Addendum to “Guide to Health Insurance for People with Medicare”; Issued 01/30/2020

1 CHARLES D. BAKER Governor The Commonwealth of Massachusetts Executive Office of Elder Affairs One Ashburton Place, 5th Floor Boston, Massachusetts 02108 Tel: (617) 727-7750 Fax: (617) 727-9368 www.mass.gov/elders KARYN E. POLITO Lieutenant Governor ELIZABETH CHEN, PhD Secretary Massachusetts Bulletin for People with Medicare January 2020 Health Insurance Options for People with Medicare  Original Medicare (Part A and Part B)  Medicare Supplement Insurance (Medigap)  Medicare Advantage Plans (Medicare Part C)  Medicare Prescription Drug Coverage (Medicare Part D)  Employer, Union, Retiree, other group health insurance coverage  COBRA  Veterans Health Benefits  Military Benefits (TRICARE)  Indian Health Services Programs for People with Limited Income and Resources  Extra Help Paying for Medicare Prescription Drug Coverage (Part D)  Medicare Savings Programs (help with Medicare costs)  Prescription Advantage (prescription drug insurance assistance program for Massachusetts residents) 2  MassHealth (Medicaid) This Bulletin provides basic health insurance information for people eligible for Medicare. Contact your plan benefits administrator for information about employer, union, retiree, or other group health coverage. Contact your local Veterans Service Officer for Veterans and TRICARE health insurance information. Contact the Indian Health Services for health information for American Indians and Alaska Natives. Medicare Medicare is a Federal Government health insurance program administered by the Centers for Medicare and Medicaid Services (CMS) for people:  age 65 or older  under age 65 with certain disabilities Medicare has 4 parts:  Part A (Medicare Hospital Insurance) Helps pay for inpatient care in hospitals, skilled nursing facilities, hospice, home health care and other services.  Part B (Medicare Medical Insurance) Helps pay for outpatient medical services including doctor visits, medical equipment, home health care, outpatient care, and some preventive services.  Part C (Medicare Advantage Plan) Medicare Advantage Plans include Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Some Medicare Advantage Plans may offer Medicare Part D, prescription drug coverage at additional charge and other services not covered by Medicare. Medicare Advantage Plans (like HMOs, PPOs) are sold by private health insurance companies approved by Medicare.  Part D (Medicare Prescription Drug Coverage) Helps pay for outpatient prescription drugs. Medicare prescription drug plans are sold by private insurance companies approved by Medicare. 3 There are 2 ways to get Medicare coverage: (1) Original Medicare is fee-for-service coverage administered directly by Medicare. Original Medicare covers Medicare Part A (Hospital) and Part B (Medical) services. Under Original Medicare, you have the choice of doctors, hospitals and other providers that accept Medicare. You may purchase optional Medicare Supplement (Medigap) insurance from a private company or have employer or other health insurance to help pay for deductibles and coinsurance in Original Medicare. You may decide to purchase a Medicare Prescription Drug plan (Part D) to help pay for outpatient prescription drugs. (2) Medicare Advantage Plan (like an HMO or PPO) Medicare Advantage Plan/s (MA-PD) cover Medicare Part A and Part B Services. MA-PDs are sold by private companies approved by Medicare and usually charge a monthly premium. Some plans offer additional benefits not covered by Medicare. Most plans require use of network doctors, hospitals and other providers. Most MA-PDs offer Medicare prescription drug coverage (Part D) at additional cost. Some plans do not offer drug coverage (MA plans) You must be enrolled in Medicare A and B, pay plan