%. Minnesota versions of Plans K, L, M, and N are also available, along with a Minnesota high-deductible Plan F for people who had or were eligible for Medicare before January 1, 2020. Because of the rider system, two Minnesota residents can hold quite different coverage built on the same base plan.5

The federal rule that closed Plans C and F to people who became Medicare-eligible on or after January 1, 2020, carries through Minnesota's framework: the Part B deductible rider and high-deductible Plan F are limited to residents eligible for Medicare before that date.5

The federal Open Enrollment Period still applies in Minnesota. Your strongest opportunity to buy a Medigap plan remains the six months that begin when you turn 65 and enroll in Part B. During that window, an insurer must sell you any plan it offers at the standard rate, regardless of your health history.11 Outside that window, Minnesota insurers may apply medical underwriting.

For a side-by-side comparison of Original Medicare with Medigap against Medicare Advantage, see our guide to Original Medicare vs. Medicare Advantage. For more on how Medigap works nationally and how the MN-specific plan structure fits, see How Medigap Works.

Help Paying for Medicare in Minnesota

Two programs can significantly reduce Medicare costs for people with limited income.

Medicare Savings Programs

The Medicare Savings Programs are administered in Minnesota through Minnesota DHS Medicare Savings Programs. They are mandatory Medicaid eligibility groups, and you can apply for an MSP on its own or for both an MSP and Medical Assistance. Minnesota states its own income limits as percentages of the federal poverty guidelines rather than as dollar amounts: QMB at 100%, SLMB at 120%, and QI at 135%. Each dollar limit below is that percentage plus $20, the monthly SSI general income exclusion, and Minnesota applies that same $20 as a standard deduction against the income it counts, so it is one adjustment, not two. Minnesota sets its own higher resource (asset) limits rather than the federal MSP figures.2

QMB is the most generous tier: it covers your Part B premium, your Part A premium if you are one of the few people required to pay one, and your deductibles, coinsurance, and copayments, and federal law prohibits providers from billing a QMB enrollee for that cost-sharing.2 For all three programs, Minnesota sets its own resource (asset) limit of $10,000 for a household of one and $18,000 for a household of two or more, above the federal resource standard of $9,950 for an individual and $14,910 for a couple. Those are limits on counted assets, not on everything your household owns: Minnesota says MSP follows many of the same asset eligibility policies as Medical Assistance for people who are aged, blind or have a disability, and it is that program's countable-asset and excluded-asset policy that decides what gets counted. The income compared against the limits above is counted income too, after Minnesota applies an ordered list of disregards and deductions, and it excludes Aid and Attendance benefits and Allowances for Unusual Medical Expenses from the Veterans Administration.2

Income limits are tied to the federal poverty guidelines, so the dollar amounts change whenever those guidelines change.2 They are a federal standard rather than an absolute cutoff, and states can effectively raise both the income and the resource limits by disregarding certain income and resources, so apply rather than rule yourself out.2 Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help with Part D.2 QDWI, the fourth Medicare Savings Program, is the exception: it pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not confer Extra Help, so a QDWI enrollee who wants Extra Help has to apply through Social Security.2,12

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024, the partial-subsidy tier is gone; everyone who qualifies now gets the full subsidy.12

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple in the 48 contiguous states and DC; Alaska and Hawaii are higher12
• Resource limits: $16,590 for an individual, $33,100 for a married couple; those limits rise to $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses12
• If you qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically2

Apply through the Social Security Administration at ssa.gov/medicare/part-d-extra-help.12 You can also reach SSA by phone at 1-800-772-1213 (TTY 1-800-325-0778).13

Medicare Enrollment Periods

These windows are set by federal law and identical in Minnesota and every other state. Miss a deadline and you can face coverage gaps or permanent penalties.14

Changes made during Annual Open Enrollment take effect January 1 of the following year. If you're already receiving Social Security before 65, Parts A and B enroll automatically. If not, you sign up yourself through Social Security.14 If you miss your Initial Enrollment Period and don't qualify for a Special Enrollment Period, you can still sign up for Part B during the General Enrollment Period (January 1 to March 31), with coverage starting the first day of the month after you enroll. If you're still working past 65 with group health coverage based on that current employment, you can delay Part B without penalty and use an eight-month Special Enrollment Period to sign up, counted from the month that job or coverage ends, whichever comes first. COBRA and retiree coverage do not count as coverage based on current employment, and if you're self-employed or your plan isn't available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay; if it doesn't, sign up at 65. This Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD).15

For a full breakdown, see our guide to Medicare enrollment periods.

Free Medicare Help: Minnesota Aging Pathways

You don't have to work through this alone, and you don't have to pay a broker. Minnesota Aging Pathways (formerly the Senior LinkAge Line) is Minnesota's federally designated State Health Insurance Assistance Program (SHIP), and its Medicare page says it offers free, unbiased help with your Medicare choices.1 Nationally, the Administration for Community Living describes SHIPs as providing free, in-depth, one-on-one health insurance counseling and assistance to Medicare beneficiaries, their families, and caregivers.16 SHIPs aren't connected to any insurance company or health plan, so a counselor has nothing to sell you.17

The Minnesota Board on Aging says Aging Pathways can help with:

• Health insurance counseling, including Medicare, long-term care planning, and prescription drug costs1
• Forms assistance, including help applying for Medical Assistance and Medicare Extra Help1

Nationally, Medicare's official appeals guide tells people with Medicare to call their SHIP for free, personalized health insurance counseling, including help with appeals.16

Call Minnesota Aging Pathways at 1-800-333-2433, Monday through Friday, 8 a.m. to 4:30 p.m.1

Learn More

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.