Medicare Supplement Insurance (also called Medigap) helps senior and disabled Massachusetts residents pay for some Medicare out-of-pocket costs.
MA Medicare enrollment quick facts:
- Over 973,000 Massachusetts residents were enrolled in Medicare Part A and/or Part B in 2017, according to data from the Centers for Medicare and Medicaid Services (CMS)
- 292,062 Massachusetts residents had a Medigap policy in 2015, according to data from America’s Health Insurance Plans (AHIP)
- Nearly 30 percent of Medicare beneficiaries in Massachusetts were also enrolled in a Medigap plan in 2015, according to AHIP
How Medigap Plans in Massachusetts Differ From Medigap Plans in Other States
Medigap plans sold in Massachusetts work the same as Medigap plans sold in other states. However, insurance companies offer different plan options in Massachusetts than they do in most other states.
Insurance companies in most states offer up to 10 standardized Medigap plan options to Medicare beneficiaries (plans A, B, C, D, F, G, K, L, M and N). In Massachusetts, Medicare beneficiaries can choose between one of two plans: the Core Plan and the Supplement 1 Plan.
Massachusetts Plan Options
Both plans cover four basic benefits:
- Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends
- Part B coinsurance
- The first three pints of blood each year
- Part A hospice coinsurance or copayment
The chart below shows the differences between the two Medigap plans in Massachusetts. A check mark means the benefit is covered at 100 percent.
|
Core Plan |
Supplement 1 |
|
|
Basic benefits |
✔ |
✔ |
|
Part A inpatient hospital deductible |
✔ |
|
|
Part A skilled nursing facility coinsurance |
✔ |
|
|
Part B deductible |
✔ |
|
|
Foreign travel emergency |
✔ |
|
|
Inpatient mental health hospital |
60 days per calendar year |
120 days per calendar year |
|
State-mandated benefits (yearly Pap tests and mammograms. Check with your plan for additional benefits). |
✔ |
Medicare Supplement Insurance Pricing Methods
Medigap pricing methods are important because they dictate how your premiums may increase in future years. There are 3 different pricing methods:
- Attained-age rated: The premium increases as you age
- Issue-age rated: The premium is based on your age when you buy the policy and it may increase due to inflation and other factors, but not due to your age
- Community rated: The same premium is charged to all Medigap policyholders
The majority of Medigap policies issued in Massachusetts are community rated, according to the Kaiser Family Foundation (KFF).
Under-65 Enrollment Rules
Although Medicare Supplement Insurance is primarily for senior citizens, it’s also available to disabled people and those with end-stage renal disease (ESRD) in some states. Each state’s insurance department dictates the rules governing Medicare beneficiaries under the age of 65.
According to the KFF, insurance companies selling Medigap plans in Massachusetts must offer at least one Medigap plans to under-65 Medicare beneficiaries. Medigap insurers in Massachusetts must charge under-65 policyholders the same premiums as all other Medicare beneficiaries.
Learn More
To learn more about Medicare Supplement Insurance, read through the guides below.
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