
Comparing Medicare Supplement Plans in Massachusetts can be a daunting task, but it doesn't have to be.
Medicare Supplement Plans in Massachusetts offer a range of benefits, including coverage for copays, coinsurance, and deductibles. Massachusetts offers 10 standardized Medicare Supplement Plans, each with its own set of benefits.
Massachusetts residents can enroll in Medicare Supplement Plans during their Initial Enrollment Period, which starts when they turn 65 and are enrolled in Medicare Part A and Part B. This six-month period is the best time to enroll in a Medicare Supplement Plan, as it ensures coverage with no health questions asked.
Plan F is the most comprehensive Medicare Supplement Plan in Massachusetts, covering 100% of Medicare-approved expenses, including copays, coinsurance, and deductibles.
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What Are Medicare Supplement Plans?
Medicare Supplement plans, also known as Medigap, help fill in the gaps left by Original Medicare. They can cover copays, coinsurance, and deductibles, but not prescription drug coverage.
In Massachusetts, Medigap plans are unique because there are only three standardized plans to choose from, making it easier to select coverage. This is in contrast to most states, where there are 10 standard plans.
Medigap plans don't cover services not covered by Original Medicare, such as routine dental care. They're designed to help with out-of-pocket costs, not provide additional coverage.
Massachusetts state law prohibits Medigap insurers from charging age-based premiums, which means beneficiaries can't be charged higher rates based on their age. This protection extends to Medicare beneficiaries who qualify due to disability instead of age.
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Eligibility and Enrollment
To be eligible for a Medicare Supplement plan in Massachusetts, you must have Original Medicare and be 65 or older, or qualify for Medicare due to a disability. You can also enroll in a Medigap plan if you're a Massachusetts resident eligible for Medicare.
Massachusetts is not one of the states that requires insurers to offer plans to under-65 Medicare beneficiaries with end-stage renal disease (ESRD). However, you may still be able to enroll in a Medigap plan if you have a guaranteed issue right.
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You can enroll in a Medigap plan during your Medigap Initial Open Enrollment, which gives you six months from when you first become Medicare eligible to join any plan, regardless of medical history. Coverage usually begins the first of the month following your application.
You can also switch or join a Medigap plan during the Mass Medigap Annual Open Enrollment period, which is a 2-month period from February 1 to March 31. New coverage usually begins on June 1st.
There are certain situations that may give you guaranteed issue rights to purchase a Medigap policy, regardless of your health conditions or any preexisting health conditions. These situations 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
Choosing a Plan
You have a bit more leeway than other Medicare beneficiaries in Massachusetts, with 2 months every year where you enjoy guaranteed issue rights. Most people enrolled in Medicare don't get that.
Consider the following factors as you compare Medicare Supplement Insurance plans available in your area: monthly premium, benefits, insurance provider, and extra discounts. Look at ratings and past experience with the carrier you are considering, and contact a company representative to get an idea of their customer service and responsiveness.
Here are some key benefits to consider: Part A coinsurance and hospital costs up to an additional 365 days, Part B coinsurance or copayment, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and Part A deductible.
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Under 65
If you're under 65 and qualify for Medicare in Massachusetts, you're in luck - you can enroll in Medigap as long as you're first enrolled in Medicare Part A and Part B.
Medigap insurers in Massachusetts can't refuse to sell you a policy, exclude or limit coverage, or make you wait before coverage starts due to existing health problems.
There's one big exception: if you're under 65 and eligible for Medicare solely because of End-Stage Renal Disease (ESRD), you're not eligible for Medigap.
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Choosing a Plan
You have 2 months every year where you enjoy guaranteed issue rights when choosing a Massachusetts Medigap plan. This is a bit more leeway than other Medicare beneficiaries have.
Medigap premiums vary according to the insurance provider you choose, but since Massachusetts forbids age-based pricing methods, all plans are community rated. This means your rates will not go up due to age, although they may rise due to inflation.
To compare Medicare Supplement Insurance plans, consider the following factors: monthly premium, benefits, insurance provider, and extra discounts. You pay the monthly premium in addition to your Part B monthly premium, so it affects your monthly cash flow.
Most people enrolled in Medicare don't get guaranteed issue rights, but you do in Massachusetts. This means you can enroll in a Medigap plan at any time, regardless of your health status.
The government decides what benefits each plan offers, so coverage remains the same across all companies. For example, the basic benefits you'll receive if you purchase Medicare Supplement Plan G from Cigna Healthcare are the exact same basic benefits you'll receive if you purchase a Medicare Supplement Plan G from a different insurance company.
