Plans · Minnesota’s third path
Medicare Cost plans in Minnesota: where they remain and who they fit
Almost extinct nationally, Medicare Cost plans are still sold in 21 Minnesota counties. A local network at home, Original Medicare everywhere else, and the freedom to join or leave any month of the year.
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Before 2019, Medicare Cost plans covered more Minnesotans than Medicare Advantage did, and most of the state never had to learn the difference. Then a federal rule retired Cost plans in every county with at least two competing Advantage plans, and roughly 300,000 Minnesotans had to choose something else. The plans survived where competition was thin — the north woods, the Arrowhead, a band of southwestern prairie counties — and they are still there.
How a Cost plan works
- At home, you use the plan’s network, with plan copays, much like an HMO.
- Outside the network, Original Medicare pays as if you had no plan at all. Care in Rochester, Fargo, Arizona or Florida is covered the way Original Medicare covers it — you owe Medicare’s deductibles and coinsurance, not a denial.
- Drug coverage can be built into the plan or bought as a standalone Part D plan; if you buy it separately, it does not have to come from the same company.
- Enrollment is continuous. You can join whenever the plan is accepting new members and leave any time by switching to Original Medicare, which makes a Cost plan easier to test-drive than an Advantage plan.
- Some Cost plans are sold with a supplement-like layer that covers Original Medicare’s cost-sharing when you go out of network. Ask what happens to the Part A deductible out of area — that is the question that separates the designs.
The 2026 county list
According to Minnesota Aging Pathways, the state’s official Medicare counseling program, and the Minnesota Department of Commerce’s annual Cost plan guide, Cost plans are offered for 2026 in these 21 counties:
- Aitkin
- Carlton
- Cook
- Goodhue
- Itasca
- Kanabec
- Koochiching
- Lake
- Le Sueur
- McLeod
- Meeker
- Mille Lacs
- Pine
- Pipestone
- Rice
- Rock
- St. Louis
- Sibley
- Stevens
- Traverse
- Yellow Medicine
The list has been stable since 2019 but is re-published each fall, and a carrier can add or drop a county. Check the current guide, or ask us, before you count on it.
Cost plan vs Medicare Advantage vs a Minnesota supplement
| Cost plan | Medicare Advantage | Basic / Extended Basic supplement | |
|---|---|---|---|
| Care at home | Plan network, plan copays | Plan network, plan copays | Any provider that accepts Medicare |
| Care out of area | Original Medicare pays; you owe its cost-sharing | Emergencies only on most plans | Fully covered anywhere in the U.S. |
| When you can join or leave | Any month the plan is open | Enrollment periods only | Guaranteed during set windows; underwritten otherwise |
| Drug coverage | Built in or add Part D | Usually built in | Add a Part D plan |
| Where sold | 21 counties | Varies by county, changing yearly | Statewide |
Why Minnesota snowbirds keep asking about Cost plans. A Cost plan is the only network plan that follows you to Arizona through Original Medicare. If your county is on the list and you winter away, it belongs in the comparison — alongside a supplement, which covers even more out of state. Our snowbird guide lays the three side by side.
Who a Cost plan tends to suit
People in a Cost-plan county who like a local network and low premiums but travel, split the year between states, or get specialty care in Rochester or the metro; and people who want the option of leaving mid-year without waiting for October. People who never leave their county and want the richest extras may prefer an Advantage plan; people who want no network question at all may prefer a supplement.
Good to know
Frequently asked questions
Are Medicare Cost plans still available in Minnesota?
Yes, in 21 counties for 2026: Aitkin, Carlton, Cook, Goodhue, Itasca, Kanabec, Koochiching, Lake, Le Sueur, McLeod, Meeker, Mille Lacs, Pine, Pipestone, Rice, Rock, St. Louis, Sibley, Stevens, Traverse and Yellow Medicine, per the Minnesota Department of Commerce. They ended in the Twin Cities metro and most other counties in 2019.
Who sells Medicare Cost plans in Minnesota?
Blue Cross Blue Shield of Minnesota and Medica. The Minnesota Department of Commerce publishes each company’s Cost plan premiums by county every year.
What is the difference between a Cost plan and Medicare Advantage?
Both use a network at home. Outside the network, a Cost plan falls back on Original Medicare so your care is still covered (with Medicare’s cost-sharing), while most Advantage plans cover only emergencies. Cost plans also let you enroll or leave any month; Advantage plans are tied to enrollment periods.
Can I join a Cost plan outside the Annual Election Period?
Yes. Cost plans accept enrollment any month they are open to new members, and you can leave any time by returning to Original Medicare. If the plan includes Part D, the drug portion follows Part D’s enrollment rules.
Ready when you are
In a Cost-plan county? Let’s compare all three paths.
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Sources we used on this page
- Minnesota Aging Pathways: Medicare 101 (the 21 Cost plan counties)
- Minnesota Department of Commerce: 2026 Medicare Cost plan premium guide (PDF)
- Medicare.gov: Other Medicare health plans (Medicare Cost plans)
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025)
Figures are checked against the source at the review date in the byline below. If a source has changed since, the source wins.
Written and reviewed by Darin Weidauer — licensed insurance agent (NPN 18580338), Gerontologist (USC Leonard Davis School of Gerontology), MBA, Registered Social Security Analyst, and 22-year U.S. Air Force veteran.Last reviewed September 3, 2026. Plan availability, benefits and costs change every plan year — verify current details at Medicare.gov, 1-800-MEDICARE, or Minnesota Aging Pathways at 800-333-2433.