Choosing a Massachusetts Medicare Supplement or Medicare Advantage Plan

Choosing a Massachusetts Medicare Supplement or Medicare Advantage Plan

Last updated on: November 08, 2022

If you’re new to Medicare, you might be wondering what the best coverage option is. There’s Medicare Part A, Part B, and Part D. There are many different supplement plans, and there’s also the Medicare Advantage Plan (also known as Medicare Part C). Trying to figure out which plan(s) to enroll in can be difficult and end up being very overwhelming. Hopefully we can break it down for you in a way that makes sense so you can choose the best option for you and your family!

Medicare Supplement Plan in Massachusetts

Medicare Part A and Part B are known as Original Medicare. A Medicare supplement plan is coverage in addition to Part A (hospital insurance) and Part B (medical insurance). People purchase supplement plans because the original Medicare plans don’t cover one-hundred percent of your health costs. Without a supplement, you will be responsible for twenty percent of your bill once you’ve paid your Original Medicare deductible.

What Is A Massachusetts Medicare Advantage Plan?

The Medicare Advantage Plan, also called Medicare Part C in Massachusetts, is a health insurance plan offered by private companies that have contracted with Medicare. The Advantage plan is basically a bundle that includes Medicare Part A and Medicare Part B. Many of The Advantage Plans also include Medicare Part D, the prescription drug plan, but not all of them have it. Since the plans are offered by private companies, prices will differ as well. Make sure you do your research before purchasing to ensure that you’re getting the best plan at the best price.

Advantage Plan Costs in Massachusetts

Since Medicare Advantage Plans are offered by private companies, the cost will be different depending on whom you purchase it from. The Medicare Advantage Plan has its own premium, and then you’re also responsible for the premium for Medicare Part B. The coverage is not always the same, so you’ll need to do some shopping around to find the best option. Some Medicare Advantage Plans have no premium, while others have premiums that cost up to one hundred dollars per month. Additionally, some Medicare Advantage Plans will pay for some or all or your Part B premium, while others won’t pay any of it.

Massachusetts Out of Pocket Maximum for Advantage Plans

An out-of-pocket maximum is the amount of money you have to pay before your plan covers all of your services in full. In 2021, the out-of-pocket maximum for the Medicare Advantage Plans is $7,550. This is the limit for Medicare Advantage Plans that don’t include Part D coverage. Some plans have lower out-of-pocket costs, but you should never come across a plan that has a higher out-of-pocket maximum than $7,550. 

Other Costs in Massachusetts For Advantage Plans and Supplements

In addition to monthly premiums, keep in mind that you also have costs for copays, coinsurance, and deductibles. Coinsurance is the amount that you are responsible for once Medicare pays their portion. When you have Medicare Part B in Massachusetts, you will be responsible for twenty percent of your bill. A deductible is the amount of money you have to spend out of your own pocket before Medicare will cover your healthcare costs. A copay is the fixed amount you pay each time you see a doctor or receive other medical services.

Why Would Someone Choose A Medicare Advantage Plan?

There are a few reasons that the Medicare Advantage Plan might be the better option for you if you live in Massachusetts.

  • Lower Premiums. Many Medicare Advantage Plans have very low premiums. However, keep in mind that you also have to pay the Part B premium each month. 
  • Out-of-Pocket Maximum. If you’re choosing between only original Medicare and a Medicare Advantage Plan, many people prefer the Advantage Plan because of the out-of-pocket maximums. Original Medicare does NOT have an out-of-pocket maximum, so there’s no limit to what you can spend each year. However, this can also be combated by enrolling in Original Medicare and a Supplement Plan.
  • Part D is often included. Some people prefer that everything is just rolled into one plan. It can be a benefit that many Medicare Advantage Plans include Part D.
  • Eye Care: Some Advantage Plans include coverage for eye care. Most other Medicare plans won’t offer coverage for that.

Benefits of a Medicare Supplement Plan in Massachusetts

  • Coverage: There’s no question that choosing original Medicare in conjunction with a Medicare Supplement plan will offer you the most comprehensive coverage. If you choose the right supplement plan, you can have one hundred percent of your medical costs covered. Sometimes this even includes copays and deductibles. 
  • Flexibility: You can see any doctor that accepts Medicare. There are no networks. If a provider accepts Medicare, then you can use your supplement plan! There are more than a million Medicare providers across the United States, so you’ll always be able to find a quality provider to see.
  • No Referrals: You never need a referral to see a specialist or a specific doctor. The supplement plans offer you a ton of freedom.

Which Should I Choose?

If you choose the right Supplement plan, it can be very helpful. It helps bridge the gaps for the twenty percent coinsurance that original Medicare doesn’t cover. Some of the Medicare Supplements cover both deductibles and copays as well, which can amount to a significant amount of money. 

Other Supplement plans may not cover the entire twenty percent coinsurance, but they offer much lower out-of-pocket maximums. For example, Supplement Plan L covers seventy-five percent of coinsurance fees, and you will be responsible for the other twenty-five percent of the charges. This plan also has lower premiums, and the maximum out-of-pocket amount for Plan L is $3,110. That is substantially lower than the $7,550 max out of pocket for Medicare Advantage Plans.

There’s no right or wrong answer. Both the Advantage Plan and all of the Medicare Supplement Plans can be a good option. It’s less about which is the best and more about which is the best for you. There are positives and negatives to each plan. The most important thing is that you have all the information available so you can make the most informed decision.

Enroll Medicare Massachusetts Can Help

If you need help deciding which plan to choose, or you still have questions, don’t hesitate to contact Enroll Medicare today. We have expert support staff and licensed Medicare Supplement insurance agents in Massachusetts who are always available to help. Our goal is to make it as easy as possible for you to take control of your health!


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