Medicare Supplement Plans in Massachusetts

Massachusetts Medicare
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What is a Medicare Supplement plan?

In Massachusetts, a Medicare Supplement plan is designed to work in combination with Original Medicare (Part A and Part B). Also known as Medigap or MedSup, Medicare Supplement plans provide coverage for expenses not currently covered under Original Medicare, such as copayments, coinsurance, and deductibles.

In addition, some Medicare Supplement Plans in Massachusetts might include coverage for care in a skilled nursing facility or emergency medical services received outside the United States. Some could also include state-mandated benefits like Pap tests and mammograms, as well as extended stays in mental health facilities.

Enrolling in a Medicare Supplement plan in Massachusetts

Beneficiaries are eligible for enrollment in a Medicare Supplement Plan in Massachusetts if they are already enrolled in Original Medicare. Medicare Supplement plans cannot be used in combination with a Medicare Advantage plan.

The best time to enroll in a Medicare Supplement plan in Massachusetts is during the Open Enrollment Period (OEP). This period begins on the first day of the month that a beneficiary turns 65 and continues for six full months. The beneficiary must also already be enrolled in Medicare Part B. During this time, insurance companies are prohibited from charging higher monthly premiums or denying coverage to beneficiaries based on their medical history or current health status.

Federal law does not require companies to offer Medigap Plans to Medicare beneficiaries under the age of 65. However, some states do require insurance companies to offer plans to beneficiaries who are under the age of 65 and qualify for Medicare benefits due to a disability.

Choosing a Medicare Supplement plan in Massachusetts

There are two basic types of Medicare Supplement plans in Massachusetts:

Core Plans – These plans include basic Medigap benefits and some state-mandated benefits. They also provide coverage for up to 60 days of inpatient care at mental health hospitals.

Supplement 1 Plans – These plans include all the benefits of Core plans, plus some additional coverage. All state-mandated benefits are included, as well as coinsurance for a skilled nursing facility and emergency medical care outside the U.S. The plans also cover the Part A inpatient hospital deductible and up to 120 days of inpatient care at mental health hospitals.

Basic benefits for Medicare Supplement Plans in Massachusetts include inpatient hospital care for up to 365 days after Original Medicare coverage ends, Part B coinsurance, and Part A hospice coinsurance and copayment. The basic benefits also include up to three pints of blood each year.

Medicare Supplement plan trends in Massachusetts

  • There were 1,104,483 Medicare beneficiaries living in Massachusetts during 2012
  • That number comprised 17% of the total population in the state during that year
  • Eight companies offered Medicare Supplement plans in Massachusetts during 2013
  • The lowest monthly premium for Medicare Supplement Core in 2013 was $97
  • The highest monthly premium for Medicare Supplement 1 in 2013 was $226

Data provided by the Commonwealth of Massachusetts Executive Office of Elder Affairs. Data provided by the Henry J. Kaiser Family Foundation