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Medicare Supplement Insurance in Massachusetts

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:

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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