Explore your options
Compare options, including Medicare Advantage, Medicare Supplement, and prescription plans.
Find a Licensed Medicare agent in Massachusetts
Connect with Medicare agents in Massachusetts
Toni Aldridge
Kevin Hatfield
Shannon Davis
Tyler Eby
Kayla Torry
Brandon Kauffman
Calvin Fritz
Sara Morrissey
Matt Willenborg
Ariel De Jesus
Why work with a Medicare agent
Enroll in Medicare
Get the help you need to enroll in Medicare, from Original Medicare to supplemental coverage.
Use your coverage
Receive extended support to help you use your plan effectively, find doctors, and get savings.
A Snapshot of Medicare in Massachusetts
65% of people with Medicare in Massachusetts are enrolled in Original Medicare. Original Medicare provides coverage for inpatient hospital stays (Part A) and outpatient services, such as doctor visits (Part B). The other 35% of people on Medicare are enrolled in a Medicare Advantage plan or other type of Medicare health plan. Medicare Advantage plans include Part A and Part B coverage and can also include additional coverage and benefits.
Original Medicare, made up of Part A and Part B, does not include prescription coverage. Medicare beneficiaries need to get Part D coverage to get their prescriptions covered. They can get Part D either through a standalone Part D plan or through a Medicare Advantage plan that includes Part D. Part D coverage is not uniform. Before you enroll in a plan, make sure your prescriptions are covered at a price you can afford.
Medigap, also known as Medicare Supplement insurance, helps cover some out-of-pocket costs that Original Medicare doesn't pay (deductibles, copayments, and coinsurance). These policies are sold by private insurance companies and cannot be used with Medicare Advantage. Premiums vary by plan and insurer.
Medicare doesn’t cover a traditional physical exam. Instead, it covers an annual wellness visit at no cost to you. Before your appointment, find out if extra tests or treatment will be billed separately and what you would owe.
How to apply for Medicare in Massachusetts?
Medicare eligibility in Massachusetts follows the same nationwide rules as everywhere else in the country. You qualify for Medicare as a US citizen if you meet one of these criteria:
- You're 65 or older
- You have a qualifying disability, such as End-Stage Renal Disease or ALS
- You've received SSDI for 24 months or more
Enrolling in Massachusetts takes three key steps:
- Sign up for Original Medicare (Part A and Part B)
- Decide on your supplemental coverage:
- Medicare Supplement (Medigap)
- Medicare Advantage (Part C)
- Part D (prescription drug coverage)
- Confirm your doctors are in network, update your pharmacy with your new plan, and activate any additional benefits included with your coverage
FAQs
How can I get help comparing Medicare coverage in Massachusetts?
Online resources and Massachusetts Medicare agents can help you understand your Medicare options. Chapter's licensed Massachusetts agents can help you compare Medicare plans based on your healthcare needs, preferences, and budget. Call (855) 900-2427 or schedule a free consultation to discuss your coverage options.
How does Massachusetts' continuous Medigap open enrollment work?
Massachusetts residents with Original Medicare can apply for or switch Medigap plans throughout the year. Eligible residents cannot be denied coverage or charged more because of their health. Different rules may apply to beneficiaries under 65 with end-stage renal disease (ESRD). Those with Medicare Advantage must wait for an eligible enrollment period to return to Original Medicare before they can purchase a Medigap plan.
What Medigap plans are available in Massachusetts?
While most of the nation has the same 10 plans named by letters A-N, Massachusetts offers three Medigap plans: Core, Supplement 1, and Supplement 1A. All three plans cover “basic benefits,” which include inpatient hospital costs, medical costs, blood (for transfusion), and Part A hospice coinsurance or copayments. In addition to basic benefits, the Core Plan covers 60 inpatient days in mental health hospitals. Supplement Plan 1A covers the Part A inpatient hospital deductible, Part A skilled nursing facility coinsurance, foreign travel emergency care, 120 inpatient days in mental health hospitals, and state mandated benefits (including annual Pap tests and mammograms). The Supplement 1 Plan covers everything that the Supplement Plan 1A covers as well as the Part B deductible. The Supplement Plan 1 is only available for people who became eligible for Medicare before January 1, 2020.
Do I need a referral to see a specialist in Massachusetts?
Original Medicare does not require referrals to see specialists who accept Medicare. Medicare Advantage plans may have different requirements. Depending on the plan, beneficiaries may need a referral from their primary care doctor or prior authorization for certain services, even when the specialist is in the plan's network.