premiums, deductibles, copays and coinsurance. (Medicare Supplement Insurance cannot be sold to MA-PD enrollees) Medicare Advantage Plans sold in Massachusetts  Health Maintenance Organizations (HMO) Must be a resident of the plan’s service area and use provider network  Preferred Provider Organization (PPO) Must be a resident of the plan’s service area May use out-of-network Medicare providers at higher premium  Point-of Service (HMO/POS) Must be a resident of the plan’s service area. May use of out-of-network Medicare providers at higher premium  Private Fee-for-Service (PFFS) 4 May use any Medicare provider that agrees to treat patient. The Plan determines provider and patient payment for the services.  Special Needs Plan (SNP) For people with Medicare and Medicaid or special conditions. Medicare Prescription Drug Coverage (Part D) Medicare prescription drug coverage (Part D) helps pay for prescription drugs. Medicare prescription drug plans are sold by private companies approved by Medicare. Each plan can vary in cost and specific drugs covered. Medicare Prescription Drug Plans (PDPs) are stand-alone plans for for enrollees in Original Medicare. Most Medicare Advantage Plans offer optional Medicare prescription drug coverage. Medicare Supplement Insurance (Medigap) Medicare Supplement Insurance (also called Medigap Insurance) is sold by private insurance companies to help pay health care costs that Original Medicare does not cover such as deductibles and coinsurance. Some Medigap insurers may include coverage for services that are not covered by Original Medicare. Two standard Medigap policies, Medicare Supplement Core and Medicare Supplement 1A (new as of January 1, 2020), are offered to Massachusetts residents. NOTE: Medicare Supplement 1 policies are no longer available to persons newly eligible for Medicare on or after January 1, 2020, however, persons eligible for Medicare prior to January 1, 2020 will have the right to keep or enroll in a Medicare Supplement 1 policy. Medicare Supplement Insurance (Medigap) for Massachusetts residents is regulated by federal and state laws including the following:  Medigap policies must be clearly identified as “Medicare Supplement Insurance” 5  Policies and text are standard for all insurers. Basic benefits are the same, some may offer additional benefits  Medigap insurance is guaranteed renewable and cannot be cancelled unless the beneficiary stops paying the premium or provides false information on the application.  Medigap insurers cannot refuse to sell a policy, exclude or limit coverage, or require a waiting period before coverage starts due to existing health problems.  Medigap insurers must offer the same premium to all policyholder and cannot charge a different premium based on age or health. Medicare Select Plan  Medicare Select Plans are Medicare supplement plans that require the use of a provider network. (Note: As of January 1, 2020, no Medigap carrier is currently offering a Medicare Select plan to new members.) The Massachusetts Division of Insurance monitors insurance companies authorized to sell insurance in Massachusetts, For information contact: Massachusetts Division of Insurance 617-521-7794 (Boston) www.mass.gov/doi Programs for People with Limited Income and Resources Extra Help for Medicare Prescription Drug Coverage (Part D) also known as the Limited Income Subsidy (LIS) is a federal program that helps Medicare beneficiaries with limited income and assets pay some of the costs for Medicare prescription drug coverage (Part D). For more information or to enroll in Extra Help, contact Social Security at 1-800-772-1213 or visit www.socialsecurity.gov Medicare Savings Program (MassHealth Buy-In) are federal programs that help pay Medicare premiums and Part A and Part B deductibles and coinsurance for Massachusetts residents with limited income and assets and not receiving other MassHealth benefits. 