A little over 72% of Medicare beneficiaries in Cambridge, Massachusetts, have chosen to stick with Original Medicare over a Medicare Advantage supplement plan. But are they pairing their Medicare with a Medigap plan? If not, it could cost them a pretty penny.

Supplemental Medicare Plans in Cambridge, Massachusetts

Statistically speaking, most of the Cambridge retirees on Original Medicare in Massachusetts who are reading this right now are 72-year-old females.

Regardless of age or gender, taking care of your health during your golden years is important, and you should have a health plan that meets your needs.

Average Medicare Advantage Plans in Cambridge, Massachusetts

There are around 40 different Massachusetts Medicare Advantage plans available for purchase in Middlesex County. About 23% of Medicare beneficiaries in Cambridge are using those plans right now to meet their healthcare needs.

The MOOP in the chart below stands for “maximum out-of-pocket” expenditure. Out of Cambridge’s top five Medicare Advantage plans, Wellcare has the smallest MOOP at $6,500 per year. This means that once you spend that much, your insurance will start paying for more health care costs.

Tufts Health ties Fallon Health with the most expensive MOOP. Both companies have high customer service ratings, but Tufts has a perfect 5-star rating. Comparatively, Fallon Health has only four stars, which is still good.

Three of the top five plans have HMO medical networks, meaning you have less choice regarding doctors and facilities. On the other hand, BCBS of Massachusetts and Unitedhealthcare are PPO networks. This means you won’t be charged as much for going out of network as you would with an HMO.

PLAN PREMIUM MOOP Plan Type Star Rating
BCBS of Massachusetts $0 $6,700 LOCAL PPO 4
Tufts Health $0 $7,550 HMO 5
Wellcare $0 $6,500 HMO N/A
UnitedHealthcare $0 $6,700 LOCAL PPO 3
Fallon Health $0 $7,550 HMO 4

Average Medicare Supplement Plans in Cambridge, Massachusetts

Medigap plans are smaller and simpler supplements compared to Medicare Advantage. This is because they’re meant to supplement Original Medicare truly. They aren’t meant to replace it the way Medicare Advantage plans are.

Although most states have standardized Medigap plans, Massachusetts Medigap plans are different. Your choices start with the Core Plan, which offers you the following basic benefits:

  • Part A coinsurance plus 365 days in hospital after Medicare benefits end
  • Part B Coinsurance
  • Hospice coinsurance/copayments
  • First 3 pints of blood each year

The Core Plan also offers:

  • The basic benefits listed above
  • 60 days of inpatient mental health hospital treatment
  • State-mandated benefits

The Supplement 1 Plan offers the basic benefits and:

  • Part A deductible
  • Your Part A skilled nursing facility coinsurance
  • Part B deductible
  • Foreign travel insurance
  • 120 inpatient mental health treatment days per year
  • State-mandated benefits

It should be noted for Medicare beneficiaries who were not eligible to enroll before January 1, 2020, that from now on, you can only choose between the Core Plan and the Supplement 1A Plan. The only difference between the two plans is that the Supplement 1A Plan does not cover your Part B deductible.

PLAN LOWEST PREMIUM HIGHEST PREMIUM
CORE $113.58 $203.79
SUPPLEMENT 1 $205.70 $329.84
SUPPLEMENT 1A $165.75 $319.54

Average Medicare Part D in Cambridge, Massachusetts

If you do not have Medicare Advantage, the cheapest way to get your Massachusetts prescriptions covered is through the Medicare Part D prescription drug program. You pay a monthly premium, fulfill an annual deductible, and your prescriptions are significantly discounted for the rest of the year.

Out of the top five plans listed below, all have at least a three-star customer service rating, including Aetna. While Aetna comes with an average deductible, it has the lowest monthly premium is $7.40.

Humana is the most affordable drug plan with a four-star customer service rating. It comes with an average $480 deductible but costs $22.70 per month in premiums.

Be sure to carefully calculate your anticipated costs before you decide on a plan. For example, UnitedHealthcare may look like the second most costly listed below, but its lower deductible means your annual upfront costs are only $661.60. Conversely, despite having a lower monthly premium, Humana will cost at least $752.40 per year because of the higher deductible.

PLAN PREMIUM DEDUCTIBLE STAR RATING
Aetna $7.40 $480 3
Wellcare $13.00 $480 3
Humana $22.70 $480 4
UnitedHealthcare $29.30 $310 4
Cigna $32.10 $480 3

Medicare Special Needs Plans in Cambridge, Massachusetts

If you have a chronic illness, you can qualify for a more affordable Special Needs Plan (SNP) through Medicare Advantage. To qualify in Massachusetts, your disease must be chronic and disabling, not just one or the other. The medical networks assigned to these plans may be limited, but they will help make your healthcare more affordable.

There aren’t very many differences between the Special Needs Plans available in Cambridge, Massachusetts. The one that stands out among the rest is Tufts Health, which has a significantly smaller MOOP compared to the other plans.

All other plans, including Fallon Health and Commonwealth (among others), have identical MOOPs of $7,550 and dual-status eligibility requirements.

PLAN PREMIUM MOOP Plan Type Eligibility
UnitedHealthcare $0 $7,550 HMO Dual
Fallon Health $0 $7,550 HMO Dual
Commonwealth $0 $7,550 HMO Dual
Senior Whole $0 $7,550 HMO Dual
Tufts Health $0 $3,450 HMO Dual

FAQs

Who pays for Medigap in Cambridge, Massachusetts?

You do. You pay a monthly premium for one of Massachusetts’s three Medicare Supplement Insurance plans (the Core Plan, Supplement Plan 1A, or Supplement Plan A if you are eligible). This is a separate expense from your Medicare expenses.

Can I switch from Medicare Advantage to Medigap in Cambridge, Massachusetts?

Yes, but you can only do it during certain times of the year. For more information on specific dates and procedures, look at our Medicare Enrollment Periods page.

Which company has the best Medicare Advantage plan in Cambridge, Massachusetts?

That depends on what you’re looking for in a Medicare Advantage plan. Wellcare has the lowest out-of-pocket costs with a $6,500 cap. Tufts Health has the highest customer service rating. And BCBS of Massachusetts has the highest customer service rating in addition to a large PPO medical network.

How to Sign Up for Supplemental Medicare in Cambridge, Massachusetts

Your Medicare benefits are great, but they don’t cover anything. So if you’re a resident of Cambridge, Massachusetts, and want a fixed monthly cost with everything covered, consider a Supplemental plan to make that happen.

You can use the expertise and time of our licensed insurance agents free of charge while getting excellent advice and being presented with all the options available to you.

Give us a call today. Or complete our online rate form to be connected with the best rates in your area.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.