There are a number of Medicare plans in Massachusetts. Medicare is a government funded health insurance program designed to help you meet your health needs.
Learn about the different Medicare plans in Massachusetts in 2021 and find the right plan for you.
Original Medicare is the basic Medicare plan, including parts A and B.
In Massachusetts, you also have the option to sign up for a Medicare Advantage (Part C) plan. These plans are all-in-one plans offered through private health insurance carriers.
Medicare Advantage plans cover all the same services as original Medicare, as well as provide drug coverage with some plans. There are hundreds of Medicare Advantage plans in Massachusetts to choose from, and many include supplemental coverage for services such as vision, hearing, or dental care.
Part D (prescription drug coverage) covers the cost of medications and lowers out-of-pocket prescription costs. This plan is often added to original Medicare to provide more comprehensive coverage.
You may also choose to add a Medigap plan. These supplemental plans can help provide additional coverage to pay fees not covered through original Medicare, such as copays, coinsurance, and deductibles.
Medicare Advantage plans in Massachusetts are available to all residents who qualify for Medicare coverage. These Medicare plans in Massachusetts have higher premiums but include many additional health care services.
Medicare Advantage plan providers in Massachusetts include:
- Aetna Medicare
- Blue Cross Blue Shield of Massachusetts
- Fallon Health
- Harvard Pilgrim Health Care, Inc.
- Lasso Healthcare
- Tufts Health Plan
When choosing a Medicare Advantage plan, you’ll want to compare different rates and coverage plans. Ensure the plan you want is offered in your area. Plans vary by county, so use your ZIP code to check if the plans you’re comparing are available in your area.
Medicare is available to all U.S. citizens and residents over the age of 65, as well as to individuals with specific disabilities or chronic illnesses.
You may be automatically enrolled in Medicare when you turn age 65, but if you haven’t been enrolled, make sure you meet the following eligibility requirements:
- you are a citizen of the United States or have permanent residency
- you paid Medicare payroll deductions during your career
If you’re under age 65, you may be eligible for Medicare if you:
Are you ready to enroll in a Medicare plan in Massachusetts?
Your first opportunity to sign up will be during your initial enrollment period (IEP). This is a 7-month period starting 3 months before your 65th birthday, including your birth month, and ending 3 months after your birthday. During this time, you may be automatically enrolled in original Medicare if you’re receiving benefits from the Railroad Retirement Board or from Social Security. Others may need to register manually.
During your IEP, you can also opt into Plan D coverage, or consider a Medicare Advantage plan in Massachusetts.
After your IEP, you’ll have two opportunities per year to enroll in original Medicare, add coverage, or switch to a Medicare Advantage plan. You’ll be able to change your coverage during the Medicare open enrollment period, which is January 1 to March 31, as well as the Medicare annual enrollment period, during October 15 and December 7.
You may also qualify for a special enrollment period and be able to enroll in Medicare right away if you’ve recently had changes in your employer insurance or you’ve just been diagnosed with a chronic health condition.
There’s a lot to consider when choosing a Medicare plan. Here are some enrollment tips to help you choose the right Medicare plan:
- Costs. Look back at all the premiums and out-of-pocket expenses you paid in the past year. Did your existing health insurance plan provide adequate coverage? If not, look for a plan that will give you more coverage and help you to access the services you need to maintain your health and well-being.
- Plan network. An important tip to remember is that not all doctors are covered by every insurance plan. If you’re considering Medicare Advantage plans in Massachusetts, call your doctor and find out what networks they belong to. This will help you narrow your search so you won’t need to change doctors.
- Medication needs. Consider adding Part D or drug coverage to your original Medicare Massachusetts plan. If you’ve recently started taking new medications, adding Part D or finding an Advantage plan can help you save on out-of-pocket costs in the coming year.
- Pharmacy coverage. Call your pharmacy and ask what coverage they accept. You may find a great plan that covers your medications but isn’t accepted by your pharmacy. Look for another pharmacy in your area that will accept the plan to help you save on medication costs.
To learn more about original Medicare and Medicare Advantage plans in Massachusetts, you can access the following resources or get advice from the experts.
- Medicare.gov (800-633-4227). Learn more about coverage options, find PACE plans, and compare different Medicare Advantage Plans in Massachusetts.
- SHINE (800-243-4636). With SHINE, you can access free health insurance counseling, learn how to set up a MyMedicare account, and access Mass Health programs.
- Group Insurance Commission (617-727-2310). If you have GIC health coverage, get details on enrolling in Medicare Massachusetts as well as research premium costs.
- MassHealth (800-841-2900). Find out if you’re eligible for One Care and access information regarding Medicare laws in Massachusetts.
- MassOptions (844-422-6277). Contact MassOptions to get more information on in-home care, independent living for adults with disabilities, and other free resources.
If you’re eligible to enroll in Medicare Massachusetts in 2021, carefully compare Medicare plans to weigh your options.
- Determine the premiums you’d like to pay and look for a Medicare Massachusetts plan in your county that will provide the coverage you need.
- Call your doctor to find out what network they belong to and compare a minimum of three Medicare plans in Massachusetts.
- Enroll in Medicare online or by calling the Medicare Advantage plan carrier directly.
Whether you’re new to Medicare or considering switching to a Medicare Advantage plan in Massachusetts, you can easily find a plan that will cover all your health needs in 2021.
This article was updated on October 5, 2020 to reflect 2021 Medicare information.
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