You can choose from a Medicare Core or Medicare Supplement 1A Plan in Massachusetts. These plans offer different benefits, such as Part A deductible coverage and skilled nursing facility fee coverage.
Here's a summary of the benefits offered by each plan:
*Medicare Supplement 1 is ONLY available to those who qualified for Medicare prior to January 1, 2020.
Plan Details
In Massachusetts, you have 2 months every year where you enjoy guaranteed issue rights, giving you more leeway when choosing a Medigap plan.
Medigap premiums in Massachusetts are community rated, meaning your rates won't go up due to age, although they may rise due to inflation.
You'll pay a monthly premium in addition to your Part B monthly premium, affecting your monthly cash flow. This premium amount is determined based on the type of plan you get, your age, gender, tobacco use, and state of residence.
All Medigap plans in Massachusetts offer basic coverage for Part A copays and coinsurance, at least a portion of Part B copays and coinsurance, three pints of blood, and hospice care.
The type of plan you choose will determine the benefits you receive, so it's essential to check which benefits are most important to you. Some plans may not include all benefits, so make sure to review the plan details carefully.
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Here's a breakdown of the 10 standardized Medigap plans, which are regulated by federal and state governments:
Note that some plans and insurers offer added perks or discounts once you become a member, such as discounted hearing aid providers or eyeglass suppliers.
Cost and Discounts
In Massachusetts, you can save money on your Medicare Supplement Plan by enrolling when you're first eligible. You may be eligible to receive a discount for the first 3 years.
There are several discounts available, including a 15% monthly discount for being the first eligible for Medicare, and a $2 monthly discount for autopay.
Additionally, you may be eligible for a Massachusetts Medigap Household discount, which can save you up to 5% a month. If you live with a roommate who also qualifies, you may receive a discount of 5% to 12% off each.
The cost of Medigap policies in Massachusetts varies depending on the insurer and how your premium is rated. You can expect to pay between $114 and $320 a month for a Medicare Core or Medicare Supplement 1A Plan.
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Here are the three ways Medigap policies can be rated:
- Community rated (or no age-rated): Your premium isn’t based on your age.
- Issue-age rated (or entry age-rated): Your premium is based on your age when you buy the policy.
- Attained-age-rated: Your premium is based on your age and can increase as you grow older.
Resources
If you're looking for guidance on Medicare options in Massachusetts, there are several organizations you can turn to. The state's Area Agencies on Aging (AAAs), local public health agencies, and nonprofit groups offer a wealth of information and resources.
The Central Massachusetts Agency on Aging is one such organization, providing information and resources to the 61 cities and towns in the state's center. They also administer programs to help seniors maintain their health and independence.
The Massachusetts Division on Insurance protects consumers by ensuring insurers adhere to regulations, and monitoring factors like licensure, rates, and reviews. This includes the SHINE program, which offers free, unbiased Medicare guidance.
The Massachusetts Department of Human Services provides health benefits for qualifying individuals, along with other resources. You can contact them at (800) 841-2900 for more information.
If you qualify, the MassHealth Buy-In program can help you pay for Medicare expenses and save on out-of-pocket costs like Medicare Advantage premiums.
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Frequently Asked Questions
What is the best medicare supplemental plan?
The best Medicare supplemental plan depends on your specific needs, but top options include Humana for extra benefits, State Farm for straightforward coverage, AARP by UnitedHealthcare for extensive medical care, and Blue Cross Blue Shield for a range of Medigap plans. Consider your priorities to choose the best fit for you.
What is the downside to Medicare supplement plans?
Medicare supplement plans come with some downsides, including high premiums and limited coverage for services like dental care, vision care, and long-term care
What are the four most common Medigap plans?
The four most common Medigap plans are Plan A, Plan G, Plan N, and Plan B. These plans are popular among Medicare beneficiaries due to their comprehensive coverage and affordable premiums.
Is Medicare Plan G offered in Massachusetts?
Medicare Plan G is not offered in Massachusetts, where Medigap plans are unique and differ from the standard plans available in other states
What Medigap plan is most popular?
Plan G is the most popular Medigap policy, covering nearly 5.3 million people in 2023. It accounts for 39% of all policyholders, making it a widely chosen option.
Sources
- https://clearmatchmedicare.com/medicare-supplement/massachusetts
- https://www.senior65.com/medicare/article/how-do-medigap-plans-work-in-massachusetts
- https://www.medicareplans.com/medicare-supplement-plans-massachusetts/
- https://www.cigna.com/medicare/shop-plans/supplemental/compare-plans
- https://seniorbenefitclient.com/medicare-supplement-plans-by-state/
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