Finding Medicare Plans in Massachusetts
Sorting through the Medicare plans available in Massachusetts to find the right level of coverage can be daunting. We don’t think it has to be! We’ll help you navigate the wide variety of Medicare plans available in Massachusetts to find the coverage that’s right for you.
Who’s Eligible for Medicare Plans in Massachusetts?
Medicare is a government-sponsored insurance program that provides healthcare benefits to those who qualify, by either age, illness, or disability. Most people become eligible for Medicare plans in Massachusetts when they turn 65. If you are under 65, you can also qualify if you have received Social Security Disability Insurance (SSDI) for two years. You may also qualify if you’ve been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
To qualify, you must be a citizen or permanent resident, having lived in the US for the past five years. You or your spouse must also have worked and paid Medicare taxes for 10 years.
If you are unsure whether you’re eligible or will be turning 65 in the next six months, we can help. Talk to a licensed insurance agent now by calling the number above.
What Medicare Plans are Available in Massachusetts?
Original Medicare (Parts A and B)
Original Medicare is split up into two parts:
Part A (Hospital Insurance) covers certain services, like inpatient hospital care, care received at a skilled nursing facility, and hospice care.
Part B (Medical Insurance) covers outpatient medical services and supplies that are considered medically necessary. Part B also covers some preventive care, like flu shots and cardiovascular screenings.
It is important to note that Original Medicare doesn’t cover everything. For example, it generally doesn’t cover prescription medications, hearing exams or hearing aids, long term care received at a nursing home, dental care, eyeglasses, etc. That’s why there is a variety of additional Medicare plans, offered by Medicare-approved private insurance companies, to help expand your coverage.
Medicare Advantage Plans (Part C)
Medicare Advantage plans offer an alternative way to get the coverage provided by Original Medicare (Parts A and B). These plans provide the same coverage as Original Medicare (except for hospice care, which remains covered by Part A). They can also provide additional benefits, like dental and vision coverage. Some plans, called Medicare Advantage Prescription Drug (MAPD) plans, also include prescription drug coverage.
In order to enroll in a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare. Premiums for these plans generally start at $0 and increase according to the level of coverage offered by the plan. In addition to your Part C premium, you will need to continue paying your Part B premium. There is a wide selection of Medicare Advantage plans available in Massachusetts, offering varying degrees of coverage.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug plans work alongside Original Medicare (Parts A and B) to provide prescription drug coverage. This is not covered by Original Medicare or Medigap plans. Medicare Prescription Drug plans place medications into tiers, each tier with an associated copay/coinsurance. Each plan provides a formulary, allowing you to see where your medications fall and their associated costs. This helps you determine which plan would provide the best value for your prescription needs.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans work alongside your Original Medicare to fill some gaps in coverage. Medigap plans can reduce your out-of-pocket costs by covering certain costs, like copayments, coinsurance, and deductibles.
When Can I Enroll In A Plan?
Medicare Advantage and Medicare Prescription Drug Plans
You are first eligible to sign up for Medicare plans in Massachusetts during your Initial Enrollment Period (IEP). Your IEP starts three months before your 65th birthday month and continues through the following three months. This means you have a total of seven months to enroll.
Following this period, you will be able to make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). The AEP occurs once per year, from October 15th to December 7th.
Key Fact: Each year, the General Enrollment Period (GEP) provides an additional opportunity to enroll in Original Medicare. The GEP begins January 1st and ends March 31st. Immediately after this period, you can select a Medicare Advantage plan between April 1st and June 30th.
Medicare Supplement Plans
Enrolling during your Medigap Open Enrollment Period ensures access to the Medicare Supplement plan of your choice. Your Medigap Open Enrollment Period is a six-month period that starts at the beginning of the month you are both 65 or older and enrolled in Medicare Part B.
Important Note: If you fail to enroll during your Medigap Open Enrollment Period, carriers can increase premiums or deny you coverage entirely.
Special Enrollment Periods
Special Enrollment Periods provide an opportunity to make changes to your Medicare coverage outside of the usual enrollment periods. Certain qualifying life events, such as moving into or out of a care facility or moving out of state, may qualify you for a Special Enrollment Period. Our team of licensed insurance agents can help you determine whether you are eligible for a Special Enrollment Period.
How Can I Compare Plans?
MedicareMatchup makes it convenient to explore the many Medicare plans in Massachusetts and find the coverage you need. By working with trusted partners, we’ll help you find the coverage that’s best fits your unique needs.
If you are unsure about your eligibility or will be turning 65 in the next 6 months, we help you make sense of your options and help you prepare for enrollment. Give us a call today or get plan information online using our form below.
Additional Medicare Resources in Massachusetts
The SHINE program (Serving the Health Insurance Needs of Everyone) is a state health insurance assistance program that provides Massachusetts Medicare beneficiaries and their representatives with free health insurance information, counseling and assistance.
MassHealth Buy-In is a federal/state program for people with limited income and resources get help to pay Medicare costs.
Sources: www.medicare.gov ; www.mass.gov