This table compares the three Medicare Supplement plans (also called Medigap) available in Massachusetts. Massachusetts passed Medicare reform at the state level before it was done at the Federal level. Similar to plans C and F, Plan 1 pays the Part B deductible and is only available to those who were born before 1955 or those with Medicare Part A effective prior to January 1, 2020.

Massachusetts residents have continuous guarantee issue acceptance. They can change plans and companies without facing medical underwriting. Consequently, they pay more in premium than most of the country.

SERVICES
MEDICARE PAYS
CORE
PLAN 1
PLAN 1A
   
Core Pays
You Pay
Plan 1 Pays
You Pay
Plan 1A Pays
You Pay
HOSPITALIZATION
Semiprivate room and board,
general nursing and
misc. services and supplies

First 60 days
61st thru 90th day
91st day and after:
-- (While using 60 lifetime reserve days)
- Once lifetime reserve days are used:
-- Additional 365 days
-- Beyond add'l 365 days
Part A Pays




All but $1,600
All but $400 / day
All but $800 / day




$0
$0
Core




$0
$400
$800




100%
0%
You Pay




$1,600
$0
$0




$0
100%
Plan 1




$1,600
$400
$800




100%
0%
You Pay




$0
$0
$0




$0
100%
Plan 1A




$1,600
$400
$800




100%
0%
You Pay




$0
$0
$0




$0
100%
SKILLED NURSING FACILITY CARE
You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days - Copay/Day
21st - 100th day- Copay/Day
101st day and after
Part A Pays









All approved amounts
All but $200 / day
$0
Core









$0
$0
$0
You Pay









$0
$200
100%
Plan 1









$0
$200
$0
You Pay









$0
$0
100%
Plan 1A









$0
$200
$0
You Pay









$0
$0
100%
BLOOD
First 3 pints
Additional amounts
Part A Pays
$0
100%
Core
100%
$0
You Pay
$0
$0
Plan 1
100%
$0
You Pay
$0
$0
Plan 1A
100%
$0
You Pay
$0
$0
HOSPICE CARE
You must meet Medicare's
requirements, including a
doctor's certification of
terminal illness.
Part A Pays

All except small
copayment or
coinsurance.
Core


Remaining balance
You Pay



$0
Plan 1


Remaining balance
You Pay



$0
Plan 1A


Remaining balance
You Pay



$0
MEDICAL EXPENSES - IN
OR OUT OF THE
HOSPITAL AND
OUTPATIENT HOSPITAL
TREATMENT, such as
Physician's services, inpatient
and outpatient medical and
surgical services and supplies,
physical and speech therapy,
diagnostic tests, durable
medical equipment.

First $226 of Medicare
Approved Amounts
Part B Pays












$0
Core












$0
You Pay












$226
Plan 1












$226
You Pay












$0
Plan 1A












$0
You Pay












$226
Remainder of Part B
Approved claims after $226

DR Visit
ER Visit
Part B Pays
80%
80%
80%
Core
20%
20%
20%
You Pay
0%
0%
0%
Plan 1
20%
20%
20%
You Pay
0%
0%
0%
Plan 1A
20%
20%
20%
You Pay
0%
0%
0%
EXCESS
CHARGES
Part B Pays
$0
Core
$0
You Pay
100%
Plan 1
$0
You Pay
100%
Plan 1A
$0
You Pay
100%
BlOOD
First 3 pints
Next $226 of Medicare
approved amounts

Remainder of Medicare
approved amounts
Part B Pays
$0

$0


80%
Core
100%

$0


20%
You Pay
0%

$226


0%
Plan 1
100%

$226


20%
You Pay
0%

$0


0%
Plan 1A
100%

$0


20%
You Pay
0%

$226


0%
CLINICAL LABORATORY
SERVICES
Tests for
Diagnostic Services
Part B Pays

100%
Core

0%
You Pay

0%
Plan 1

0%
You Pay

0%
Plan 1A

0%
You Pay

0%
HOME HEALTH CARE
Medicare approved services
Medically necessary
skilled care services
and medical supplies
Part A&B Pay



100%
Core



0%
You Pay



0%
Plan 1



0%
You Pay



0%
Plan 1A



0%
You Pay



0%