Massachusetts has unique plan options other states don't

You might be familiar with Medicare Supplement plans, also known as Medigap. There are Plans G, K, L, M and N, often with straightforward guidelines for choosing the best plan. But the Commonwealth does things a little differently. We will talk through the plans unique to your state. And we discuss best practices for getting the best coverage in Massachusetts.

Why Medicare Supplements over Medicare Advantage?

Medicare Advantage plans might have extra benefits like dental, vision, and hearing. You might even see flashier perks like transportation and Flex Cards, but these often come at the expense of great core benefits that you will get on Medicare Supplement plans. You also have the best network with Medicare Supplement, including over 90% of doctors nationwide. On Medicare Advantage, your network might be limited based on the plan you select.

Key Differences in Massachusetts

You might have heard that Medicare Supplement Plan G offers the most comprehensive coverage, but Massachusetts doesn't offer Plan G. In fact, Medicare Supplement Plans are broken down into only two plans: Core Plan and Medigap Supplement 1 Plan (we'll get into the distinction between 1 and 1A later). Both plans cover these four basic benefits:

1. Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends

2. Part B coinsurance

3. 3 pints of blood each year

4. Part A hospice and respite care cost sharing

Let's go through the differences between these two options in Massachusetts.

Core Plan

In addition to the basic benefits listed above, you have coverage for the following:

• 60 days per calendar year of inpatient days in mental health hospitals

• Preventative care that is covered by Medicare (such as colonoscopies)

• 20% of physical therapy

• Mandated benefits defined by Massachusetts (some benefits might not be included, check your plan for specific information)

There are some gaps in the coverage, which can be addressed by going to the next level of coverage, the Supplement Plan.

Supplement 1A Plan

In addition to the benefits listed above in the Basic Plan, the Extended option offers the following:

• Inpatient hospital deductible

• Skilled nursing facility (SNF) coinsurance

• Foreign travel emergency costs

• 120 days per calendar year of inpatient days in mental health hospitals

• All mandated benefits defined by Massachusetts

For Medicare beneficiaries eligible before 2020, you can also get the Part B deductible covered under the Supplement 1 Plan. But that option is not available for those who became eligible more recently.

How Much Does it Cost?

You can expect to pay different rates for various levels of coverage in different areas of the state. Let's take a look at what five different plans in Massachusetts would cost you:

1. UnitedHealthcare AARP Core Plan Standard Rate with Discount(s) - $122.50/month

2. UnitedHealthcare AARP Plan 1A Standard Rate with Discount(s) - $172/month

3. Humana Standard Medicare Supplement Core Plan - $202.82/month

4. Humana Standard Medicare Supplement Plan 1A - $327.62/month

5. Humana Standard Medicare Supplement Plan 1 - $338.64/month

Your monthly premium in Boston could range from as low as $116 to as high as $352 (depending on your zip code and other demographic info). These premiums are in addition to the standard Part B premium of $164.90 so add that to your budget calculations.

Best Practices

Medicare Supplement plans offer the most comprehensive coverage paired with the best network. If you are between the Core Plan and Supplement 1A Plan, weigh out how much you would like to spend, but remember that the higher monthly premiums can save you money compared to the out-of-pocket costs. Before you know it, your out-of-pocket expenses can pile up. If you want to talk about how to balance your healthcare needs and your budget, our team of Medicare experts is ready to help. Call Fair Square Medicare today.