Home > Medicare Supplement Plans in Massachusetts

Medicare Supplement Plans in Massachusetts

Fact Checked
Jump to section:

What Are Medigap Plans?

Medigap plans are Medicare Supplement Insurance offered by Medicare-approved private insurance companies to help cover cost sharing requirements of Original Medicare Parts A and B.

While Medicare pays for a large percentage of the health care services and supplies you may need, you are still responsible for a portion of the costs in the form of deductibles, copays, and coinsurance. Medigap policies help with these costs and sometimes offer more coverage for excess charges and foreign travel health emergencies.

Medigap plans are standardized by Medicare and regulated by state laws and insurance commissioners. You pay a monthly premium for Medigap. Costs and availability of Medigap plans vary depending on several factors including your age and gender, the insurer, and your state of residence. Learn about Medigap in Massachusetts so you can determine which plan best meets your needs.

  • Massachusetts offers different Medigap plans than other states, where Plans F and G are the most popular and comprehensive. In Massachusetts, you can choose from a Medigap Core Plan, Medigap Supplement 1 Plan, or Medigap Supplement 1A Plan. The most comprehensive is Medigap Supplement 1A and the Supplement 1 Plan is no longer available if you turned 65 after January 2020.
  • Monthly premiums for the Medigap Supplement 1A Plan for a 65-year-old female who doesn’t use tobacco ranges from $166 to $320.

Medicare Supplement Plans in Massachusetts

Compare ratings of some of Massachusetts’ Medigap providers:
Insurance company A.M. Best rating NAIC complaint index BBB rating Consumer Affairs
Blue Cross Blue Shield A Above average F 1.2/5
Humana A- Above average A+ 2.3/5
UnitedHealthcare A- Below average A+ 2.1/5

What Medicare Supplement Plans Cover

Medigap policies serve as your secondary source of insurance after Medicare pays. Medigap fills in the “gaps” between what Medicare pays for covered services and what you are charged. Some plans offer extended coverage for Part B excess charges and foreign travel emergency costs.

There are 10 standardized Medigap plans that are regulated by federal and state governments. Two of the 10 plans (F and G) are the most comprehensive plans and also offer high-deductible versions. All plans are not available in all states.

Medigap policies may include the following benefits:

  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
  • Part B coinsurance or copayment
  • The first three pints of blood
  • Part A hospice care coinsurance or copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible (only certain plans for people eligible for Medicare before January 1, 2020)
  • Part B excess charges
  • Foreign travel emergency services
  • Out-of-pocket limits

Do You Need a Medicare Supplement in Massachusetts?

Should you consider a Medicare supplement?
Yes, if you:
  • Rely on Original Medicare for your health care coverage. There is no cap on what you may pay for Part A and Part B services, so if you need much healthcare, your out-of-pocket costs for deductibles, copays, and coinsurances may be high and unpredictable. A Medigap plan offsets your portion of costs.
  • Want freedom of choice of providers because you can see any Medicare provider in the U.S.
  • Travel abroad and want coverage for emergency care.
  • Anticipate the need for frequent healthcare now or in the future.
  • Are in your initial open enrollment period and are guaranteed the opportunity to join a plan regardless of your health condition.
  • Can afford the monthly premiums
  • Don’t want a Medicare Advantage Plan
 No, if you:
  • Want a Medicare Advantage Plan with zero or low monthly premiums
  • Don’t mind following the rules and restrictions of a Medicare Advantage Plan to get your healthcare services and drugs.
  • Don’t want to purchase a standalone Part D prescription drug plan
  • Missed your open enrollment period, and the policy you want is not available or the premium cost is too high.
  • Have Medicaid which will pay for most of your out-of-pocket expenses for Medicare
  • Don’t anticipate the need for frequent healthcare now or in the future
  • Have other creditable coverage and don’t need Medicare Part B yet. When you sign up for Part B, your Medigap six-month open enrollment period will start

What Medigap Plans Cost in Massachusetts

Expect to pay $114 to $320 for a Medicare Core or Medicare Supplement 1A Plan in Massachusetts.. Premiums will vary depending on your insurer and how your premium is rated.

Medigap policies can be rated in three ways:

  • Community rated (or no age-rated): Your premium isn’t based on your age and may only increase due to inflation or other factors. Everyone, regardless of age, is charged the same premium.
  • Issue-age rated (or entry age-rated): Your premium is based on your age when you buy the policy and won’t increase as you grow older. Your premium may only increase due to inflation or other factors.
  • Attained-age-rated: Your premium is based on your age and can increase as you grow older and due to inflation and other factors.

Medigap vs. Medicare Advantage Plans

Medigap and Medicare Advantage Plans are very different. You are eligible for either type of plan when you are enrolled in Medicare Part A and B, but you cannot have both at the same time. Both Medigap and Medicare Advantage Plans are offered by Medicare-approved private insurance companies. You can only choose to join plans that are available in your area.

Compare your options:

Plan type Medigap Medicare Advantage
What it is Medigap is insurance designed to supplement Original Medicare and helps cover your out-of-pocket expenses, like deductibles, copays, and coinsurance you incur when you access your Medicare services. You pay a monthly premium for Medigap. Medigap plans are standardized across the U.S. Benefits, costs, and availability of plans vary depending on your age, gender, tobacco use, and state of residence. Medicare Advantage Plans, on the other hand, are an alternative way to receive your Medicare benefits. These plans must offer all the services Original Medicare does, and frequently add on prescription drug coverage and other services, such as hearing, vision, and dental.
What it covers Covers:
  • Coinsurance
  • Copayments
  • Deductibles
  • Excess Part B charges (some plans)
  • Foreign travel emergency costs (some plans)
 Covers:
  • All Original Medicare services (Part A hospital and Part B medical insurance)
  • Often, Part D prescription drug coverage
  • May offer additional services, including dental, vision, and auditory care
What it works with
  • Original Medicare
  • Part D prescription drug coverage
  • Replaces Original Medicare
  • Network of providers determined by insurer
  • Cannot typically buy separate Part D prescription drug coverage
When it’s best If you frequently access your Part A and B benefits, want your out-of-pocket expenses covered, and want to choose your providers. If you want all of your health and drug coverage through one plan, want extra benefits, and are willing to follow your plan’s rules and network restrictions.