6 For more information about Medicare Savings Programs contact MassHealth Customer Service 1-800-841-2900 (TTY: 1-800-497-4648 for people with partial or total hearing loss) Prescription Advantage/State Pharmacy Assistance Program (SPAP) Is a state program that helps people with limited income and/or medical condition and age pay for prescription drugs. Prescription Advantage is funded by state legislation and is administered by the Massachusetts Executive Office of Elder Affairs. For information about eligibility and enrollment contact: Prescription Advantage Customer Service 1-800-AGE-INFO (1-800-243-4636) press 2 www.prescriptionadvantage.com (TTY: 1-800-610-0241 for people with partial or total hearing loss) MassHealth MassHealth provides a wide range of medical services and other benefits. These programs are authorized by state and federal laws and help pay medical costs for people with limited income and resources and meet other eligibility requirements.  MassHealth Standard provides a full range of health care benefits.  MassHealth CommonHealth for people with disabilities whose income is too high to be eligible for MassHealth Standard.  MassHealth Frail Elder Waiver Program provides coordinated community based services to frail elders living in the community. 7  MassHealth Personal Care Attendant Services (PCA) helps people with long-term disabilities live independently at home.  Program for All-inclusive Care for the Elderly (PACE) PACE providers deliver needed medical and support services to people living in the community. MassHealth Plans for Dual Eligible (MassHealth & Medicare) Senior Care Options (SCO) is a coordinated health plan that combines Medicare and Medicaid health care with long term care supports for consumers 65 and older. One Care (Integrated Care Organization or ICO) is a coordinated care demonstration project in Massachusetts that combines Medicare and MassHealth services with long term care supports for consumers 21-64 years old with disabilities. Enroll through MassHealth. MassHealth Long-Term Care(LTC) covers LTC costs for individuals living in LTC facilities For information or questions about eligibility, enrollment and to receive a senior application, contact: MassHealth Customer Service 1-800-841-2900 TTY: 1-800-497-4648 (for people with partial or total hearing loss) or visit www.MAhealthconnector.org for information Helpful Numbers Massachusetts Executive Office of Elder Affairs/MassOptions To directly connect with elder services in your area call and press or say: 1-800-AGE-INFO (1-800-243-4636) or 1-844-422-6277 8  to connect to your local elder service agency or caregiver program: Press 1  to connect to Prescription Advantage-state prescription drug program: Press 2  to connect to your regional SHINE Program: Press 3  to report elder abuse, neglect or financial exploitation: Press 4  cell phone or all other matters: Press 5 Massachusetts Division of Insurance Boston 617-521-7794 www.mass.gov/doi Regulates insurance companies authorized to sell insurance in Massachusetts. Elder Protective Services Elder Abuse Hotline (24 hour/7 days) 1-800-922-2275 A statewide program is administered by the Executive Office of Elder Affairs. Protective Service Agencies investigates reports of elder abuse and provide protective services to abused elders. Attorney General of Massachusetts Elder Hotline 1-888-243-5337 www.mass.gov/ago The Attorney General of Massachusetts is the state’s chief law enforcement officer The Hotline provides information about elder-related issues and programs. Massachusetts Medicare Advocacy Project (MAP) 1-617-603-1700 Provides Medicare beneficiaries free legal advice and legal representation for appealing Medicare decisions. MCPHS