Medicare supplement plans (Medigap) are extra insurance plans that you can purchase through Medicare-approved private insurance companies if you have Original Medicare (Part A and Part B).
Medigap helps cover certain costs related to Original Medicare and offers additional coverage.
Glossary of common Medicare terms
- Out-of-pocket cost: This is the amount you pay for care when Medicare doesn’t pay the full cost or offer coverage. It includes premiums, deductibles, coinsurance, and copayments.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is the annual amount you must spend out of pocket before Medicare begins to cover services and treatments.
- Coinsurance: This is the percentage of treatment costs you’re responsible for paying out of pocket. With Medicare Part B, you typically pay 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments or services. With Medicare, this often applies to prescription medications.
Generally, Medigap plans are categorized into 10-lettered plans. In most states, the coverage for each plan is standardized. The only difference is the cost, which varies by the insurance company offering the plan.
However, Massachusetts is one of the states that standardizes Medigap plans differently. Instead of lettered plans, Massachusetts has the following plan types:
- Core plan
- Supplement 1 Plan
- Supplement 1A Plan
The Supplement 1 Plan is available only if you were eligible for Medicare before January 1, 2020.
Various insurance companies offer Medigap plans in Massachusetts, including:
- Blue Cross and Blue Shield of Massachusetts
- Fallon Health and Life Insurance Company
- Humana Benefit of Illinois
- Transamerica Life Insurance Company
- Tufts Insurance Company
- UnitedHealthcare
Medigap plans in Massachusetts offer the following basic benefits:
- inpatient hospital costs
- medical costs
- blood
- Part A hospice coinsurance or copayment
The following chart shows a comparison of coverage for each of the Medigap plans available in Massachusetts.
| Medigap benefit | Core Plan | Supplement 1 Plan | Supplement 1A Plan |
|---|---|---|---|
| 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 care | 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) | No | Yes | Yes |
The monthly premiums for Medigap plans can vary by company. The Medicare online search tool can help you find plans available in your state and cost information.
The following chart gives some examples of Medigap policies and prices in Massachusetts. These prices do not include the Medicare Part B premium, which you are responsible for paying in addition to the Medigap premium.
Medigap also premiums depend on:
- age
- sex
- health status
- when you purchase the plan
| Medigap plan | Monthly premium range |
|---|---|
| Core Plan | $127 to $178 |
| Supplement 1 Plan | $196 to $298 |
| Supplement 1A Plan | $182 to $287 |