by Russell Noga | Updated February 19th, 2024
In Boston and need a Medicare supplement plan? Understand your options with a straightforward comparison of Massachusetts-specific Medicare Supplement Plans Boston, like Core, Supplement 1, and Supplement 1A. This article offers a no-nonsense guide to costs, benefits, and provider choices, helping you select a Medigap plan that complements your Medicare coverage without the hassle.
Key Takeaways
- Medicare Supplement plans in Massachusetts include unique options like Core, Supplement 1, and Supplement 1A not found elsewhere, with community rating and no pre-existing condition waiting periods.
- Premiums for Medicare Supplement plans in Boston can vary widely depending on the provider and plan type, despite standard benefits, and cover additional costs Original Medicare doesn’t, except for prescription drugs.
- The best time to enroll in a Medigap plan is during the Open Enrollment Period when starting Medicare Part B coverage, as it allows for the purchase of any plan without medical underwriting or a Late Enrollment Penalty.
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Understanding Medicare Supplement Plans in Boston
Medicare Supplement plans, also known as Medigap, work alongside Original Medicare to cover additional healthcare costs that Original Medicare doesn’t cover, such as deductibles, coinsurance, and copayments. In Boston, Medicare beneficiaries are faced with the decision of choosing between Medicare Supplement plans and Medicare Advantage plans since they can’t have both simultaneously. The supplement plans are offered by Medicare-approved private insurance companies and are available based on one’s geographical area.
What sets Massachusetts apart is its unique offering of Medicare Supplement plans called Core, Supplement 1, and Supplement 1A, distinct from standard Medigap plans that are not available in the state.
What are Medicare Supplement Plans?
Medicare Supplement (Medigap) plans are designed to fill the gaps in Original Medicare coverage. These plans, also known as Medicare supplement insurance, are offered by Medicare-approved private insurance companies to assist with healthcare costs not covered by Original Medicare Parts A and B, such as deductibles, coinsurance, and hospitalization days beyond what Medicare pays. Medicare benefits are supplemented by these Medigap plans.
Keep in mind that Medigap plans usually exclude coverage for services such as:
- long-term care
- vision
- dental care
- hearing aids
- private-duty nursing
- eyeglasses
The beauty of Medigap plans is that they provide the same standard benefits across providers, ensuring consistency and reliability.
Massachusetts Medigap Regulations
In Massachusetts, the Medigap landscape operates a bit differently. For starters, the state enforces community rating for Medigap plans, meaning premiums cannot vary based on age, and no waiting periods exist for pre-existing conditions, even for beneficiaries under age 65.
The state also offers a specific Medigap open enrollment period from February 1 to March 31, allowing individuals to enroll or switch plans without undergoing any medical underwriting. Unique to Massachusetts, Medigap plans include the Core Plan and Supplement 1 and 1A, with the latter introduced in 2020 to align with changes in federal law for new Medicare beneficiaries.
Comparing Boston's Medicare Supplement Plan Options
In Boston, residents have the flexibility to choose from three types of Medigap plans: Core, Supplement 1, and Supplement 1A, each offering different levels of coverage to suit individual healthcare needs. Unlike Original Medicare, these Medigap plans cover the remaining out-of-pocket costs like the 20% coinsurance after the Part B deductible is met, and they do not have a yearly limit on out-of-pocket expenses. Furthermore, Massachusetts Medigap plans offer the flexibility to see any doctor or hospital that accepts Medicare without network restrictions or needing referrals for specialists. However, it’s worth noting that prescription drug coverage is not included in Massachusetts Medigap plans.
Core Plan
The Core Plan is the foundation of Medigap coverage in Massachusetts. It provides coverage for inpatient hospital costs, medical costs, blood, and Part A hospice coinsurance or copayment. In addition to these basic benefits, the Massachusetts Core Plan includes state-mandated benefits such as yearly Pap tests and mammograms and provides coverage for 60 days per calendar year for inpatient mental health hospital stays.
Bear in mind, the Core Plan doesn’t cover the Part A inpatient hospital deductible, skilled nursing facility coinsurance, Part B deductible, or foreign travel emergency care.
Supplement 1A Plan
The Supplement 1A Plan includes the following coverage:
- Part A hospital deductible
- All subsequent inpatient expenses for covered services
- All covered medical expenses such as laboratory services, X-rays, and diagnostic procedures after the annual Medicare Part B deductible is met.
The plan also offers unique benefits, including:
- a $150 annual reimbursement for weight management programs
- another $150 for fitness club memberships or instructional fitness classes
- a $100 annual reimbursement for eyewear or contact lenses
However, it excludes coverage for routine hearing exams, hearing aids, or dental services benefits.