University Pharmacy Outreach Program 1-866-633-1617 www.mcphs.edu/pharmacyoutreach Provides free prescription drug information and referrals. The Pharmacy Outreach 9 Program is a public service of the MCPHS and EOEA. Social Security Administration 1-800-772-1213 www.ssa.gov Contact SSA to enroll in Medicare and for information and issues about Social Security and other related programs. Massachusetts Health Connector 1-877-623-6765 www.MAhealthconnector.org Health insurance, assistance and on-line application for people without insurance or small businesses; dental plan list for anyone. SHINE (Serving Health Insurance Needs of Everyone) 1-800-243-4636 Press or say 3 www.800ageinfo.com SHINE, a State Health Insurance Assistance Program (SHIP), provides information, counseling and assistance to Medicare beneficiaries and their families regarding Medicare and other health insurance issues. SHINE Health Insurance Counselors are trained and certified by the Massachusetts Executive Office of Elder Affairs (EOEA). SHINE is administered by EOEA in partnership with elder service agencies, councils on aging, independent living centers and community based programs. SHINE is partially funded by the Administration on Community Living. Medicare Supplement Plans Offered in Massachusetts 2020 As of January 1, 2020 Comparison of Plans Core Supplement 1 Supplement 1A Basic Benefits Included In All Plans: Hospitalization Part A Co-payments Days 61 - 90: $352 per day Days 91-150: $704 per day 365 Additional Lifetime Hospital days - Paid in full Part B Coinsurance Coverage of coinsurance, in most cases, 20% of approved amount Parts A and B Blood First 3 pints X X X X X X X X X X X X X X X Additional Benefits Part A Deductible for Hospital Days 1 - 60 $1408 per benefit period X X Skilled Nursing Facility Coinsurance Days 21-100 - $176 per day X X Part B Annual Deductible - $198 X Foreign Travel - For Medicare-covered services needed while traveling abroad. X X Inpatient Days in Mental Health Hospitals In addition to Medicare's coverage of 190 lifetime days and less any days previously covered by plan in same benefit period 60 days per calendar year 120 days per benefit period 120 days per benefit period IMPORTANT NOTICE: Medicare Supplement premium rates are required to be in effect for not less than 12 months. Effective dates shown for each Carrier are based on the most recent filing on record with the Division of Insurance. Medicare Supplement Plans Offered in Massachusetts 2020 As of January 1, 2020 Medigap Carriers Please note that some rates may change during 2020 Medicare Supplement Core Medicare Supplement 1 Medicare Supplement 1A Blue Cross & Blue Shield of MA (Medex) 1-800-678-2265 sales/apps 1-800-258-2226 member services 711 (TDD) www.bluecrossma.com (continuous open enrollment) $104.10 Effective 01/01/2020 $209.21 Effective 01/01/2020 $177.97 Effective 01/01/2020 Optional Preventive Care Benefits Rider $ 2.45 Effective 01/01/2020 $ 2.45 Effective 01/01/2020 $ 2.45 Effective 01/01/2020 Fallon Health & Life Assurance Company 1-866-330-6380 sales/apps 1-800-868-5200 member services TRS 711 www.fallonhealth.org/medsupp (continuous open enrollment) $126.00 Effective 01/01/2020 $229.00 Effective 01/01/2020 $215.00 Effective 01/01/2020 HNE Insurance Company 1-877-443-3314 711 (TTY) www.healthnewengland.org (continuous open enrollment) $112.00 Effective 01/01/2020 $197.00 Effective 01/01/2020 $180.00 Effective 01/01/2020 HPHC Insurance Company, Inc. 1-877-909-4742 sales/apps 1-877-907-4742 member services 711 (TTY) www.hpforlife.org (continuous open enrollment) $129.00 Effective 01/01/2020 $229.00 Effective 01/01/2020 $185.00 Effective 01/01/2020 Medicare Supplement Plans Offered in Massachusetts 2020 As of January 1, 2020 Medigap Carriers Please note that some rates may change during 2020 