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With more than 1.3 million people in Massachusetts enrolled in Medicare in 2020,1 you may be wondering if you qualified to join them. HealthMarkets can give you the facts on Medicare eligibility in Massachusetts and the ABCs—and Ds—of Medicare coverage.

Who Has Medicare Eligibility in Massachusetts? 

The Medicare program provides health insurance coverage for Americans who qualify. But who is eligible for Medicare in Massachusetts?

You may be eligible for Medicare in Massachusetts if you’re a U.S. citizen or permanent legal resident who has lived in the U.S. for more than five years and one or more of the following applies to you:2

  • You are 65 or older.
  • You have been on Social Security Disability Insurance (SSDI) for two years.
  • You have end-stage renal disease (ESRD) or Lou Gehrig’s disease.

Understanding Massachusetts Medicare Plans

Once you achieve Medicare eligibility in Massachusetts, you’ll need to make some choices on your coverage. There are four parts to Medicare:

Part A is hospitalization insurance, which covers inpatient care in a hospital, home health care, skilled nursing facility care, nursing home care (not custodial or long-term care), and hospice care.3 

Part B is medical insurance, which covers clinical research, ambulance services, durable medical equipment, mental health, and limited outpatient prescription drugs.

Parts A & B are known as “Original Medicare.” If you choose to keep this coverage, you can add to your benefits with a Part D drug plan and a Medicare Supplement plan, which can cover your out-of-pocket costs like coinsurance and deductibles.

Part C is known as Medicare Advantage. Sold through private insurance companies, Medicare Advantage bundles Parts A & B into a single plan. Most plans include drug coverage and many also have dental, vision, and/or hearing coverage.5 As of 2020, more than 327,000 eligibleMassachusetts residents are enrolled in a Medicare Advantage plan.1

Part D is prescription drug coverage. This is not part of Original Medicare and must be purchased separately.6 Drug coverage may already be included in a Medicare Advantage plan; see plan details to confirm.

How Do I Apply for Medicare in Massachusetts?

You can apply for Medicare coverage in Massachusetts by reaching out to your Social Security office via phone or by visiting them online.

At no cost to you, HealthMarkets’ innovative FitScore® can help you review your options and find the insurance plan that’s right for your needs and budget. 

Approximately 40% of Medicare-eligible Bay State residents who applied for Extra Help with prescription drug costs were deemed eligible in 2020.7Wondering if you might qualify? HealthMarkets can help you find out and get you started comparing plans now.


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References:
1.KFF. 2020. Retrieved from https://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/ | 2. CMS. 2020. Retrieved from https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol | 3. Medicare.gov. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-a-covers Accessed on March 29, 2021. | 4. Medicare.gov. Retrieved from https://www.medicare.gov/what-medicare-covers/what-part-b-covers Accessed on March 29, 2021. | 5. Medicare.gov. Retrieved from https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf Accessed on March 29, 2021. | 6. Medicare.gov. Retrieved from https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans-cover Accessed on March 29, 2021. | 7. SSA. 2020. Retrieved from https://www.ssa.gov/open/data/fy16-onwards-MPD-Plan-Cost-Yrly.csv 

HealthMarkets’ FitScore intends to identify plans that fit your needs. You should carefully review official plan materials.


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