Massachusetts's Unique Medicare Supplement System
If you've heard about Plan G or Plan N from friends or family in other states, you'll find that Massachusetts is completely different. The Bay State does NOT use the standard federal Medigap plan letters (A, B, C, D, F, G, K, L, M, N) that are used in 47 other states.
Instead, Massachusetts developed its own standardized Medigap system BEFORE the federal government created national standards, and the state was allowed to keep its unique approach. Massachusetts offers three main plan types: Core, Supplement 1, and Supplement 1A.
Important: Massachusetts Uses a DIFFERENT System
Massachusetts uses a DIFFERENT Medigap system than the rest of the country. Instead of Plans A through N, Massachusetts offers Core, Supplement 1, and Supplement 1A. These are NOT the same as federal Medigap plans. If you're moving from another state or comparing to friends' coverage elsewhere, the plan names and structures will be different.
Understanding Massachusetts Medigap Plans
Core Plan
The Core Plan is the foundation of Massachusetts Medigap coverage. All insurance companies selling Medigap in Massachusetts must offer the Core Plan. It provides:
- Part A coinsurance and hospital costs (up to 365 additional days after Medicare benefits end)
- Part B coinsurance (the 20% you'd normally pay for doctor visits and outpatient care)
- First 3 pints of blood each year
The Core Plan is similar to the federal Plan A but uses Massachusetts terminology. It provides essential coverage but leaves some gaps that the Supplement plans can fill.
Supplement 1
Supplement 1 builds on the Core Plan by adding important additional benefits:
- Everything in the Core Plan, PLUS
- Part A deductible coverage (currently $1,632 per benefit period)
- Part B deductible coverage (currently $240 per year)
- Skilled nursing facility coinsurance (days 21-100)
- Foreign travel emergency coverage (80% of costs after $250 deductible)
Supplement 1 provides comprehensive coverage similar to what Plan F or Plan G offers in other states. This is the most popular choice for Massachusetts residents who want thorough protection.
Supplement 1A
Supplement 1A is an enhanced version of Supplement 1 that may include additional benefits depending on the insurance company. The specific extra benefits can vary by insurer, so it's important to compare what each company offers in their Supplement 1A plan.
Massachusetts Medigap Premium Ranges
| Plan | Coverage Level | Key Features | MA Monthly Premium* |
|---|---|---|---|
| Core | Basic | Part A/B coinsurance, blood, hospital | $200 - $350 |
| Supplement 1 | Comprehensive | Core + deductibles, SNF, foreign travel | $300 - $500 |
| Supplement 1A | Enhanced | Supplement 1 + additional benefits | $350 - $550 |
*Premium ranges vary by age, location within Massachusetts, and insurance company. Massachusetts uses attained-age rating, meaning premiums increase as you get older.
How Massachusetts Plans Compare to Federal Plans
If you're comparing coverage to friends in other states, here's a rough comparison:
| Massachusetts Plan | Similar Federal Plan | Key Difference |
|---|---|---|
| Core | Plan A | Basic coverage, no deductible coverage |
| Supplement 1 | Plan F or Plan G | Comprehensive coverage including deductibles |
| Supplement 1A | Enhanced Plan F | Most comprehensive, varies by insurer |
Massachusetts Medigap Open Enrollment Period
Like all states, Massachusetts provides a 6-month Medigap Open Enrollment Period that begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. During this critical window:
- Insurance companies cannot deny you coverage for any reason
- They cannot charge you more due to health conditions
- You have guaranteed issue rights to any Massachusetts Medigap plan
Massachusetts Consumer Protection
Massachusetts law requires insurance companies to offer a 30-day "free look" period for all Medigap policies. During this time, you can review the policy and cancel for a full refund if you're not satisfied.
