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How Do Massachusetts Medicare Supplement Plans Work?

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How Do Massachusetts Medicare Supplement Plans Work?

The CheckUp Team at HealthCare.com
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Updated: March 4, 2019    Published: March 4, 2019

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If you’re considering a Medicare Supplement plan in Massachusetts, then you’ll have a choice between two simplified Medicare Supplement options. In most states, Medicare enrollees are faced with a choice of ten different Medicare Supplement plans, all of which provide different levels of coverage. Massachusetts is one of three states that takes a different approach.

Two Types of Medicare Supplement Plans in Massachusetts

There are two Medicare Supplement plans available to Massachusetts residents: Core and Supplement 1. These plans are similar to the most popular nationally-available plans.

MA Medicare Supplement Core

Core is the more basic of the two Massachusetts Medicare Supplement plans. It covers the following benefits:

  • Medicare Part A coinsurance for inpatient hospital care.
    • Your Core plan will pay $341 per day for days 61-90 of each benefit period, and $682 per day for days 91-150.
    • The plan will also cover the full cost of an additional 365 days of inpatient hospital care if your Original Medicare benefit has been exhausted.
  • Medicare Part A coinsurance or copayment for hospice care.
  • Medicare Part A’s first 3 pints of blood per year (the rest is already covered).
  • Medicare Part B coinsurance.
    • Your out-of-pocket coinsurance without a Massachusetts Medicare Supplement would generally be 20 percent of a medical bill.
  • 60 inpatient days per calendar year in a mental health facility if needed, in addition to the 190 days covered by Medicare Part A,
  • State-mandated benefits such as yearly pap tests and mammograms.

The Core plan is the less expensive option for Massachusetts Medicare Supplement plans. Monthly premiums for any plan will vary depending on your insurance company. In 2019, we found that Medicare Supplement Core plans had monthly premiums ranging from $98 to $183.

MA Medicare Supplement 1

Supplement 1 is more comprehensive than the Core plan. It covers all of the same benefits as Core, plus:

  • Medicare Part A inpatient hospital deductible for days 1-60 of each benefit period, up to $1,364.
  • Medicare Part A skilled nursing facility coinsurance.
    • Supplement 1 will cover $170.50 per day for days 21-100 in 2019.
  • Medicare Part B deductible ($185 per year in 2019).
  • Coverage for medical emergencies while traveling overseas.
  • 120 inpatient days in a mental health facility if needed, in addition to the 190 days covered by Medicare Part A.

Given that the Supplement 1 plan covers more, it also is more expensive. Based on our research, in 2019 monthly premiums for Supplement 1 plans range from $197 to about $285.

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How Do Massachusetts Medicare Supplement Plans Compare to Plans Offered in Other States?

Massachusetts Medicare Supplement plans serve the same purpose as plans available in other states. They provide people with Medicare with comprehensive protection from out-of-pocket Original Medicare costs.

And Massachusetts Medicare Supplement plans work nationwide, so you’re still covered if you travel out of state. Just like the plans sold in other states, Massachusetts Medigap works with any medical provider who takes Medicare.

Core Is Like Medigap Plan A: The Massachusetts Core supplement plan is very similar to Medicare Supplement Plan A, the most basic Medicare Supplement option. The Core Plan covers all of the same benefits as Plan A, with the addition of 60 extra days of inpatient mental healthcare and a few required Massachusetts tests.

Supplement 1 Is Like Plans C or F: The Massachusetts Supplement 1 Plan is most similar to Medicare Supplement Plans C and F, two of the most comprehensive and popular Medicare Supplement plans nationwide. Supplement 1 covers the same things as Plan C, plus additional days of mental health inpatient care and all Massachusetts state-mandated benefits.

Although Plan F covers Medicare Part B excess charges, Supplement 1 does not, since these are already prohibited in Massachusetts.

Who Offers Medicare Supplement in Massachusetts?

According to Massachusetts government filings, the following companies offer Medigap in the state as of 2019:

  • Blue Cross & Blue Shield of MA (d/b/a Medex)
  • Fallon Health & Life Assurance Company
  • Health New England
  • Harvard Pilgrim Health Care
  • Humana
  • TransAmerica
  • Tufts Insurance Company
  • United Healthcare/AARP

How to Enroll in a Massachusetts Medicare Supplement Plan

Guaranteed Issue Rights: You can join Medicare Supplement plans without penalty at any time of the year in Massachusetts. You cannot be charged more due to your age or health status.

All SSDI Massachusetts Medicare beneficiaries under the age of 65, except those with end-stage renal disease, also have the same guaranteed enrollment protections.

For personal assistance selecting a Medicare Supplement plan, use HealthCare.com to connect with a Massachusetts-licensed agent. They can give you personal guidance on the ins-and-outs of Medicare Supplement in MA, and help you determine which plan is the better fit for you.

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