How to Find the Best Massachusetts Medicare Advantage Plans

MoneyGeek reviewed the top-rated Medicare Advantage plans in Massachusetts that offer the broadest benefits and are also widely available. Based on our research, the best PPO plans in Massachusetts are the Aetna Medicare Explorer Plan and the Medicare PPO Blue SaverRx. In terms of HMO plans, Tufts Medicare Preferred HMO Smart Saver Rx is the best choice.

Of course, only you can figure out which Massachusetts Medicare Advantage plan is best for you, by finding one with the benefits and coverages that fit your healthcare needs.

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Last Updated: 5/19/2022
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MoneyGeek found the most widely available Medicare plans with the highest ratings by using the Centers for Medicare & Medicaid Services (CMS) five-star rating system. Our analysis determined the best plans based on various parameters such as the type of plan, whether drug coverage is included and limits on out-of-pocket expenses.

Although our analysis strives to consider every possible scenario, you should perform your own research. You want to make sure that the plan fits you and includes your preferred network of hospitals and providers in Massachusetts.

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Best Medicare Advantage Plans in Massachusetts

Best Medicare Advantage Plan in Massachusetts - Overall

The best Medicare Advantage Plan in Massachusetts for you ultimately depends on your individual needs and preferences. MoneyGeek analyzed several plans for a sample shopper to determine the best PPO plans that come with drug coverage, at least six common benefits and a high CMS star rating. Based on our research, the best PPO plans in the state are the Aetna Medicare Explorer Plan, offered by Aetna Medicare, and Medicare PPO Blue SaverRx, through Blue Cross Blue Shield of Massachusetts.

Although a PPO plan is typically more expensive than an HMO plan, it offers flexibility and access to a wider network of providers. You also don’t need a referral to see a specialist with a PPO plan.

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MoneyGeek Top Pick
Aetna Medicare

MoneyGeek’s analysis shows that the Aetna Medicare Explorer Plan is the best PPO plan in Massachusetts. However, the best option for you depends on what you want to include in your plan.

The details of the Aetna Medicare Explorer Plan are listed below:

  • No monthly premium
  • Offers drug coverage with a $0 deductible
  • Has an in-network max-out-of-pocket limit of $6,700
  • An overall star rating of 4.5 out of 5 from CMS

The Aetna Medicare Explorer Plan comes with the six common benefits you’d expect, i.e., vision, dental, hearing, fitness, worldwide emergency and telehealth. It also includes an over-the-counter drug benefit. With its worldwide emergency coverage, it’s a good option for frequent travelers. The plan is highly rated by the CMS and includes Part D drug coverage which helps cover the cost of prescription drugs.

Based on our research, Medicare PPO Blue SaverRx also ranked as the best PPO plan in Massachusetts, although your choice may differ depending on your specific requirements.

The details of the Medicare PPO Blue SaverRx plan are listed below:

  • Monthly premium of $0
  • Offers drug coverage with an annual drug deductible of $175
  • Has an in-network max-out-of-pocket limit of $6,700
  • An overall CMS star rating of 4.5 out of 5

Medicare PPO Blue SaverRx has a high CMS rating, includes Part D drug coverage and offers the six most common benefits: vision, dental, hearing, fitness, worldwide emergency and telehealth. It also includes an over-the-counter drug benefit. The worldwide emergency coverage makes it a good choice for travelers.

Best HMO Medicare Advantage Plan in Massachusetts

MoneyGeek reviewed several HMO Medicare Advantage plans in Massachusetts to determine the plan that provides the six most common benefits, includes drug coverage and has a high CMS star rating. Tufts Medicare Preferred HMO Smart Saver Rx, offered by Tufts Health Plan, is the best option in the state based on our research. However, the best plan for you may be different, based on your specific requirements.

Although HMO plans are usually cheaper than PPO, EPO and POS plans, it has certain drawbacks. You cannot go outside your provider network to use the covered services, except in an emergency, and you’ll need a referral to see a specialist. These plans are ideal if you have in-network providers in your locality.

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MoneyGeek Top Pick
Tufts Health Plan Direct

Tufts Medicare Preferred HMO Smart Saver Rx is the best HMO plan in Massachusetts based on our research, although the best plan for you depends on your particular needs.

The details of this plan include:

  • No monthly premium
  • Drug coverage with a $250 annual deductible
  • In-network max-out-of-pocket limit of $5,900
  • An overall star rating of 5 out of 5 from CMS

The Tufts Medicare Preferred HMO Smart Saver Rx offers Part D drug coverage along with a total of 9 benefits. They include all six expected benefits — vision, dental, hearing, fitness, telehealth and worldwide emergency — plus transportation, over-the-counter drugs, and home safety devices and modifications.

Best Medicare Advantage Plan in Massachusetts Without Drug Coverage

If you don’t need Part D prescription drug coverage, you’ll have more plans to choose from.

