Massachusetts handles healthcare differently than the rest of America, and Medicare insurance is no exception. Medigap plans here are not the same “alphabet soup” of standardized A-N Medigap plans available in most of the United States. The Bay State’s Medigap plans are more straightforward and easy to understand than the traditional Medigap policies. Plus, if you scroll down, you can learn how to apply for Medigap without answering any health questions. Additionally, MA doesn’t allow Medicare excess charges.
What is Medigap?
Medigap fills in the gaps that Original Medicare leaves behind. It can cover copays, coinsurance, and deductibles. However, it does not cover prescription drug coverage. It is recommended that Medigap enrollees enroll in a Part D plan.
Who can enroll in a Massachusetts Medigap plan?
Any Massachusetts resident who is eligible for Medicare can enroll in a Medigap plan, with one exception, Medicare beneficiaries under 65 with End Stage Renal Disease (ESRD) cannot enroll in a Medigap plan.
How do Medigap plans work in Massachusetts?
As we said, plans are laid out differently than the majority of Medigap plans in other states. In Massachusetts, there are only 3* standardized Medigap plans to choose from. This narrowing of key plans makes it easier to select Medigap coverage. In other states, it can be confusing to choose between the multiple plan options.
Comparing Massachusetts Medigap plans
Here is a breakdown of the 3 plans available in MA:
| Benefits | Core | Supplement 1* | Supplement 1A |
|---|---|---|---|
| Part A (Hospital) Deductible | No | Yes | Yes |
| Part B (Doctor) Deductible | No | Yes | No |
| Part B Coinsurance | Yes | Yes | Yes |
| 365 Extra Hospital Days | Yes | Yes | Yes |
| Skilled Nursing Facility Fee | No | Yes | Yes |
| First 3 Pints of Blood | Yes | Yes | Yes |
| Foreign Emergency Healthcare | No | Yes | Yes |
| Extended Mental Health Hospitalization Days | 60 days | 90 days | 90 days |
*Medicare Supplement 1 is ONLY available to those who qualified for Medicare prior to January 1, 2020. If you were eligible but did not enroll, you may still be able to enroll in Massachusetts Medigap Supplement Plan 1.
Massachusetts community-rated Medigap plans explained
In Massachusetts, Medigap plans use community rating. This means your monthly premium doesn’t vary by gender or age. With this approach, insurance companies set a single premium for everyone. Your plan can only increase due to external factors, like yearly inflation. This method keeps prices stable and prevents older individuals from facing higher premiums just because of their age. Note: Some plans offer a Medigap initial enrollment discount. This is the only time in which you may pay less than other enrollees in the same plan.
How much are Medigap plans in Massachusetts?
Since Massachusetts has different plans than all other states AND have unique community rated discounts when you first sign up, we have to give you pricing over the phone. Give us a call at 800-930-7956 and we will get you Medigap pricing and discount info.
Massachusetts Medigap : Switching Plans
Massachusetts makes it easy to manage your Medigap plan. You’re free to enroll, update, or cancel your plan whenever you want. Changes take effect on the first of the next month. (Source)
Need Help Switching Your Medicare Supplement Plan? Check out our complete guide here, or reach out to the Senior65.com team for free, personalized advice at 800-930-7956.
Medigap for Under 65 in Massachusetts
Unlike other states, Most Massachusetts residents under 65 who qualify for Medicare can enroll in Medigap as long as they are first enrolled in Medicare Part A and Part B. Medigap insurers in Massachusetts cannot refuse to sell a policy, exclude or limit coverage, or require a waiting period before coverage starts due to existing health problems.
There is one big exception: those under 65 who are eligible for Medicare solely due to End-Stage Renal Disease (ESRD) are not eligible for Medigap. Learn more about Medgap under 65 here
What happens if I move out of Massachusetts?
If you move out of Massachusetts, you can keep your Mass Medigap policy (source)
Get a Medigap Quote Enroll in Medigap
Are there any Massachusetts Medigap Discounts?
There sure are! Enrolling when you’re first eligible is important because you may be eligible to receive a discount for the first 3 years.
- 1st eligible for Medicare discount: you may receive up to 15% a month
- Autopay discount: you may receive a discount of $2 a month
- Massachusetts Medigap Household discount: you may receive a discount of 5% a month
- Massachusetts Medigap Roommate Discount: people who qualify for this discount will receive anywhere from 5% to 12% off each.
No Medicare Excess Charges in Massachusetts
In certain states, physicians have the option to add an additional fee of up to 15%, known as Excess Charges. At the end of 2020, both Congress and the Massachusetts legislature passed laws regarding surprise billing. Known as the federal “No Surprises Act,” it prohibits surprise billing and establishes a legal framework (Source). That means you won’t have to pay excess charges. Learn more in our article “How to avoid Medicare Excess Charges.”
Additional Help with Medigap in Massachusetts
If you have a question, want a quote, or are ready to enroll in a Massachusetts Medigap plan, give us a call at 800-930-7956.
Remember, Senior65.com NEVER charges you a fee to help you get a quote or enroll.