Medicare and Minnesota Medical Assistance

Some Minnesotans qualify for both Medicare and Medical Assistance — often called being “dual eligible.” When that happens, Medicare pays first, and Medical Assistance may help with costs Medicare leaves behind, like premiums, deductibles and coinsurance, plus services Medicare does not cover at all, such as long-term care at home or in a nursing facility.

How Medical Assistance works for seniors in Minnesota

Medical Assistance is administered by the Minnesota Department of Human Services (DHS), with eligibility determined by county and tribal human services offices. Eligibility is set by the state and the federal government — not by an insurance agency — so we point you to the right place to apply and help you understand how it affects your Medicare choices. People 65 and over apply through their county (or with the DHS application for seniors and people with disabilities), not through MNsure.

Minnesota Senior Health Options (MSHO)

MSHO is Minnesota’s version of a Dual Special Needs Plan, and it goes further than most states’. If you are 65 or older, have Medicare Parts A and B, and qualify for Medical Assistance, you can enroll in MSHO, and one health plan then covers Medicare, Medical Assistance, Part D drugs, and long-term services and supports, with a care coordinator who works with you and your doctors. One card, one customer-service number, no coordinating two programs yourself. MSHO plans are offered by Blue Plus (SecureBlue), HealthPartners, Medica, UCare and county-based plans, depending on where you live; UCare’s exit from ordinary Medicare Advantage did not end its MSHO plan. People 65+ with Medical Assistance who do not choose MSHO are enrolled in Minnesota Senior Care Plus (MSC+), which covers only the Medical Assistance side.

Programs that can lower your costs

• Medicare Savings Programs (MSPs) — QMB, SLMB and QI — pay the Part B premium ($202.90 in 2026) and, for QMB, Medicare’s deductibles, copays and coinsurance as well. Minnesota’s income limits change each July; its asset limits are $10,000 for a single person and $18,000 for a married couple, well above the federal floor most states use. Apply through your county human services office.
• Extra Help (Low-Income Subsidy) lowers what you pay for Part D premiums, deductibles and copays. If you qualify for an MSP or Medical Assistance you get Extra Help automatically; otherwise apply through Social Security.
• Medical Assistance with a spenddown is how Minnesota covers some seniors whose income is slightly too high — ask the county whether an MSP or a spenddown is the better fit for you.

Free, unbiased state counseling on all of this is available from Minnesota Aging Pathways — formerly the Senior LinkAge Line, Minnesota’s State Health Insurance Assistance Program — at 800-333-2433, Monday to Friday. When you are ready to talk through the Medicare side, we are here at (702) 706-6564.

How we help

We help you understand whether MSHO is available and a good fit where you live, how a Medicare Savings Program and Extra Help could reduce your costs, and how to keep your Medical Assistance benefits working alongside Medicare. Eligibility decisions rest with the county, the state and CMS; our job is to make the Medicare side clear.

ECOS Medicare Solutions is a private insurance agency and is not connected with or endorsed by Minnesota Medical Assistance, the Minnesota Department of Human Services, any county, or the federal Medicare program.