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.

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. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 or Minnesota Aging Pathways at 1-800-333-2433.

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.

Part A (Hospital Insurance)

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

The hospital deductible rose $60 from 2025. A benefit period begins the day you're admitted and ends 60 days after discharge. Get readmitted after that gap, and the deductible resets.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and most mental health care. It does not cover routine dental, vision, or hearing.

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 individual or $218,000 married, under the income-related adjustment)
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Delaying Part B past your enrollment window without other creditable coverage triggers a permanent penalty: 10% added to the standard premium for every 12-month period you could have had it.

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.

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/month) in addition to any plan premium. The CMS estimate for the average Medicare Advantage premium in 2026 is about $14 a month, and many plans charge nothing extra.
• 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.
• 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.

A Minnesota Aging Pathways counselor can walk through the Plan Finder results with you at no charge and help you compare plan networks against your specific doctors and prescriptions.

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. Part D now moves through three phases:

1. Deductible: you pay full drug prices until you meet your plan's deductible (up to $615 in 2026).
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.

That $2,100 cap is the number that matters most. It was $2,000 in 2025 and adjusts each year with drug-spending growth. The average standalone Part D premium is about $46.50 a month in 2026, though plan premiums vary widely.

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. 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.

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. Instead, Minnesota has its own plan structure regulated by the Minnesota Department of Commerce. This means the plan-choice mechanics in Minnesota differ from what you'd read in a generic national Medigap guide.

Because of this, the federal rule that closed Plans C and F to people who became Medicare-eligible on or after January 1, 2020, applies within the context of Minnesota's own plan framework rather than the standard letter-based system.

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. 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 under Minnesota Medicaid. Minnesota uses the standard federal income tiers and resource limits, without state-set modifications.

QMB is the most generous tier: it covers your Part B premium along with your deductibles and coinsurance, and federal law prohibits providers from billing a QMB enrollee for that cost-sharing. For all three programs, the 2026 resource limit is $9,950 for an individual and $14,910 for a couple.

Income limits are tied to the Federal Poverty Level and update each April. You apply through Minnesota DHS or with help from Minnesota Aging Pathways SHIP. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.

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.

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
• Resource limits: $16,590 for an individual, $33,100 for a married couple
• If you qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically

Apply through Social Security at ssa.gov or call 1-800-772-1213.

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.

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.

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's federally designated State Health Insurance Assistance Program (SHIP) is Minnesota Aging Pathways SHIP. It is administered through the state's aging services network and provides free, in-depth, and objective Medicare counseling to anyone eligible for Medicare, their families, and caregivers. Counselors are trained and don't sell insurance.

A Minnesota Aging Pathways counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans against your specific situation
• Apply for the Medicare Savings Programs and Extra Help
• Sort through claims, denials, and billing issues

Call the statewide helpline at 1-800-333-2433, Monday through Friday, 8 a.m. to 4:30 p.m.

Learn More

• Minnesota Medicare Supplement (Medigap): base plans and riders
• Medicare: The National Guide
• Original Medicare vs. Medicare Advantage
• How Medigap Works
• Medicare Part D Drug Coverage
• Medicare Enrollment Periods

Find personalized help comparing your Medicare plan options in Minnesota at brevy.com.

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.