Medicare Supplement Core Medicare Supplement 1 Medicare Supplement 1A Humana Insurance Company 1-800-872-7294 sales/apps 1-800-866-0581 member services 1-800-833-3301 (TDD) www.humana.com (continuous open enrollment) $169.91 Effective 10/01/2018 $270.85 Effective 10/01/2018 $282.20 Effective 01/01/2020 Humana Insurance Company HEALTHY LIVING (including dental and vision benefits) 1-800-872-7294 sales/applications 1-800-866-0581 member services 1-800-833-3301 (TDD) www.humana.com (continuous open enrollment) $183.26 Effective 10/01/2018 $284.20 Effective 10/01/2018 $295.55 Effective 01/01/2020 Transamerica Life Insurance Company For eligibility & plan information: 1-800-247-1771 (Group Medicare Supplement Insurance sponsored for members of various participating industry, trade, professional and other special interest associations.) (continuous open enrollment) $125.58 Effective 01/01/2020 $217.21 Effective 01/01/2020 $194.62 Effective 01/01/2020 Transamerica Premier Life Insurance Company 1-800-458-5736 (Group Medicare Supplement insurance sponsored exclusively for eligible members of the American Medical Association.) www.amainsure.com (continuous open enrollment) $108.85 Effective 01/01/2020 $188.29 Effective 01/01/2020 $168.70 Effective 01/01/2020 Medicare Supplement Plans Offered in Massachusetts 2020 As of January 1, 2020 In addition to the above-noted Medicare Supplemental plans, Massachusetts residents may enroll in Medicare Advantage Plans as well as Part D Prescription Drug Plans with the Centers for Medicare and Medicaid Services ("CMS"). For further information regarding these plans please visit the following website: https://www.medicare.gov/find-a-plan/questions/home.aspx Medigap Carriers Please note that some rates may change during 2020 Medicare Supplement Core Medicare Supplement 1 Medicare Supplement 1A Tufts Insurance Company Sales: 1-888-508-1401 Customer Relations: 1-800-701-9000 711 (TTY) www.thpmp.org/medsupp (continuous open enrollment) $124.00 Effective 01/01/2020 $218.00 Effective 01/01/2020 $201.00 Effective 01/01/2020 Optional Dental Rider $48.00 Effective 01/01/2020 $48.00 Effective 01/01/2020 $48.00 Effective 01/01/2020 UnitedHealthcare Insurance Company Only for members of AARP www.aarpmedicaresupplement.com 1-800-523-5800 (continuous open enrollment) $130.50 Effective 06/01/2019 $234.50 Effective 06/01/2019 $195.25 Effective 01/01/2020 Effective January 2020 Medicare Prescription Drug Plans Offered in Massachusetts in 2020 Company Prescription Drug Plan Monthly Premium Annual Deductible Customer Service Phone Number Blue Medicare Rx  Blue MedicareRx Value Plus $42.50 $435.00 Phone: 1-877-479-2227 TTY/TDD: 711  Blue MedicareRx Premier $128.00 $0.00 Cigna- HealthSpring Rx  Secure $32.70 $435.00 Phone: 1-800-735-1459 TTY/TDD: 711  Secure Essential $22.20 $435.00  Secure Extra $48.30 $100.00 Envision Insurance  Envision Rx Plus $14.20 $435.00 Phone: 1-888-377-1439 TTY/TDD: 711 Express Scripts Medicare  Express Scripts Medicare Choice $84.80 $250.00 Phone: 1-866-477-5704 TTY: 1-800-716-3231  Express Scripts Medicare Value $37.00 $435.00  Express Scripts Medicare Saver $24.10 $435.00 Humana Insurance Company  Humana Walmart Value Rx Plan $13.20 $435.00 Phone: 1-800-706-0872 TTY/TDD: 711  Humana Basic Rx Plan $35.10 $435.00  Humana Premier Rx Plan $62.30 $435.00 Effective January 2020 Medicare Prescription Drug Plans Offered in Massachusetts in 2020 Company Prescription Drug Plan Monthly Premium Annual Deductible Customer Service Phone Number Mutual of Omaha Rx  Mutual of Omaha Rx Plus  Mutual of Omaha Rx Value $49.30 $24.10 $435.00 $435.00 Phone: 1-800-961-9006 TTY/TDD 1-800-584-6939 SilverScript  Choice $33.10 $275.00 1-833-526-2445 TTY/TDD 711  Plus $89.80 $0.00 United HealthCare Insurance Company  AARP Medicare Rx Saver Plus $32.50 $435.00 