Supplement 1 Plan
The Supplement 1 Plan is the most comprehensive Massachusetts Medicare supplement plan available, but it’s only available to residents who were eligible for Medicare prior to 2020 but have not yet enrolled in a Medigap plan. It covers the Part A deductible and provides coverage for 120 days per calendar year for mental health hospital stays.
The plan also covers skilled nursing facility care coinsurance and foreign travel emergency care. This plan serves as an alternative to the traditional Plan F in Massachusetts and is almost identical in terms of coverage.
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Top Medicare Supplement Providers in Boston
Making the right choice of a Medigap plan also involves choosing the right provider. In Boston, some of the top Medicare Supplement providers include Health New England, Blue Cross Blue Shield, and AARP/UnitedHealthcare. While Health New England and Blue Cross Blue Shield are recognized for their affordable Core and Supplement 1A plans respectively, AARP/UnitedHealthcare stands out due to its high customer satisfaction and fewer complaints, which contributes to fewer issues with medical bills and policy resolutions.
Health New England
Health New England stands out for offering the best and most affordable Supplement 1A plan, with a monthly rate of $185, combining affordability with extensive coverage beyond the basic Core plan. The company has an A+ rating from the Better Business Bureau, reflecting its commitment to resolving complaints, although potential customers should be aware of some negative reviews focusing on coverage and care accessibility issues.
Blue Cross Blue Shield
Blue Cross Blue Shield offers the following options for Medicare Supplement plans in Boston:
- Plan A
- Plan B
- Plan C
- Plan D
- Plan F
- Plan G
- Plan K
- Plan L
- Plan M
- Plan N
Plan G is the most comprehensive option available to new members, covering the basic benefits part. Additionally, Blue Cross Blue Shield offers add-on packages for dental and vision coverage, with additional premiums. They also provide fitness and wellness programs like SilverSneakers.
AARP/UnitedHealthcare
AARP/UnitedHealthcare is recognized for its high customer satisfaction and fewer complaints, which contributes to fewer issues with medical bills and policy resolutions. The company offers a range of standardized benefit packages including the most popular Plan F, G, and N to fill gaps in Original Medicare coverage. It serves over four million members with its Medicare Supplement plans nationwide, emphasizing its significant reach and influence in the healthcare industry.
While its Medicare Supplement plans are priced higher in Massachusetts, the company distinguishes itself through its outstanding customer service record.
Costs of Medicare Supplement Plans in Boston
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Grasping the costs of Medicare Supplement plans in Boston is a key aspect of your decision-making process. Monthly premiums for Medicare Supplement plans, such as the Core Plan and Supplement 1A Plan, can range from as low as $116.73 to as high as $327.62. While the average monthly cost for Medigap plans in Boston is typically between $140 and $247, it’s important to note that specific examples of monthly premiums can vary significantly across providers.
Factors Affecting Premiums
Several factors influence the premiums for Medicare Supplement plans. In Massachusetts, community-rated premiums are the same for all enrollees within a plan regardless of age, as seen with Health New England’s Medigap offerings. However, other factors such as location, demographic details like age and smoking status, and plan type can cause variations in premiums.
Premiums can change annually due to inflation or other factors, but some companies in Massachusetts offer the option to lock in the premium rate at policy inception.
Comparing Plan Costs
When assessing Medigap plans in Boston, consider the price variations among companies and plans, notwithstanding the state-prescribed uniform benefits for standard policies. The cost of Medicare Supplement plans, such as the Core and Supplement 1A Plans, can differ significantly across providers.
For a comprehensive view, the Medigap Supplement 1A plan, with its varying Medigap cost, ranges from $166 to $320 monthly for a 65-year-old female non-smoker among different providers.
Enrollment and Eligibility for Medicare Supplement Plans in Boston
Enrollment in a Medigap plan necessitates comprehension of the eligibility criteria and the enrollment procedure. The Medigap Open Enrollment Period in Boston begins when you enroll in Medicare Part B and lasts for 6 months. It’s a one-time event that provides the best opportunity to buy a Medigap policy without medical underwriting and without incurring a Late Enrollment Penalty.
However, after the Open Enrollment Period ends, acquiring a Medigap policy in Boston may be more difficult and more expensive, particularly for those with existing or past health issues.
When to Enroll
In Massachusetts, the Medigap Open Enrollment Period includes the following benefits:
- It begins on the first day of the month following your 65th birthday and enrollment in Medicare Part B.
- It allows you to purchase a Medigap policy without being denied coverage or charged higher premiums due to pre-existing conditions.
- During this period, you have the right to purchase any Medigap policy sold in the state without medical underwriting.
- You will not incur a Late Enrollment Penalty.
If you’re switching from Medicare Advantage to Original Medicare, you can buy a Medigap policy within 63 days after your Medicare Advantage Plan ends, without medical underwriting.
