How Do Massachusetts Medicare Supplement Plans Work?

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, newly-eligible Medicare enrollees are faced with a choice of eight different Medicare Supplement plans, all of which provide different levels of coverage. Massachusetts is one of three states that takes a different approach.

Three Types of Medicare Supplement Plans in Massachusetts

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

MA Medicare Supplement Core

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

• Medicare Part A coinsurance for inpatient hospital care.
  • Your Core plan will pay $389 per day for days 61-90 of each benefit period, and $778 per day for days 91-150 in 2022.
  • The plan will also cover the full cost of an additional 365 days of inpatient hospital care if you exhaust your Original Medicare benefit.
• 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% 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,

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 2021, Medicare Supplement Core plans have monthly premiums ranging from about $108 to $204.¹

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 $1,556 in 2022.
• Medicare Part A skilled nursing facility coinsurance.
  • Supplement 1 will cover $194.50 per day for days 21-100 in 2022.
• Medicare Part B deductible ($233 per year in 2022).
• 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.
• State-mandated benefits such as yearly pap tests and mammograms.

Given that the Supplement 1 plan covers more, it also is more expensive. In 2021 monthly premiums for Supplement 1 plans range from about $188 to $307.²

MA Medicare Supplement 1A

Supplement 1A has the same benefits of Supplement 1 except for:

• Medicare Part B deductible ($233 per year in 2022).

Supplement 1A cost slightly less than Supplement. In 2021 monthly premiums for Supplement 1A plans range from about $169 to $321.²

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 coverage continues 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 Plan C

The Massachusetts Supplement 1 Plan is most similar to Medicare Supplement Plan C, a  comprehensive Medicare Supplement plan. Supplement 1 covers the same things as Plan C, plus additional days of mental health inpatient care and all Massachusetts state-mandated benefits. However, as of January 1, 2020, newly eligible beneficiaries will not be able to enroll in Supplement 1. That’s because plans sold to those newly eligible cannot cover the Part B deductible. 

Supplment 1A Is Like Plan G

Supplement 1A is like Plan G. Massachusetts introduced it in 2000. It covers all the benefits of Supplement 1, except for the Part B deductible. Beneficiaries newly eligible after January 1, 2000 will be able to enroll in this plan. 

Who Offers Medicare Supplement in Massachusetts?

According to Massachusetts government filings, the following companies offer Medigap in the state as of 2021:³

• 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 the need for medical underwriting at any time of the year in Massachusetts. You cannot be denied coverage nor 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.