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Massachusetts Medicare Supplement Plans


Medigap plans in Massachusetts are not your typical standardized Medicare Supplement plans. In 47 of 50 states, Medicare standardizes 12 lettered Medicare Supplement (Medigap) plans. However, Massachusetts is one of the three states with a slightly different approach to Medicare Supplement coverage.

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Original Medicare (Part A and Part B) does not cover services 100%, and most people don’t want to pay thousands of dollars in coinsurance each year. So, the best way to ensure protection is to enroll in a Medicare Supplement plan.

Like the options throughout the rest of the country, Medigap plans in Massachusetts don’t involve networks or referrals, so you can use your plan’s coverage at any Original Medicare-accepting doctor or hospital nationwide. The names of the plans available in Massachusetts are the CORE Plan, Supplement1, and Supplement1A Plan.

Massachusetts Medicare Supplement Plans in 2023

Medicare Supplement plans in Massachusetts look a little different than the typical Medicare Supplement plan options. However, the Medigap plans in Massachusetts still must follow federal and state regulations regarding Medicare supplemental coverage.

There are three Medicare Supplement plans available in Massachusetts:

  1. CORE Plan
  2. Supplement 1 Plan
  3. Supplement1A Plan
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Medicare Supplement CORE Plan

Coverage from the CORE plan includes the Medicare Part A hospital coinsurance and extends 365 days beyond what Medicare provides.

The CORE Plan also covers Medicare Part B coinsurance. Each calendar year, coverage includes your first three pints of blood as well as 60 days of inpatient care at a mental health hospital.

The CORE policy offers basic benefits, much like Medicare Supplement Plan A.

Medicare Supplement 1 Plan

Massachusetts’s Supplement 1 Plan includes everything the CORE Plan offers, plus more. The Supplement1 Plan covers the Medicare Part A deductible and the skilled nursing facility coinsurance. It also covers the Medicare Part B deductible and coinsurance with 120 days of inpatient care at a mental health hospital.

Additionally, the Supplement 1 Plan has the benefit of emergency foreign travel care.

The Supplement 1 Plan is considered first-dollar coverage. Beneficiaries with this plan will pay little to no out-of-pocket costs. This plan is very comparable to Medicare Supplement Plan F.

Due to MACRA, this plan will no longer be available to those new to Medicare.

Medicare Supplement 1A Plan

The new Supplement 1A Plan is equivalent to the standard Medigap Plan G. It will cover everything Supplement 1 covers, minus the Part B deductible.

This means once you meet your deductible, the Supplement 1A plan will cover 100% of your medical costs after Original Medicare pays its portion.

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Medicare Supplement Benefits CORE Plan Supplement 1 Plan Supplement 1A Plan
Basic Benefit (Medicare Part B coinsurance)
Medicare Part A inpatient hospital deductible  
Medicare Part A skilled nursing facility (SNF) coinsurance  
Medicare Part B deductible    
Foreign travel emergency  
Inpatient days in mental hospital 60 days per calendar year 120 days per benefit year 120 days per benefit year
Other Massachusetts mandated benefits
*Massachusetts cannot permit a Medicare Part B deductible rider to be issued to those who are newly eligible for Medicare on or after January 1, 2020, per MACRA. However, a Medicare Part B rider can be offered or renewed for those first eligible for Medicare prior to January 1, 2020.
*Supplement 1 Plan is unavailable to those newly eligible for Medicare on or after January 1, 2020.

The best time to enroll in a Medigap plan in Massachusetts is during your six-month Open Enrollment Period. This enrollment period begins on the first day of the month you enroll in Medicare Part B. During this time, you can enroll in any Medicare Supplement plan of your choice. There are no enrollment restrictions based on pre-existing health conditions.

Failing to enroll in coverage during this time can result in higher premiums or even denial of coverage due to medical issues.

How Much Do Medigap Plans in Massachusetts Cost?

The monthly premium for your Medicare Supplement plan depends on several factors. The rating method your state uses is one of the biggest determinants of your monthly premium price. Massachusetts state law requires insurance companies to use the community rating method for their Medigap policies. This means all members pay the same premium regardless of health or age.

Depending on your ZIP Code, the monthly premium for the CORE plan can be as low as $90 and the Supplement1 Plan can be as high as $350 or more per month, depending on the company you choose. Also, if you buy an additional rider, like dental coverage, you will pay more. The cost for which you are responsible depends on the plan and carrier in which you enroll.

Female, No Tobacco, Massachusetts ZIP Code 02110
Medigap Plan Monthly Premium Age 65 Monthly Premium Age 75
Medicare Supplement Plan F $206-$330* $206-$330*
Medicare Supplement Plan G $114-$204 $114-$204
Medicare Supplement Plan N $166-$320 $166-$320
Male, No Tobacco, Massachusetts ZIP Code 02110
Medigap Plan Monthly Premium Age 65 Monthly Premium Age 75
Medicare Supplement Plan F $206-$330* $206-$330*
Medicare Supplement Plan G $114-$204 $114-$204
Medicare Supplement Plan N $166-$320 $166-$320

* If on Medicare before 01/01/2020

Medicare Supplement Eligibility Under 65 in Massachusetts

Federal law does not require carriers to offer Medicare Supplement plans to Medicare beneficiaries under age 65. However, Massachusetts law requires insurers to offer at least one Medigap option to those under 65 and on Medicare due to disability.

Generally, the plan available to those under 65 is the basic benefit CORE plan option. Some may find that while under age 65, it is more cost-effective to enroll in a Medicare Advantage plan until they age into Medicare.

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How to Apply for Medicare Supplement in Massachusetts

Applying for Medicare Supplement plans in Massachusetts is simple and can be done over the phone. When you consult our team of licensed agents with industry knowledge, you become educated on your options.

Call us today at the number above or fill out an online rate form to see the rates for Medigap plans in Massachusetts available to you now!

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Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. Medigap in Massachusetts, Medicare. Accessed February 2022.
    https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies/medigap-in-massachusetts
  2. Medicare Supplement Plans Offered in Massachusetts 2021, Mass.gov. Accessed February 2022.
    https://www.mass.gov/doc/medigap-guide-effective-010121/download
  3. Massachusetts Bulletin for People with Medicare, Mass.gov. . Accessed February 2022.
    https://www.mass.gov/doc/addendum2003pdf/download

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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