Medicare 2026

Boston Medicare help: how to reach SHINE counselors and licensed agents

Boston is home to more than 104,000 residents aged 65 and older, and every one of them has questions about Medicare at some point — about signing up, switching plans, or making sense of a letter from an insurer. The good news is that you do not have to figure it out alone, and you do not have to pay for help.

Medicare 2027Boston, MA

Boston is in Suffolk County, where Medicare offers a mix of coverage choices and where two very different kinds of help exist side by side: free, unbiased counseling through the state's SHIP program, and licensed insurance agents who can walk you through specific plans. Knowing which one to call — and when — can save you a lot of time.

What SHIP is — and what it's called in Massachusetts

Every state has a State Health Insurance Assistance Program, or SHIP. It is funded by the federal government to give people on Medicare free, one-on-one counseling that is not tied to any insurance company.

In Massachusetts, the SHIP program is called SHINE — Serving the Health Insurance Needs of Everyone. SHINE counselors are trained volunteers and staff who can sit down with you (in person, by phone, or virtually) and go over your options without trying to sell you anything.

You can reach SHINE by calling 1-800-AGE-INFO (1-800-243-4636) and choosing the SHINE option, or by visiting the Massachusetts Executive Office of Elder Affairs website. Boston-area councils on aging and senior centers often host SHINE appointments, too.

What SHINE counselors can help with

SHINE is a good first stop when you want an explanation, not a sales pitch. Counselors can help you:

• Understand the parts of Medicare (A, B, C, and D) and how they fit together.
• Compare Medicare Advantage and Original Medicare with a Medigap policy.
• Look up your prescriptions on Medicare's Plan Finder to see how different drug plans would treat them.
• Check whether you qualify for programs that help with Medicare costs, like Extra Help or a Medicare Savings Program.
• Sort through a denial, a bill, or a confusing notice from an insurer.

Because SHINE is not paid on commission, counselors have no reason to steer you toward one plan over another.

When a licensed agent makes sense

Licensed insurance agents and brokers serve a different role. They are appointed to sell specific Medicare Advantage, Part D, and Medigap plans, and they can enroll you directly. A good agent will explain the trade-offs of the plans they carry and answer detailed questions about networks, drug coverage, and extra benefits.

A few things to keep in mind:

• Agents are usually paid a commission by the insurer when you enroll, which is legal and disclosed, but it is worth knowing.
• Not every agent represents every carrier. In Suffolk County, 10 carriers offer Medicare Advantage plans with drug coverage, and one agent may only sell a portion of them.
• You can ask an agent which carriers they are appointed with before you sit down.

Many Boston residents use both resources — SHINE to understand the landscape, and a licensed agent to enroll once they know what they want.

Boston's Medicare landscape at a glance

Boston sits in Suffolk County, where Medicare Advantage plan availability is set at the county level by the Centers for Medicare & Medicaid Services (CMS). For 2027, there are 47 Medicare Advantage plans available in Suffolk County, offered by 11 carriers. Stand-alone Part D drug plans are sold statewide rather than by county.

That's a lot to sort through, which is exactly why free counseling exists.

Key 2027 rules worth knowing before you call

A little preparation makes any Medicare conversation go faster. For 2027:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once you hit that in covered drug costs, you pay nothing more for covered drugs the rest of the year.
• The Part D deductible cannot be higher than $700 in 2027.
• The old "donut hole" is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs over monthly payments instead of paying at the pharmacy counter. It is optional and free to join.
• IRMAA surcharges on Part B and Part D start above $109,000 in income for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7.
• Medicare Advantage Open Enrollment: January 1 – March 31.

Other Boston-area resources

Beyond SHINE and licensed agents, several local resources can point you in the right direction:

• Boston Age Strong Commission — the city's department for older adults, which can connect you with local services.
• Local councils on aging and senior centers — many host SHINE appointments and Medicare education sessions in the fall.
• medicare.gov — the official federal site, with the Plan Finder tool.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7 for official answers.