Eligibility Requirements
To be eligible to purchase a Medigap plan, you must:
- Be enrolled in Original Medicare Parts A and B
- Have individual coverage, meaning each member of a couple needs a separate policy
- In Massachusetts, be eligible to purchase a Medigap policy before age 65 if you have Medicare due to End-Stage Renal Disease (ESRD) or disability
However, after the Medigap Open Enrollment Period, insurance companies are not federally required to sell a Medigap policy, and prices may be higher due to health conditions.
Choosing the Right Medicare Supplement Plan in Boston
Selecting the appropriate Medicare Supplement plan requires more than just understanding plan coverages – it also involves evaluating your personal healthcare needs and comparing various plans and providers. Consider your current health status and future health needs, which will influence your medical care expenses over time. Also, evaluate your budget to decide how premiums, deductibles, and other out-of-pocket expenses can align with your financial limitations.
Assessing Personal Needs
Understanding your individual healthcare needs, including the necessity for additional services not covered by standard Medigap plans, is crucial for choosing the right Medicare Supplement plan. For example, Blue Cross Blue Shield offers add-on packages for dental and vision coverage, which require an additional premium beyond the standard Medigap plan costs.
Comparing Plans and Providers
Despite Medigap plans being standardized, providing identical coverage for the same plan type across carriers, it’s essential to compare premiums since costs can significantly differ among companies. Provider reputation and customer service are significant factors.
It’s also advisable to compare the rate increases of Medigap policies over previous years and select a plan with minimal increases, as this can impact the long-term affordability of a policy.
Resources for Medicare Supplement Plans in Boston
Several resources are available to assist you in navigating the Medicare Supplement landscape in Boston. You can:
- Use Medicare’s online plan finder tool to explore your Medicare Supplement plan options
- Reach out to the State Health Insurance Assistance Program (SHIP) for free information and counseling about Medicare options, processes, and costs
- Contact the Massachusetts Division of Insurance for additional information and guidance on Medicare options
These resources can provide you with the information and support you need to make informed decisions about the best Medicare supplement plans.
State Health Insurance Assistance Program (SHIP)
The State Health Insurance Assistance Program (SHIP) provides free information and counseling about Medicare options, processes, and costs. In Massachusetts, SHIP is known as the SHINE (Serving the Health Insurance Needs of Everyone) Program, which serves the entirety of the Massachusetts resident population that has Medicare.
You can contact the SHINE Program for free guidance and counseling regarding various aspects of Medicare.
Massachusetts Division of Insurance
The Massachusetts Division of Insurance, overseen by insurance commissioners, is responsible for maintaining records of Medigap companies and their rates. Individuals can reach out to the Massachusetts State Insurance Department for additional information on Medigap policies and assistance in comparing plans and providers.
Summary
In conclusion, choosing the right Medicare Supplement plan in Boston involves understanding the different types of plans, comparing the options offered by various providers, and assessing your personal healthcare needs and financial situation. Remember that while the coverage for each plan type is standardized across carriers, premiums can vary significantly. Make use of resources like the SHINE Program and the Massachusetts Division of Insurance to make an informed decision.
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Frequently Asked Questions
What is the most popular Medicare supplement plan for 2023?
The most popular Medicare supplement plan for 2023 is Medigap Plan G. It offers standardized coverage, with the same benefits provided by each carrier offering this plan.
How much is the Medicare supplement in Massachusetts?
The average cost of Medicare supplement plans in Massachusetts can range from $126 to $227 per month, depending on the specific plan you choose. It’s important to compare plans to find the one that best fits your needs and budget.
What are the disadvantages of a Medicare supplement plan?
Medicare supplement plans, also known as Medigap, have some disadvantages which include potentially higher premiums and the need to purchase a separate prescription drug plan. Consider these factors when weighing your options for coverage.
What does an average person pay for Medicare with a supplement?
On average, the cost of Medicare Supplement plans ranges from $100.57 to $173.83 per month, with factors such as age and coverage influencing the final cost. The monthly costs can vary based on the coverage chosen and other factors like income.
What are the different types of Medigap plans available in Boston?
In Boston, residents can choose from three types of Medigap plans: Core, Supplement 1, and Supplement 1A, each offering varying levels of coverage to meet different healthcare needs.
Speak to the Professionals about Medigap Plans and Original Medicare
If you find understanding the benefits involved with Original Medicare and Medigap Plans challenging, you’re not alone. Whether it’s a Medigap plan, or you want to know more about the best Medicare Supplement Plans in Boston, we can help. Call our team at 1-888-891-0229 for a free consultation or complete the contact form on this site, and an expert will call you back at a convenient time.
We have decades of experience advising our clients on the complexities of Medicare and Medigap plans, the benefits, cost and deductibles. We’ll ensure you get the best rate in your state and advice you can trust.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.