Massachusetts Medigap vs Medicare Advantage
Massachusetts has a robust Medicare Advantage market, particularly in the Boston metro area. Here's how the options compare:
| Feature | Medigap (Core/Supplement) | Medicare Advantage |
|---|---|---|
| Monthly Premium | $200 - $550+ | $0 - $100 (some higher) |
| Out-of-Pocket Maximum | Very low (predictable) | Up to $8,850/year |
| Doctor Network | Any doctor accepting Medicare | Network restrictions |
| Boston Hospital Access | All major hospitals included | Varies by plan network |
| Prior Authorization | None required | Often required |
| Prescription Drug Coverage | Separate Part D plan needed | Usually included |
Read our complete Medigap vs Medicare Advantage guide to understand which option might be better for your situation.
Massachusetts-Specific Medicare Considerations
Boston Metro Healthcare Excellence
Massachusetts is home to some of the nation's most prestigious medical institutions. With Medigap, you have unrestricted access to:
- Massachusetts General Hospital
- Brigham and Women's Hospital
- Dana-Farber Cancer Institute
- Beth Israel Deaconess Medical Center
- Boston Children's Hospital (for certain adult services)
- Tufts Medical Center
With Medigap, you can see any doctor or specialist at these world-renowned institutions without referrals, prior authorization, or network restrictions.
Snowbirds and Seasonal Residents
Many Massachusetts residents spend winters in Florida or other warm-weather states. If you're a snowbird, Medigap offers critical advantages:
- Nationwide coverage: Your Massachusetts Medigap plan works anywhere in the U.S.
- Same benefits: Get the same coverage whether you're in Boston or Boca Raton
- Foreign travel coverage: Supplement 1 and 1A include emergency coverage abroad
- No network restrictions: See any Medicare-accepting doctor in your winter location
SHINE Program
Massachusetts offers SHINE (Serving Health Insurance Needs of Everyone), a free counseling program that helps Medicare beneficiaries understand their options. SHINE counselors can provide general Medicare information and help you compare plans. While SHINE offers valuable objective information, they cannot make specific recommendations. A fee-only Medicare advisor can provide personalized guidance based on your specific situation.
Regional Premium Variations
Medigap premiums in Massachusetts vary by region:
- Greater Boston: Highest premiums due to healthcare costs
- Worcester County: Moderate premiums
- Western Massachusetts (Springfield area): Generally lower premiums
- Cape Cod and Islands: Varies, often moderate to high
Frequently Asked Questions: Massachusetts Medicare
Massachusetts standardized its Medigap plans BEFORE the federal government created national standards in 1990. When federal standards were implemented, Massachusetts (along with Minnesota and Wisconsin) was allowed to keep its existing system because it was already well-established and provided strong consumer protections. That's why Massachusetts uses Core, Supplement 1, and Supplement 1A instead of the Plan A through N letters used elsewhere.
The Core Plan provides basic coverage: Part A and Part B coinsurance, blood, and additional hospital days. Supplement 1 includes everything in Core PLUS coverage for the Part A deductible, Part B deductible, skilled nursing facility coinsurance, and foreign travel emergency care. Most Massachusetts residents who want comprehensive coverage choose Supplement 1.
No. If you live in Massachusetts, you must choose from the Massachusetts Medigap plans: Core, Supplement 1, or Supplement 1A. Federal plan letters like Plan G, Plan N, or Plan F are not available to Massachusetts residents. However, Supplement 1 provides similar comprehensive coverage to what Plan F or Plan G offers in other states.
Your best opportunity is during your 6-month Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Part B. During this time, you have guaranteed issue rights. After this period, you can apply to switch plans, but insurance companies can use medical underwriting - meaning they can deny you coverage or charge higher rates based on your health. Massachusetts does not have a birthday rule or continuous open enrollment.
Yes. Like all Medigap plans nationwide, Massachusetts Core, Supplement 1, and Supplement 1A do not include prescription drug coverage. You'll need to enroll in a separate Medicare Part D plan to cover your medications. Massachusetts has many Part D options, and we can help you compare them based on your specific prescriptions.