Medicare Supplement Plans in Massachusetts
This article was updated on: 10/09/2018
When you’re on Medicare in Massachusetts, you might be eligible for a Medicare Supplement plan in Massachusetts. This might help your peace of mind if you have high out-of-pocket costs Medicare doesn’t cover. Medicare Part A and Part B deductibles, coinsurance, copayments… these are the kinds of costs we’re talking about here. Be aware, though, that your plan might not cover deductibles – it depends on the type of plan you buy.
Medicare Supplement plans are also known as Medigap plans.
How do Medicare Supplement plans in Massachusetts work?
In general, Medicare Supplement plans in Massachusetts – and all states – work alongside your Original Medicare (Part A and Part B) coverage to help pay for certain out-of-pocket expenses. Available from private insurance companies, Medicare Supplement plans are standardized into 10 plans in most states. Massachusetts, Wisconsin, and Minnesota have their own standardized plans.
Massachusetts doesn’t have the 10 standardized, lettered Medicare Supplement plans available in most states. There are just two different Medicare Supplement plans in Massachusetts. They typically cover certain basic benefits. One offers more coverage than the other. You pay a premium for either type of plan.
What do Medicare Supplement plans in Massachusetts cover?
There are two Medicare Supplement plans in Massachusetts: the Core Plan and Supplement 1. Here’s a list of what benefits they may cover.
|Benefit||Core Plan||Supplement 1|
|Hospital coinsurance and approved costs for up to 365 days after Medicare Part A coverage is used up||Yes||Yes|
|Medicare Part B coinsurance (usually 20% of Medicare-approved cost)||Yes||Yes|
|Hospice coinsurance or copayments (Part A)||Yes||Yes|
|First three pints of blood per year||Yes||Yes|
|Benefits required by the state, such as annual Pap tests and mammograms||Yes||Yes|
|Inpatient days per year in a mental health hospital||Yes (60 days)||Yes (120 days)|
|Part A deductible||No||Yes|
|Part B deductible||No||Yes|
|Part A skilled nursing facility coinsurance||No||Yes|
|Limited emergency care during foreign travel||No||Yes|
Why would I want to buy a Medicare Supplement plan in Massachusetts?
People may have different reasons for buying Medicare Supplement plans in Massachusetts. Here are a couple of possible reasons you might want to think about:
Choice of doctors – You don’t have to get your care from providers in a plan network. You can see any doctor or specialist who accepts Medicare assignment. So, if you have a favorite doctor or specialist, your Medicare Supplement plan in Massachusetts will generally pay your coinsurance under Part B (assuming she or he accepts Medicare assignment).
Portability – Your Medicare Supplement plan will generally cover your Original Medicare out-of-pocket costs the same way whether you’re in Massachusetts, or out of state. So, for example, if you like to go to Florida for the winter, you may be covered. Supplement 1 may even cover certain emergency medical care when you’re out of the country.
Guaranteed renewal – Your Medicare Supplement plan in Massachusetts can’t drop you as a member, unless you fail to pay your premiums; you knowingly gave false information on your application; or the plan goes bankrupt.
Can I buy a Medicare Supplement plan in Massachusetts if I’m under 65?
If you’re eligible for Medicare before age 65 (due to a disability), you might be able to buy a Medicare Supplement plan in Massachusetts. For more information, contact the state Division of Insurance at (617) 521-7794 Monday through Friday, 8:45 am-5:00 pm ET.
When can I buy a Medicare Supplement plan in Massachusetts?
If you want to make sure you’re accepted into a Medicare Supplement plan in Massachusetts, you may want to buy a plan during your Medicare Supplement Open Enrollment Period (OEP). This period begins the first month that you’re age 65 or older and enrolled in Medicare Part B. It lasts six months.
During your OEP, an insurance company cannot charge you a higher premium if you have a health condition and must accept you as a plan member.
If your OEP is over, you can still apply for a Medicare Supplement plan in Massachusetts. For specific rules about whether the plan has to accept you or other details, please contact the Massachusetts Department of Insurance (contact information above).
Want to check out Medicare Supplement plans in Massachusetts right now? Just use the Find Plans button on this page. To set up a phone call with me or have me email you customized information, use the links below.
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