Medigap in Massachusetts

If you live in Massachusetts, you have guaranteed issue rights to buy a Medigap policy, but the policies are different.

Basic benefits

  • Inpatient hospital care: covers the Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends.
  • Medical costs: covers the Part B coinsurance (generally 20% of the Medicare-approved amount).
  • Blood: covers the first 3 pints of blood each year.
  • Part A hospice coinsurance or copayment.

Medigap plans 

Core Plan

Covers

  • Basic Benefits [Glossary] .
  • 60 days per calendar year of inpatient days in mental health hospitals.
  • State-mandated benefits (yearly Pap tests and mammograms. Check your plan for other state-mandated benefits).

Doesn't cover

  • Part A: inpatient hospital deductible.
  • Part A: skilled nursing facility coinsurance.
  • Part B: deductible.
  • Foreign travel emergency.

Supplement 1 Plan

Covers

  • Basic benefits.
  • Part A: inpatient hospital deductible.
  • Part A: skilled nursing facility coinsurance.
  • Part B: deductible.*
  • Foreign travel emergency.
  • 120 days per calendar year of inpatient days in mental health hospitals.
  • State-mandated benefits including yearly Pap tests and mammograms. Check your plan for other state-mandated benefits.

*Note: Supplement 1 Plan (which includes coverage of the Part B deductible) will no longer be available to people who are new to Medicare on or after January 1, 2020. These people can buy Supplement 1A Plan. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Supplement Plan 1.

Supplement 1A Plan

Covers

  • Basic benefits.
  • Part A: inpatient hospital deductible.
  • Part A: skilled nursing facility coinsurance.
  • Foreign travel emergency.
  • 120 days per calendar year of inpatient days in mental health hospitals.
  • State-mandated benefits including yearly Pap tests and mammograms. Check your plan for other state-mandated benefits.

Compare these plans side-by-side

If a "yes" appears, the plan covers the described benefit 100%. If "no" appears, the policy doesn't cover that benefit.

Medigap Benefits                                     Medigap Plans
Core Plan Supplement 1 Supplement 1A
Basic benefits Yes Yes Yes
Part A: inpatient hospital deductible No Yes Yes
Part A: skilled nursing facility coinsurance No Yes Yes
Part B: deductible* No Yes* No
Foreign travel emergency No Yes Yes
Inpatient days in mental health hospitals 60 days per calendar year 120 days per benefit year 120 days per benefit year
State-mandated benefits (yearly Pap tests and mammograms. Check your plan for other state-mandated benefits.) No Yes Yes

*Supplement 1 Plan (which includes coverage of the Part B deductible) will no longer be available to people who are new to Medicare on or after January 1, 2020. These people can buy Supplement 1A Plan. However, if you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy Supplement Plan 1.

For more information