If you’re shopping in Massachusetts for a Medicare Advantage plan without drug coverage, with six core benefits and a high CMS rating, MoneyGeek found Tufts Medicare Preferred HMO Smart Saver Rx, offered by Tufts Health Plan, is the best option.

In fact, this plan is the best option irrespective of whether you want Part D drug coverage included or not.

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MoneyGeek Top Pick
Tufts Health Plan Direct

In Massachusetts, Tufts Medicare Preferred HMO Smart Saver Rx could be the best plan for you, with or without drug coverage. It offers drug coverage and has all six common benefits including hearing, fitness, vision, dental, worldwide emergency and telehealth — plus three less common benefits (transportation, over-the-counter drugs, and home safety devices and modifications). Tufts Medicare Preferred HMO Smart Saver Rx also has a perfect CMS rating.

Some of the features of this plan include:

  • No monthly premium
  • The in-network max-out-of-pocket limit with this plan is $5,900
  • An overall CMS star rating of 5 out of 5

Best Medicare Advantage Plan in Massachusetts for Low Max Out-of-Pocket Costs

Most Medicare Advantage plans in Massachusetts either have low or no premiums. While that sounds attractive, the drawback is that you may still have to pay thousands of dollars in out-of-pocket expenses. To avoid this, it’s best to find a plan with a low in-network max-out-of-pocket limit.

MoneyGeek’s analysis found Medicare PPO Blue ValueRx offered by Blue Cross Blue Shield of Massachusetts is the best plan for most shoppers in the state. It has a low max out-of-pocket limit, drug coverage, six of the common benefits you’d expect and a high star rating from the Centers of Medicare and Medicaid Services.

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MoneyGeek Top Pick
Blue Cross Blue Shield

The Medicare PPO Blue ValueRx plan is the best option for individuals in Massachusetts looking to minimize out-of-pocket expenses with or without drug coverage. MoneyGeek determined this is the best option by filtering out plans with high out-of-pocket limits.

People who choose this plan:

  • Pay a monthly premium of $76
  • Have a maximum out-of-pocket limit of $4900 per year
  • Have a plan with a high CMS star rating of 4.5 out of 5

A plan with a low max out-of-pocket limit protects you from high costs if you have a very expensive year for health payments. With this plan, you pay a maximum of $4,900 in health payments in a year. Once you reach this limit, you won’t pay any more for in-network coverage.

Similarly, this plan’s maximum out-of-pocket limit for out-of-network coverage is $4,900.

Medicare Advantage Plan in Massachusetts - Statistics

Twelve organizations offer Medicare Advantage plans in Massachusetts. The breakdown of the various types of plans and their features below will give you a better understanding of the most common benefits these plans provide versus those not commonly offered.

1

Massachusetts Medicare Advantage Plans are a mix of HMO, PPO and MSA with 79.9% offering drug coverage

At 48.1%, Health Maintenance Organization (HMO) plans are the most widely available Medicare Advantage plans in Massachusetts, while Preferred Provider Organization (PPO) plans are the second most commonly available plans at 31.8%. Some insurers also offer Medical Savings Account (MSA) plans, and these make up 6.2% of the total plans. Approximately 79.9% of all plans provide drug coverage.

2

44% of Medicare Advantage Plans in Massachusetts have a $0 premium

In Massachusetts, 44% of all plans do not charge a premium. For plans that do charge premiums, the average monthly cost is $105.20.

3

Hearing, vision and dental are the common benefits in Massachusetts, with most plans offering them

The most commonly available benefits in Medicare Advantage plans in Massachusetts are hearing, vision, dental as well as worldwide emergency and telehealth. In comparison, benefits such as transportation and over-the-counter drugs are less common, while in-home support, home safety devices and modifications, and emergency response device benefits are rarely offered by insurers.

Expert Insight on Renters Insurance in Massachusetts

What is the best way to shop around for Medicare Advantage plans in Massachusetts?

Mitchell Glavin
Mitchell Glavin:

Another important resource is SHINE, which is the State Health Insurance Assistance Program (SHIP) for the Commonwealth of Massachusetts. This federally funded program offers free advice to Medicare beneficiaries about identifying their best Medicare coverage options. The website for SHINE is located at www.mass.gov/health-insurance-counseling. SHINE counselors can also be reached by telephone: Call 1-800-243-4636 TTY 1-877-610-0241 The Medicare program itself provides the best tool for identifying the Medicare Advantage plans and Medicare Part D plans that are available in Massachusetts.

Methodology

MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in Massachusetts were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of Massachusetts based on county availability.

About the Author


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Mark Fitzpatrick is a senior content manager with MoneyGeek specializing in insurance. Mark has years of experience analyzing the insurance market and creating original research and content. He graduated from Boston College with a Bachelor of Arts and Johns Hopkins University with a Master of Arts.