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Massachusetts Medicare Plans

Massachusetts Medicare Plans do not limit out-of-pocket costs unless they are paired with a Medicare Supplement. In all but three states Medicare Supplements, also known as Medigap plans, are standardized under federal law. Massachusetts is one of those three. 

As such, there are only two plans to choose from and they are not standardized from insurer to insurer. However, state law provides consumer protection such as the rule that premiums cannot vary based on age and another that prohibits pre-existing condition waiting periods.

Massachusetts Medicare plans open enrollment

Medicare beneficiaries in Maryland are eligible for Medicare at age 65. Initial enrollment begins three months before your birth month and lasts three months after. During initial enrollment, you can also apply for Medicare Supplements. 

Although you can enroll in a supplement at any time, initial enrollment is the best time to do so because you cannot be turned down due to your health. 

In Massachusetts, there is another Medigap guaranteed-issue, open enrollment period  that spans from February 1 to March 31.

Medigap Plans

Medicare Supplements in Massachusetts cover some of the deductibles and coinsurance left over by Original Medicare. However, unlike other states, Massachusetts doesn’t use standard Medigap plan terminology.

Residents can get a Core plan, a Supplement 1 plan, or a Supplement 1A plan.

Core plans: include some basic benefits and some state-mandated benefits, including:

    • Part A hospital coinsurance — for inpatient hospital care
    • Part B coinsurance
    • First 3 pints of blood every calendar year
    • Up to 60 days of inpatient care in mental health facilities
    • An additional 365 days of inpatient medical care — once Medicare’s coverage ends

Supplement 1 plans include all the benefits of Core plans, plus:

    • Medicare Part A coinsurance — for skilled nursing facility stays
    • All state-mandated benefits
    • Part A inpatient hospital deductible
    • Part B medical deductible
    • Up to 120 days of inpatient stays in mental health facilities
    • Emergency medical care outside the country

Supplement 1A plans include all of the benefits of Supplement 1 plan — minus the Medicare Part B deductible.

People eligible for Medicare before 2020 may buy any of these three Medicare Supplement plans in Massachusetts. For residents who are first eligible in 2020 or later, the Core plan and Supplement 1A are available options — since they don’t cover Medicare Part B deductibles.

For many folks, the best time to buy a Medigap plan in Massachusetts is during the Medigap Open Enrollment Period. Should you need help, just give us a call, and we’ll shop your coverage for you.

Medicare Advantage plans

Massachusetts has up to 44 Medicare Advantage plans available, depending on what county you live in. Also known as Medicare Part C plans, Medicare Advantage is a private Medicare plan that provides all Original Medicare benefits but also include extra benefits like dental, prescription drugs, and vision coverage.

Medicare Part D

While Original Medicare and Medicare Supplement plans don’t offer coverage for prescription drugs, there is an option to enroll in Medicare Part D. There are 26 Part D plans available in Massachusetts in 2019. If you don’t want to pay out-of-pocket for your prescriptions, be sure to look into Medicare Advantage or a standalone Part D plan.

How we can help

Our licensed Massachusetts Medicare Plans specialists are available to help you at absolutely no charge to you. We pride ourselves on assisting you finding you a plan that fits your needs. Because Medicare Supplement plans are not standardized in Massachusetts, you’ll need to be sure you are getting the best price and proper coverage. We will shop your policy for you for free. 

Let us help so you can feel comfortable knowing you’re getting the best value for your healthcare coverage.

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