Medicare Supplement

Which Medigap plans can you still buy in Massachusetts, and how to compare insurers

Boston shoppers who go looking for a Medicare Supplement policy quickly notice something odd: the plan letters most guides talk about — Plan G, Plan N, Plan F — are not what's sold here. Massachusetts is one of three states (along with Minnesota and Wisconsin) that runs its own Medigap system. So before you compare insurers, it helps to know what you're actually comparing.

What Medigap looks like in Massachusetts

In most states, Medigap comes in ten federally lettered plans (A through N). Massachusetts standardizes its policies differently. Here, the choices are:

• Core — the base plan, covering Part A coinsurance and hospital costs, Part B coinsurance, and certain other basics.
• Supplement 1 — a broader plan that is generally only available if you were eligible for Medicare before January 1, 2006.
• Supplement 1A — the broader plan available to people who became eligible for Medicare on or after January 1, 2006.

Whatever insurer you buy from, Core is Core, Supplement 1 is Supplement 1, and Supplement 1A is Supplement 1A. The state defines the benefits. That means the coverage does not get "better" at one company versus another — but the price, the way that price rises over time, and the service you get can be very different.

How to find which insurers sell Medigap in Boston

Boston is in Suffolk County, and Medigap availability is set by the state and your ZIP code. There is no single public list of every carrier in this article, so here is the reliable way to build one yourself:

1. Medicare.gov Medigap policy search. Go to medicare.gov, choose "Find a Medigap policy," and enter a Boston ZIP code. You'll see the insurers licensed to sell the Massachusetts standardized plans in your area. 2. Massachusetts Division of Insurance rate guide. The state publishes a Medigap rate comparison document that lists the companies selling here and how their premiums are structured. Search "Massachusetts Division of Insurance Medigap" to find the most current version. 3. SHINE (Serving the Health Insurance Needs of Everyone). This is Massachusetts's State Health Insurance Assistance Program. Trained counselors can walk you through the current carriers at no cost. You can reach SHINE through Mass.gov or by calling 1-800-243-4636.

Using all three sources together gives you both the full list of licensed insurers and the plain-language help to understand what you're looking at.

Pricing methods: why the "same" plan costs different amounts

The single biggest thing that separates one insurer from another is how they build the premium. There are three common approaches:

• Community-rated (also called no-age-rated). Everyone with the same plan pays roughly the same premium regardless of age. Your premium can still change with inflation, but not because you had a birthday.
• Issue-age-rated. Your premium is based on the age you were when you first bought the policy. Buy at 65, and your rate is anchored there; it can rise with inflation but not simply because you're older.
• Attained-age-rated. Your premium starts lower at 65 but goes up as you get older, in addition to any general rate increases.

Massachusetts has strong rules protecting Medigap buyers, but the pricing method still matters over a 10- or 20-year horizon. A policy that looks affordable at 66 may look very different at 78 if it's attained-age-rated. Ask each insurer, in writing, which method it uses.

Rate history, household discounts and underwriting

Once you know the pricing method, dig into three more comparisons:

• Rate increase history. Ask how much the insurer has raised premiums on this exact plan in each of the last several years. The Massachusetts rate guide and the Division of Insurance filings are useful for this. A carrier with steady, modest increases may be a better fit than one whose rates jump around.
• Household or spousal discounts. Some insurers offer a small discount if more than one adult in the home has a policy with them. The amount and rules vary — always ask.
• Underwriting rules. Massachusetts is friendlier than most states here. The state has a continuous open enrollment rule, meaning Medigap insurers must sell you a policy regardless of health, and generally cannot charge you more because of pre-existing conditions, during annual open enrollment windows the state sets. Still, timing matters. Confirm the current rules with SHINE or the Division of Insurance before you switch.

How to actually compare, step by step

The table on this page lists the Massachusetts Medigap plan structure. Once you've pulled a list of insurers from Medicare.gov and the state rate guide, work through them this way:

1. Decide which plan you want first — Core, Supplement 1 or Supplement 1A — based on your eligibility date and how much coverage you want. 2. Then, and only then, compare insurers offering that same plan. 3. For each insurer, note the pricing method, the last 3–5 years of rate increases, any household discount, and the current premium for your ZIP code. 4. Call two or three finalists to ask about billing options, customer service hours, and how claims are handled.

Because the benefits are identical by law, this is essentially a pricing-and-service decision, not a coverage decision.