Phone: 1-888-867-5564 TTY/TDD: 711  AARP Medicare Rx Preferred $77.60 $0.00  AARP Medicare Rx Walgreens $36.20 $435.00 WellCare  WellCare Wellness Rx $13.30 $435.00 Phone: 1-888-293-5151 TTY: 711  WellCare Value Script $15.70 $435.00  WellCare Medicare Rx Selelct $21.90 $400.00  WellCare Classic $31.90 $435.00  WellCare Medicare RxSaver $35.10 $435.00  WellCare Rx Value Plus $70.30 $0.00 Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties AARP Medicare Complete Provided by United Healthcare Phone: 1-800-555-5757 TTY/TDD: 711 Medicare Advantage Plan 1 HMO $0.00 Yes Plan Doctors for Most Services Bristol Essex Hampden Middlesex Plymouth Suffolk Worcester Medicare Advantage Plan 2 HMO $42.00 Yes Plan Doctors for Most Services Middlesex Suffolk Medicare Advantage Plan 2 HMO $49.00 Yes Plan Doctors for Most Services Bristol Essex Hampden Plymouth Worcester Medicare Advantage Plan 3 HMO $76.00 Yes Plan Doctors for Most Services Middlesex Suffolk Medicare Advantage Plan 3 HMO $79.00 Yes Plan Doctors for Most Services Bristol Essex Hampden Plymouth Worcester Medicare Advantage Walgreens PPO $0.00 Yes Any Doctor Bristol Essex Hampden Middlesex Plymouth Suffolk Worcester Medicare Advantage Choice PPO $47.00 Yes Any Doctor Barnstable Berkshire Bristol Dukes Essex Franklin Hampden Hampshire Middlesex Nantucket Norfolk Plymouth Suffolk Worcester Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Aetna Medicare 1-855-275-6627 TTY/TDD: 711 Medicare Value HMO $0.00 Yes Plan Doctors for Most Services Bristol Essex Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Medicare Explorer PPO $0.00 Yes Any Doctor Bristol Essex Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Medicare Explorer Premier PPO $56.00 Yes Any Doctor Bristol Essex Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Blue Cross Blue Shield of Massachusetts Phone: 1-800-678-2265 TTY/TDD: 711 Medicare HMO Blue PlusRx HMO $266.00 Yes Plan Doctors for Most Services Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Medicare HMO Blue Saver Rx HMO $0.00 Yes Plan Doctors for Most Services Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Medicare HMO Blue Value Rx HMO $36.00 Yes Plan Doctors for Most Services Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Medicare HMO Blue Value Rx HMO $56.00 Yes Plan Doctors for Most Services Worcester Medicare HMO Blue FlexRx HMO- POS $96.00 Yes Plan Doctors for Most Services Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Blue Cross Blue Shield of Massachusetts (continued) Phone: 1-800-678-2265 TTY/TDD: 711 Medicare HMO Blue FlexRx HMO- POS $106.00 Yes Plan Doctors for Most Services Worcester Medicare PPO Blue PlusRx PPO $262.00 Yes Any Doctor Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Medicare PPO Blue ValueRx PPO $76.00 Yes Any Doctor Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Medicare PPO Blue ValueRx PPO $86.00 Yes Any Doctor Worcester Blue Cross Blue Shield of Massachusetts (continued) Medicare PPO Blue SaverRx PPO $0.00 Yes Any Doctor Barnstable Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Erickson Advantage Phone: 1-866-774-9671 TTY/TDD: 711 Erickson Advantage Signature with Drugs HMO- POS $195.00 Yes Plan Doctors Only Essex Plymouth Erickson Advantage Freedom HMO- POS $60.00 Yes Plan Doctors Only Essex Plymouth Erickson Advantage Liberty without Drugs HMO- POS $0.00 No Plan Doctors Only Essex Plymouth Erickson Advantage Liberty with Drugs HMO- POS $25.00 Yes Plan Doctors Only Essex Plymouth Fallon Health Phone: 1-888-325-5669 TTY/TDD: 711 Medicare Plus Blue HMO $154.00 Yes Plan Doctors Only Bristol Middlesex Norfolk Medicare Plus Blue HMO $207.00 Yes Plan Doctors Only Berkshire Medicare Plus Blue HMO $100.00 Yes Plan Doctors Only Hampden Hampshire Medicare Plus Blue HMO $174.00 Yes Plan Doctors Only Essex Plymouth