The Best Medicare Supplement (Medigap) Plans in Massachusetts

More than 346,000 Massachusetts residents are enrolled in a Medicare Supplement Insurance plan to round out their Medicare health care coverage. Commonly referred to as Medigap plans, these policies pay for some of the deductibles, coinsurance and out-of-pocket expenses that aren't paid for by Medicare Part A and Part B. About three out of 10 Medicare beneficiaries in Massachusetts pay premiums to a private insurer for this coverage.

When you combine the government's Original Medicare plan with a private Medigap policy in Massachusetts, Medicare pays a portion of covered costs including hospital care, doctor's visits, imaging tests and treatments. Medigap then pays certain expenses that otherwise come out of your wallet, such as deductibles and copays. The specific benefits you get depend on which Massachusetts Medigap plan you have. 

What Are the Best Massachusetts Medicare Supplement Plans?

By law, insurance companies can sell three types of standardized Medigap plans in Massachusetts: Core, Supplement 1 and Supplement 1A. 

In Massachusetts, the Core plan provides the most basic coverage, including:

• Part A copayments for inpatient hospital stays
• Part B coinsurance for medical costs, which is 20% of most covered services

If you want additional coverage, consider Medigap Supplement 1 and Supplement 1A plans, which include: 

• Part A deductible
• Part A coinsurance for skilled nursing care
• Emergency care when traveling outside of the United States

The only difference between these two plans is that Supplement 1 covers the Part B deductible. However, Medicare rules have changed and Medigap is no longer permitted to cover the Part B deductible. Anyone who's new to Medicare after January 1, 2020, can't purchase Supplement 1 and can opt instead for Supplement 1A.

How Do I Enroll in a Massachusetts Medigap Plan?

For the best Medigap coverage, Massachusetts residents should join a plan during their six-month Medigap open enrollment period. This window opens once you're 65 or older and enrolled in Medicare Part B. 

During these six months, you can sign up for any Medicare Supplement Insurance plan sold in Massachusetts. Insurance companies, which usually underwrite policies based on your health, can't refuse to sell you a policy or charge you higher premiums because of their risk assessment. It's important to take advantage of this open enrollment period because you might not have the same choice of plans once it ends. Your Medigap policy may also cost much more.

There are a few exceptions outside of this open enrollment period where Medicare may give you guaranteed issue rights. In these cases, an unavoidable situation forces you to change health insurance.

• You no longer have health care coverage through your union or employer.
• You no longer live in your Medicare Advantage service area.
• You've decided your Medicare Advantage plan doesn't meet your needs and return to Original Medicare during your trial right period.
• Your health insurance plan stops providing coverage or goes out of business.

If you qualify for guaranteed issue rights, the insurance company can't underwrite your policy. Be sure to keep any documentation showing your coverage has been terminated to help make your case.