Medicare vs. MNsure in Minnesota: which one applies to you

Under 65, not on Medicare, no employer plan: MNsure or an individual plan bought directly. Sixty-five and over: for most people, Medicare, plus either a Medigap plan and Part D or an Advantage plan, most of which include drug coverage. One exception is someone who would have to pay a premium for Part A: they may be able to stay on a MNsure plan instead, though late penalties can apply if they sign up for Medicare later, so that one is worth a call. Under 65: Medicare after 24 months of Social Security or Railroad Retirement disability benefits, as soon as disability benefits start for someone with ALS, and with kidney failure (ESRD) if you, a spouse or a parent has enough work history, though for ESRD you have to apply.

Enroll in Medicare during your Initial Enrollment Period — the three months before your birthday month is the time to do it — and set the MNsure plan to end the day before Medicare begins. Do it in that order. Ending the MNsure plan early leaves a gap; leaving it running means two premiums, and the credit will have already stopped.

Part B costs $202.90 a month in 2026 for most people; skipping it because the MNsure plan feels fine carries a penalty of 10% for each full year you were eligible and not enrolled, for as long as you have Part B. Minnesota is one of three states that set their own Medigap plan designs instead of using the lettered plans sold elsewhere: every insurance company that sells Medigap here offers Basic, with optional riders, and Extended Basic; some also sell a few other Minnesota plan types. Premiums here are not based on age, and anyone enrolling in Part B gets a six-month window to buy a Medigap plan with no health questions, whatever their age.

If you become eligible for Medicare through disability while on a MNsure plan, the same rule applies: the tax credit ends with Medicare eligibility and Medicare becomes primary. Minnesota is one of the states where people under 65 on Medicare get the same six-month Medigap window as everyone else, which matters — in many states they do not.

One spouse on Medicare and one on MNsure is normal. The MNsure application still counts the whole household’s income, including the Medicare spouse’s Social Security, but only the younger spouse is covered by the marketplace plan. We handle both sides so the timelines line up.