Types of Medigap Plans in Massachusetts

Massachusetts does not offer standardized Medigap plans. Instead, you can choose from a Medicare Core or Medicare Supplement 1A Plan.

Medicare Core
  • Does not include Part B premium
  • Generally a $0 cost for approved Part B services
  • Does not include skilled nursing facility, Part A deductible, Part B excess charges, or foreign travel emergency
 Medigap Supplement 1 Plan
  • Not available to anyone who turned 65 after January 2020
  • Includes skilled nursing facility, Part A deductible, Part B deductible, Part B excess charges, and foreign travel emergency
Medicare Supplement 1A
  • This is the plan replacing Supplement A for those who turned 65 after January 1, 2020.
  • It includes all of the same benefits except for the Part B deductible.
  • It does not include the Standard Part B premium.

Compare Medicare Supplement Options

Medigap Benefits Plan A Plan B Plan C Plan D Plan F* Plan G* Plan
K		 Plan
L		 Plan M Plan N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes***
Blood (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Part A hospice care coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled nursing facility care coinsurance No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess charge No No No No Yes Yes No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A $6,620 in 2022 $3,310 in 2022 N/A N/A

* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of$2,490 in 2022 before your policy pays anything. (Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020.)

** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.

What’s the most popular Massachusetts Medigap plan in 2023?

Nearly all Medigap users have plans that are waivered under the state’s unique rules. It also has strong consumer protections in place for planholders, including a requirement to use community ratings.

When to Sign Up for Medicare Supplement Plans in Massachusetts

In general, you will get the best price for Medicare Supplement Insurance if you purchase a plan as soon as you are eligible for Medicare and enrolled in Parts A and B.

Medigap Open Enrollment starts on the first day of the month that you turn 65 and are enrolled in both Parts A and B and lasts for six months. An insurance company is not allowed to use medical underwriting to decide whether to accept your application or change the price during this time.

To enroll in a Medigap Plan, contact the insurance company to make sure you are in your open enrollment period or have guaranteed issue rights. Complete the application and determine when you want your policy to start.

There are certain situations which may give you guaranteed issue rights to purchase a Medigap policy, regardless of your health conditions or any preexisting health conditions.

These include:

  • Moving out of the coverage area while in a Medicare Advantage Plan or Medicare SELECT Plan
  • Your existing Medicare Advantage Plan leaving Medicare coverage
  • Your other insurance plan outside of Medicare is ending
  • You are within your trial right period
  • Your plan coverage ends through no fault of your own

How to Choose a Medigap Plan in Massachusetts

Consider these factors as you compare Medicare Supplement Insurance plans available in your area:

Monthly premium This is in addition to your Part B monthly premium, so it affects your monthly cash flow. You pay whether or not you access your benefits. Your premium amount is determined based on the type of plan you get, your age, gender, tobacco use, and state of residence.
Benefits Basic coverage for Part A copays and coinsurance and at least a portion of Part B copays and coinsurance, three pints of blood, and hospice care are offered with every type of plan. Other benefits may not be included, so check to see which benefits are most important to you.
Insurance provider Look at ratings and past experience, either your own or other consumers, with the carrier you are considering. Contact a company representative to get an idea of their customer service and responsiveness.
Extra discounts Some plans and insurers offer added perks or discounts once you become a member. You may have access to discounted hearing aid providers or eyeglass suppliers, for instance.

Medicare Supplement Resources in Massachusetts

Learning about your Medicare options is important. Seniors and their caregivers have a number of Massachusetts organizations that they can turn to if they need guidance including the state’s Area Agencies on Aging (AAAs), local public health agencies, and nonprofit groups. These organizations also offer a variety of services and programs aimed at promoting a high quality of life for aging residents.

Central Massachusetts Agency on Aging  Contact information: Website | Central Massachusetts Agency on Aging The Central Massachusetts Agency on Aging offers information and resources in the 61 cities and towns in the state’s center. They also administer programs designed to help seniors 60 and older maintain their health and independence, including resources to guide you through the Medicare enrollment process, and the counselors will help you understand the available benefits fully.
Massachusetts Division on Insurance Contact information: Website | (617) 521-7794 The state’s Division of Insurance protects consumers by ensuring that insurers adhere to regulations, and monitoring factors like licensure, rates, and reviews. The division also administers the SHINE program that offers free, unbiased Medicare guidance.
Massachusetts Department of Human Services Contact information: Website | (800) 841-2900 The state’s Department of Human Services provides health benefits for qualifying individuals along with other resources.
MassHealth Buy-In Contact information: Website | (800) 841-2900 This state program can help you pay for Medicare expenses if you qualify. You could also save on out-of-pocket costs like Medicare Advantage premiums.

 

Kelly Blackwell - Small Profile Image
Kelly Blackwell
Certified Senior Advisor (CSA)®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Kelly Blackwell - Small Profile Image
Kelly Blackwell
Certified Senior Advisor (CSA)®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Learn More From Our Sources