Medicare in Massachusetts

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Massachusetts Medicare Plans

Original Medicare

Medicare plans are offered by the federal government to the Massachusetts citizens of age 65 or over. The Medicare plans offer various forms of health coverage, as Medicare Part A primarily covers hospital visits and associated treatment and Part B cover primary care physician costs, outpatient procedures and similar treatments. Medicare Part A and Part B plans are together termed as Original Medicare and are offered at a much lower cost than traditional health insurance plans. Medicare Part A plan is free for seniors having ten years of employment or more and Medicare Part B comes with a monthly premium. The vast majority of the expenses while receiving medical care in a hospital is taken care by Part A whereas Part B benefits help to pay for outpatient facilities like regular check-ups, preventive care and medical supplies. Around 1.3 million Massachusetts residents are enrolled in Medicare. Medicare plans are certainly a good option for the Massachusetts residents that help them pay their medical care cost after retirement, and these plans become essential especially with the rising healthcare costs.

Medicare Part C In Massachusetts

Though a majority of Massachusetts residents with Medicare get their health coverage from Original Medicare, some of the residents wish to receive benefits from a Medicare Advantage plan. Individuals involved in Medicare Advantage plan receive the benefits offered by Original Medicare along with some additional benefits like dental and vision care, caregiver counseling and training along with in-home support like housekeeping. Though, not all Medicare Advantage plans cover these additional benefits, so individuals availing Medicare Part C need to check with the plan details to learn about its benefits covered. Some of the popular Medicare Advantage plan available in Massachusetts are HMOs plans, PPOs plans, Private Fee-for-Service plans. Availability of Medicare Advantage plans may vary within each county of Massachusetts. Medicare Advantage plan in Massachusetts may vary in terms of cost and coverage details, depending on the company so residents should remember to compare out-of-pocket expenses, copayments, coinsurance, deductibles and monthly premium of all the plans.

Medicare Part D

It is a fact that 90% of people over the age of 65 years in the U.S. take at least one drug every week and with Original Medicare does not providing coverage for most of the precsription medications, residents in Massachusetts are left with two options for obtaining coverage for prescription drugs. First is by enrolling in a medicare Advantage plan providing such a benefit and second option is by enrolling in a standalone Medicare Part D plan. Medicare Part D plans are used in conjunction with Original Medicare and exclusively provide coverage for prescription drugs. Since, Part D plans are offered by private insurance companies, each plan varies in terms of list of drugs included, premiums, deductibles, and copayments. In the state of Massachusetts around 988,022 people are enrolled in Medicare Part D plan as of early 2018 and there are 22 Part D plans available in the state. Each Part D plan differs in terms of cost and coverage so residents should look for a plan that best fits their needs and budget.

Medigap in Massachusetts

Original Medicare does cover out-of-pocket costs so most of the Medicare enrollees need to obtain some form of supplemental coverage. Medicare Supplement insurance plan or Medigap in Massachusetts is designed to work along with Original Medicare and it provides coverage for expenses like copayments, coinsurance and deductibles. Some of the Medicare Supplement insurance plans in Massachusetts also include coverage for care received in skilled nursing facility or emergency medical services received outside the United States and some plans also include state-mandated benefits like Pap tests and mammograms along with additional inpatient days in mental health facilities. There are two major types of Medicare Supplement plans available in Massachusetts:

Core Plans – Core plans include some basic Medigap benefits and some state-mandated benefits. In addition to it these plans also provide coverage for up to 60 days of inpatient days at mental health hospitals.

Supplement Plans – Supplement plans include all the benefits of Core plans along with some additional coverage. These plans have all state-mandated benefits as well as medicare Part A coinsurance for a skilled nursing facility and emergency medical care outside the U.S. In addition to this, it also cover Part A inpatient hospital deductible and up to 120 days of inpatient days in mental hospitals.

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