Suffolk Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Medicare Plus Blue HMO $238.00 Yes Plan Doctors Only Franklin Worcester Medicare Plus Blue HMO $227.00 Yes Plan Doctors Only Barnstable Medicare Plus Central Blue HMO $128.00 Yes Plan Doctors Only Worcester Medicare Plus Orange HMO $0.00 Yes Plan Doctors Only Bristol Essex Franklin Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Fallon Health (Continued) Phone: 1-888-325-5669 TTY/TDD: 711 Medicare Plus Orange HMO $19.00 Yes Plan Doctors Only Barnstable Berkshire Medicare Plus Central Orange HMO $0.00 Yes Plan Doctors Only Worcester Medicare Plus Saver No Rx HMO $59.00 No Plan Doctors Only Berkshire Medicare Plus Saver No Rx HMO $44.00 No Plan Doctors Only Bristol Essex Middlesex Norfolk Plymouth Suffolk Medicare Plus Saver No Rx HMO $66.00 No Plan Doctors Only Franklin Worcester Medicare Plus Saver HMO $8.00 No Plan Doctors Only Hampden Hampshire Medicare Plus Saver No Rx HMO $91.00 No Plan Doctors Only Barnstable Medicare Plus Green HMO $94.00 Yes Plan Doctors Only Berkshire Medicare Plus Green HMO $73.00 Yes Plan Doctors Only Bristol Essex Middlesex Norfolk Plymouth Suffolk Medicare Plus Green HMO $51.00 Yes Plan Doctors Only Hampden Hampshire Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Medicare Plus Green HMO $104.00 Yes Plan Doctors Only Franklin Worcester Medicare Plus Green HMO $113.00 Yes Plan Doctors Only Barnstable Fallon Health (Continued) Medicare Plus Central Green HMO $33.00 Yes Plan Doctors Only Worcester Medicare Plus Super Saver Rx HMO $46.00 Yes Plan Doctors Only Barnstable Medicare Plus Super Saver Rx HMO $40.00 Yes Plan Doctors Only Berkshire Bristol Essex Franklin Middlesex Norfolk Plymouth Suffolk Worcester Medicare Plus Super Saver Rx HMO $21.00 Yes Plan Doctors Only Hampden Hampshire Harvard Pilgrim Health Care Phone: 1-877-431-4742 TTY/TDD: 711 Stride Basic Rx HMO $0.00 Yes Plan Doctors Only Barnstable Bristol Essex Middlesex Norfolk Plymouth Suffolk Worcester Stride Value Rx Plus HMO $168.00 Yes Plan Doctors Only Barnstable Bristol Essex Middlesex Norfolk Plymouth Suffolk Stride Value Rx Plus HMO $195.00 Yes Plan Doctors Only Worcester Stride Value Rx HMO $67.00 Yes Plan Doctors Only Barnstable Bristol Essex Middlesex Norfolk Plymouth Suffolk Stride Value Rx HMO $79.00 Yes Plan Doctors Only Worcester Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Health New England Phone: 1-877-433-3314 TTY/TDD: 711 HNE Medicare Basic No Rx HMO $0.00 No Plan Doctors Only Berkshire Franklin Hampden Hampshire HNE Medicare Plus Rx HMO $109.00 Yes Plan Doctors Only Berkshire Franklin Hampden Hampshire HNE Medicare Premium No Rx HMO $79.00 No Plan Doctors Only Berkshire Franklin Hampden Hampshire HNE Medicare Premium Rx HMO $166.00 Yes Plan Doctors Only Berkshire Franklin Hampden Hampshire HNE Medicare Value HMO $0.00 Yes Plan Doctors Only Berkshire Franklin Hampden Hampshire HNE Medicare Select HMO- POS $90.00 Yes Plan Doctors for Most Services Berkshire Franklin Hampden Hampshire Tufts Health Plan Phone: 1-877-218-4835 TTY/TDD: 711 Medicare Preferred HMO Basic No Rx HMO $20.00 No Plan Doctors Only Worcester Medicare Preferred HMO Basic No Rx HMO $28.00 No Plan Doctors Only Essex Suffolk Medicare Preferred HMO Basic Rx HMO $27.00 Yes Plan Doctors Only Hampden Hampshire Medicare Preferred HMO Basic Rx HMO $40.00 Yes Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Medicare Preferred HMO Basic Rx HMO $55.00 Yes Plan Doctors Only Essex Suffolk Medicare Preferred HMO Basic Rx HMO $42.00 Yes Plan Doctors Only Worcester Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Tufts Health Plan (Continued) Phone: 1-877-218-4835 TTY/TDD: 711 Medicare Preferred HMO Prime No Rx HMO $133.00 No Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Medicare Preferred HMO Prime No Rx HMO $156.00 No Plan Doctors Only Essex Suffolk