October 6, 2016
In Massachusetts, as in other states, US citizens and permanent residents are eligible to enroll in Medicare to receive health coverage once they turn 65. Options include hospital and medical insurance under Original Medicare, Part A and Part B, and Medicare approved private health insurance under Medicare Advantage (Medicare Part C) and Medicare Part D (prescription drug coverage).
Together, Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) are referred to as Original Medicare. Massachusetts beneficiaries, as it is for beneficiaries of other US states, usually don’t pay a monthly premium for Medicare Part A coverage if they or their spouses paid enough Medicare taxes while working. Part A benefits include, but are not limited to, the following health services:
Original Medicare also covers medical insurance, under Medicare Part B. As in other states, most Medicare beneficiaries in Massachusetts have to pay a standard monthly premium for Medicare Part B. Medicare beneficiaries in Massachusetts whose annual income is above a certain amount may have to pay a higher premium. Under Medicare Part B, Massachusetts beneficiaries receive, among others benefits, the following covered services and supplies:
Residents of Massachusetts may enroll in Original Medicare, Part A and/or Part B, during the following enrollment periods:
You are eligible for Medicare in Massachusetts if:
In Massachusetts as in other states, you can apply for Medicare through the SSA. If you are applying for retirement benefits, you can enroll in Medicare at the same time. You can apply:
Medicare beneficiaries in Massachusetts can opt to receive their Medicare benefits through Medicare Advantage (Medicare Part C) by enrolling in Medicare plans offered by Medicare- approved private insurance companies. Medicare Advantage plans are required by the government to offer at least the same coverage as Original Medicare, Part A and Part B. Some Medicare Advantage plans offer extra coverage not available under Original Medicare, like routine vision (for eyeglasses, for example) and hearing (if you wear a hearing aid), so be sure to compare all Medicare Advantage plans available in Massachusetts before you make your selection. Read more about Medicare Advantage plans in Massachusetts.
Medicare Advantage Prescription Drug Plans combine health and prescription drug coverage into one plan, and they’re also available to Medicare beneficiaries in Massachusetts. But Medicare beneficiaries in Massachusetts should be aware that even if they sign up for a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, they have to stay enrolled in Original Medicare and continue paying the Medicare Part B premium in order to keep their health coverage and avoid being disenrolled from Medicare.
If you decide to stay with Original Medicare (Part A and Part B), another option you may have is to sign up for a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles. Massachusetts offers two Medicare Supplement plans, specifically for Massachusetts beneficiaries. Get more information about Medigap plans in Massachusetts.
In addition, Massachusetts residents enrolled in Original Medicare, Part A and/or Part B, may also enroll in a stand-alone Medicare Part D Prescription Drug Plan offered by a Medicare-approved private insurance company to provide Medicare prescription drug coverage (sometimes referred to as Medicare Part D). Find out about Medicare Part D plans in Massachusetts.
Remember that private Medicare plan benefits may vary depending on the Massachusetts county in which you reside. If you live in Boston in Suffolk County, for example, you may have different Medicare plan offerings than a resident of Worcester in Worcester County. Considering the various Medicare insurance plans available in Massachusetts, it’s important to customize your search for plans based on your individual medical and prescription drug needs.
There are a number of resources designed to help Medicare beneficiaries in Massachusetts with Medicare-related issues and concerns. Here are some of the resources that may be helpful to you: