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Best Medicare Advantage Plans in Massachusetts 2019

Have you heard that the best Medicare Advantage Plans in Massachusetts for 2019 can help you manage such out-of-pocket healthcare expenses better than Original Medicare? If so, it’s important to understand that Massachusetts Medicare Advantage plans may reduce Medicare Part A and Part B copayments, deductibles, and coinsurance amounts. In some cases, a Medicare Advantage plan may not offer a beneficiary the best flexibility when compared to Original Medicare, but in return, it can help lower costs. Plus, your plan might include a Medicare prescription drug plan that will give you Part D prescription drug coverage, although you will need to ask your insurance agent if this is included in the Medicare Part C plan that you choose for 2019.

Best Time to Enroll in Medicare Advantage Plans in Massachusetts for 2019

Sometimes, you may hear Medicare Advantage plans called Medicare Part C. When a beneficiary enrolls in Medicare Part C plans in Massachusetts for 2019, that plan will offer the same or better benefits in a way that is different than Medicare Part A and Part B. If you enroll in a Medicare Advantage plan in Massachusetts, you will usually present your new insurance card and not your Original Medicare card.

Basically, you have been already or almost ready to have enrolled in Medicare Part A and Part B to qualify for a Medicare Advantage plan in Massachusetts. The only health restriction is that you cannot have ESRD, but there are other plans that can best serve people who suffer from this illness.

Besides these basic qualifications for a Medicare Advantage plan, you should also know that you can only enroll in Massachusetts Medicare Advantage plans at certain times:

  • Initial Coverage Election Period: If you’re getting Medicare Part A and Part B because you’re approaching 65, you get seven months to sign up. This includes three months prior, three months after, and the month you qualify for Original Medicare.
  • Annual Election Period: Every year, you get a few months in the year to switch your Medicare Advantage plan.
  • Special Election Periods: Certain circumstances may trigger an SEP that gives you about two months to switch your Medicare Advantage plan in Massachusetts.
  • Medicare Advantage Disenrollment Period: You also get six weeks at the start of every year to drop your Massachusetts Medicare Advantage plan and just stay enrolled in Medicare Part A and Part B. You can also select a Part D plan during this period if you need drug coverage.

Best Types of Medicare Advantage Plans in Massachusetts for Each Individual

Some Medicare Advantage plans in Massachusetts are more common than others in 2019, but you should know that you can actually compare the best coverage from a variety of different types.

This list has a brief summary of the more common Medicare Part C plan choices in the state:

  1. Health Maintenance Organization HMO plans:

    Most of the time, an HMO helps the insurance company control costs the best. At the same time, this type of Medicare Advantage plan will impose more restrictive rules. Almost three-quarters of all beneficiaries who choose Massachusetts Medicare Advantage plans, enroll in an HMO.

  2. Preferred Provider Organization PPO plans:

    About 26 percent of Medicare Part C members in Massachusetts will select more flexible PPO for 2019. They also use networks but will cover out-of-network providers at higher rates than in-network providers.

  3. Special Needs Plans SNPs:

    Insurers design Special Needs Plans to help people with specific health issues, such as institutional conditions and chronic health conditions. For instance, a beneficiary with diabetes or who is confined in a nursing home may find an SNP that best suits them better than a general plan.

  4. Dual-Eligible:

    Some people qualify for both Medicaid and Medicare Part A and Part B, and they may benefit the best from a Dual-Eligible Medicare Advantage plan in Massachusetts that offers more benefits and a $0 premium.

  5. End Stage Renal Disease ESRD plans:

    People who suffer from ESRD must enroll in special Medicare Part C plans.

  6. PFFS/Private Fee-for-Service Plans:

    PFFS plans are not as popular as the other types of Medicare Advantage plans in Massachusetts for 2019, but they can provide you an alternative if you don’t want network restrictions but also don’t want to sign up for one of the Medicare Supplement plans. You should know that costs can be higher for those who sign up for these plans, though, because insurance companies determine the parts that they will pay for and that you will pay for in regards to doctor’s visits, hospital visits, care in a skilled nursing facility and more.

Enrollment Numbers for Medicare Advantage Plans in Massachusetts for 2019

Learning more about how other Massachusetts Medicare recipients use their Medicare Part A and Part benefits may help some beneficiaries make the right choices. These are brief enrollment statistics for Medicare Advantage plans in Massachusetts:

  • Massachusetts percent qualified for Original Medicare enrolled in Medicare Part C plans: 20 percent
  • Total number of Massachusetts enrollment: 246,018

These are the biggest Massachusetts counties by population numbers:

  • Middlesex County, Mass:    1,594,314
  • Worcester County, Mass:    820,681
  • Suffolk County, Mass:791,165
  • Essex County, Mass:780,633
  • Norfolk County, Mass:696,818

Finding Best Coverage for Medications with Medicare Advantage Plans in Massachusetts

Medicare Part A and Part B do not cover most prescriptions. Most of the time, insurers offer Medicare Advantage Prescription Drug plans, so you won’t need a stand-alone Part D policy. If you get medicine covered with a Medicare Advantage plan or Part D, you should compare your 2019 drug coverage.

Also, each Medicare Part C plan in Massachusetts will come with a formulary that lists the medication covered. In addition, the insurer will establish Prescription Drug tiers to show members how different classes of medication will get paid for. For instance, some specialty drugs may cost considerably more. Typically, generic medicine will cost less than brand-name drugs.

Network Restrictions for Medicare Advantage Plans in Massachusetts

Original Medicare doesn’t rely upon plan networks, but a Part C PPO or HMO will. You should understand how managed care plans work:

  • HMO Medicare Advantage Plans: you must virtually always get in-network services in order to get coverage for non-emergency services. You also need to pick a PCP, or primary care doctor, and this doctor has to offer you a referral for a visit to a specialist.
  • PPO Medicare Advantage Plans: will cover an out-of-network doctor or hospital, but you will end up paying higher rates if you don’t stick to the list of in-network providers. A PPO Medicare Advantage plan is often best for individuals that travel or who plan live in multiple locations throughout the country during a given year.

In any case, check the provider list to make sure you can find your doctor and a nearby hospital. If not, you might keep looking until you find the best Medicare Advantage plan in Massachusetts for 2019 that does include your preferred medical providers. You are more likely to get a $0 premium Medicare Part C plan when you accept more restrictions; however, you may only feel satisfied if you can continue to see the providers who have served you in the past. While premiums are important, you should also consider the value of your insurance.

If you plan to move out of the local service area, you will trigger an SEP. This will give you a few weeks to find the best Medicare Advantage plan in your new city or town.

Top-Rated Companies for Medicare Advantage Plans in Massachusetts for 2019

It might help you begin your 2019 comparison by checking out some of these leading providers of Medicare Advantage plans:

  • Blue Cross of Massachusetts: This insurance company has HMO plans with 5-star ratings. They have enrolled 22 percent of the Medicare Advantage plans in Massachusetts.
  • Humana: No information was found on Humana star ratings in Massachusetts at this time.
  • Tufts: Tufts has the highest market share with about 37 percent of the market, and they offer HMO Medicare Advantage plans that have earned star ratings of 5 stars too.

Best Massachusetts Medicare Resources

Medicare beneficiaries who are looking for a complete description of benefits for their 2019 health insurance or those who are prepared to sign up for Medicare coverage through the federal government for the first time can check out these resources. These resources also offer more information about the Medicare Part B premium:

After checking out these resources, you could be hoping for more information, or you might be curious about your best Medicare Advantage plan options in Massachusetts for 2019. We work with Medicare beneficiaries to help them find the health plans that are right for their needs. Along with helping you look for Medicare Advantage insurance plans, we can also tell you about the benefits and monthly premiums for Medicare Supplement/Medigap plans. Our goal is to help you reduce your out of pocket costs for health care while buying a plan through a company with a top star rating, so give us a call today!