Medicare Preferred HMO Prime No Rx HMO $152.00 No Plan Doctors Only Worcester Medicare Preferred HMO Prime Rx HMO $165.00 Yes Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Medicare Preferred HMO Prime Rx HMO $83.00 Yes Plan Doctors Only Hampden Hampshire Medicare Preferred HMO Prime Rx HMO $188.00 Yes Plan Doctors Only Essex Suffolk Medicare Preferred HMO Prime Rx HMO $185.00 Yes Plan Doctors Only Worcester Medicare Preferred HMO Prime Rx Plus HMO $103.00 Yes Plan Doctors Only Hampden Hampshire Medicare Preferred HMO Prime Rx Plus HMO $199.00 Yes Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Medicare Preferred HMO Prime Rx Plus HMO $220.00 Yes Plan Doctors Only Essex Suffolk Medicare Preferred HMO Value No Rx HMO $103.00 No Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Effective January 2020 Medicare Advantage Plans Offered in Massachusetts in 2020 Plan Name Plan Type Monthly Premium Drugs Doctor Choice Counties Tufts Health Plan (Continued) Medicare Preferred HMO Value No Rx HMO $123.00 No Plan Doctors Only Essex Suffolk Medicare Preferred HMO Value No Rx HMO $112.00 No Plan Doctors Only Worcester Medicare Preferred HMO Value Rx HMO $135.00 Yes Plan Doctors Only Barnstable Bristol Middlesex Norfolk Plymouth Medicare Preferred HMO Value Rx HMO $58.00 Yes Plan Doctors Only Hampden Hampshire Medicare Preferred HMO Value Rx HMO $155.00 Yes Plan Doctors Only Essex Suffolk Medicare Preferred HMO Value Rx HMO $150.00 Yes Plan Doctors Only Worcester Medicare Preferred HMO Saver Rx HMO $0.00 Yes Plan Doctors Only Barnstable Bristol Essex Hampden Hampshire Middlesex Norfolk Plymouth Suffolk Worcester Effective January 2020 Types of Plan and Program Offerings HMO = Health Maintenance Organization A type of plan in which you can only go to doctors, hospitals and other providers that belong to the plan network, except in an emergency. MSA = Medical Savings Account A plan that has two parts. The first part is a high-deductible Medicare Advantage MSA Health Plan. This health plan won't begin to pay covered costs until you have met the annual deductible, which varies by plan. The second part is a Medical Savings Account which Medicare deposits money that you may use to pay health care costs. PPO = Preferred Provider Organization A type of plan in which you pay less if you use doctors, hospitals and other providers that belong to the plan network. You may also use doctors, hospitals, and other providers outside of the network for an additional cost. PFFS = Private Fee for Service A type of Medicare Health Plan in which you may go to any Medicare-approved doctor or hospital that accepts the plan's payment. The insurance plan, rather than the Medicare Program decides how much it will pay and how much you will pay for the services you receive. Under this type of plan, you may pay more or less for Medicare-covered benefits and you may have extra benefits that Original Medicare Plan doesn't cover. SCO = Senior Care Option A voluntary program that combines health care services with social support services to help lowincome seniors maintain their health and stay in their own homes. With SCO, a team of medical professionals work together to provide you with care that is individually tailored to meet your needs. You must be 65 years of age or older and eligible for MassHealth (Medicaid) to join. You may also have Medicare. SNP = Special Needs Plan A special type of Medicare Advantage Plan that provides all Medicare Part A and Part B health care and services to people which may include services like special care for chronic illnesses, care management of multiple diseases and focused care management. These plans may limit membership to people in certain institutions (like a nursing home), eligible for both Medicare and Medicaid or with certain chronic or disabling conditions.