Medicare Plans in Massachusetts
How Do You Qualify for Medicare?
Medicare is a federally-funded health insurance program. American citizens living in the United States qualify for Medicare once they turn 65. They may also qualify if they are under 65 and meet one of the following conditions:
- Receive Social Security disability insurance (SSDI) for at least 24 months
- Have End-Stage Renal Disease (ESRD)
- Have amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease)
- Receive Railroad Retirement Benefits
There is no income requirement to qualify for Medicare.
What Medicare Plans Are Available in Massachusetts?
Medicare enrollees have multiple options to receive their benefits. These are:
- Original Medicare includes Part A (hospital insurance) and Part B (medical insurance)
- Medicare Advantage (MA) plans, also known as Part C, cover the same services as Original Medicare, with most MA plans offering additional coverage
- Medicare Part D plans provide prescription drug coverage
- Medicare Supplement Insurance plans, also known as Medigap, help pay for some of the costs not covered by Original Medicare
Medicare Advantage, Part D, and Medigap plans are provided by private insurance companies. Coverage and costs vary according to each plan and provider. However, beneficiaries still pay their Part B premium, even if they have an MA plan.
Massachusetts does not require Medigap providers to offer plans to beneficiaries who are under age 65.
Medicare Savings Programs in Massachusetts
Although Medicare is a federally-funded program, there are state-level programs to help Massachusettsns pay their Medicare costs. These are known as Medicare Savings Programs (MSPs) and include:
- Qualified Medicare Beneficiary (QMB) Program
- Special Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program.
- Qualified Disabled and Working Individuals (QDWI) Program
While Medicare has no income requirements, MSPs do. Refer to the table below to see the income and resource limits for each program. If you are still employed, you may qualify even if your income exceeds these limits. It's always worth applying to see if you qualify.
Medicare Savings Program Requirements (Massachusetts)
|Program Name||QMB Program||SLMB Program||QI Program||QDWI Program|
|Individual Income||$1,320 Per Month||$1,580 Per Month||$1,775 Per Month||$5,285 Per Month|
|Married Income||$1,781 Per Month||$2,133 Per Month||$2,398 Per Month||$7,129 Per Month|
|Helps Pay||All out-of-pocket costs||Part B Premiums||Part B Premiums||Part A Premiums|
Additional Massachusetts Resources
The following sites offer additional information on Medicare in Massachusetts.
- Massachusetts Division of Insurance
- GIC Medicare Health Insurance Products
- Turning 65 with GIC Coverage
You can also call ClearMatch™ Medicare toll-free at 1-855-537-2378. Our licensed agents are happy to answer your questions and guide you through the Medicare program. The best part? Working with ClearMatch™ Medicare is always free!