Key Takeaways

  • Massachusetts residents have several Medicare options, including Original Medicare (parts A and B), Medicare Advantage, Part D for prescription drugs, and Medigap plans to supplement Original Medicare costs.
  • Medicare Advantage plans in Massachusetts offer similar coverage to Original Medicare, often with extra benefits like vision, dental, and hearing care. In 2026, the average monthly premium is $38.03, but some plans have $0 premiums.
  • When choosing a Medicare plan in Massachusetts, consider individual healthcare needs, preferred providers, and cost requirements. For assistance, utilize resources like Medicare, the Social Security Administration, or the Massachusetts Serving the Health Insurance Needs of Everyone (SHINE) program.

If you live in Massachusetts and are currently, or soon to be, eligible for Medicare, you’re probably wondering about your options.

Medicare is a national insurance program for those 65 and older and people of any age who have certain disabilities.

While the federal government runs Medicare, you have the option to purchase certain Medicare plans from private insurance companies in your state.

Snapshot of Medicare in Massachusetts

The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Massachusetts for the 2026 plan year:

  • A total of 1,476,060 Massachusetts residents are enrolled in Medicare.
  • There are 103 Medicare Advantage plans available in Massachusetts for 2026, compared with 96 plans in 2025.
  • The average monthly Medicare Advantage plan premium changed from $32.74 in 2025 to $38.03 in 2026.
  • All Massachusetts residents with Medicare have access to a Medicare Advantage plan with a $0 premium.
  • In 2026, there are 11 stand-alone Medicare Part D prescription drug plans available in Massachusetts, and the lowest monthly premium for a stand-alone Part D plan is $8.40.
  • 31.74% of people with a stand-alone Part D plan get Extra Help.

Medigap plans work differently in Massachusetts than in the rest of the United States. For 2026, there are three different Medigap plans available in Massachusetts.

In Massachusetts, as in other states, Medicare includes several types of coverage:

  • Original Medicare: This plan is managed by the federal government and includes Part A (inpatient hospital insurance) and Part B (outpatient medical insurance). It includes some limited medications but does not include take-home prescription drug coverage.
  • Medicare Advantage (Part C): These plans are administered by private insurers and include all Original Medicare benefits along with extras such as vision, dental, and take-home drug coverage. Some plans have network restrictions, so you should confirm your preferred doctors and facilities are in-network before enrolling.
  • Medicare Part D: People with Original Medicare can choose a stand-alone Part D plan for their take-home prescription medications. Part D coverage is typically included in Medicare Advantage plans.
  • Medicare supplement insurance (Medigap): Medigap plans are standardized differently in Massachusetts and offer basic benefits, including coverage for inpatient hospital costs, outpatient medical costs, blood, and Part A hospice coinsurance or copayments. These plans are called:
    • Medigap Core Plan
    • Medigap Supplement 1 Plan
    • Medigap Supplement 1A Plan

Massachusetts residents may qualify for Medicare at age 65 if they’re U.S. citizens or legal residents for at least 5 years. People under age 65 with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), or those living with a disability, may also qualify for Medicare coverage.

When choosing a plan, you can consider whether your preferred healthcare professionals and facilities are in-network, the costs, and the quality ratings. You have the option to join a plan or change your coverage during one of the following enrollment periods:

  • Initial enrollment period (IEP): You can enroll during your 7-month IEP, which runs from 3 months before until 3 months after your birth month.
  • Open enrollment period (OEP): You can join or change plans between October 15 and December 7.
  • Medicare Advantage open enrollment period: From January 1 to March 31, you can switch to a different plan or return to Original Medicare if you already have a Medicare Advantage plan.
  • Special enrollment period: After a qualifying life event, such as losing job-based coverage, you will have an opportunity to enroll in a different plan. The length of time you have to enroll can depend on the specific life event.

Enrollment is automatic for people eligible for Medicare due to a disability. If you are eligible based on age, you will need to enroll yourself.

You can consider choosing a plan that:

  • has preferred doctors and healthcare facilities
  • covers the services you need
  • provides affordable coverage
  • has a high star rating for quality and patient satisfaction from CMS

You can find answers to questions and get help with Medicare plans in Massachusetts from the following resources:

  • Serving the Health Insurance Needs of Everyone (SHINE) Program: With SHINE, you can access free health insurance counseling, learn how to set up a Medicare account, and access Mass Health programs. You can contact them at 800-243-4636 (MassRelay: 711 or 800-439-0183 (voice) or TTY/ASCll 800-439-2370).
  • Group Insurance Commission (GIC): If you have GIC health coverage, you can get details on enrolling in Medicare in Massachusetts and research premium costs. You can contact them online or by calling 617-727-2310.
  • MassOptions: MassOptions can provide information about in-home care, independent living for adults with disabilities, and other free resources. You can call them at 800-243-4636.
  • Social Security Administration (SSA): The SSA website has information about signing up, applying for Extra Help, and managing benefits.
  • Medicare: People can contact Medicare by phone at 800-633-4227 (TTY: 877-486-2048) or online.

More than 1.4 million Massachusetts residents are enrolled in Medicare. Several private insurance companies offer various types of Medicare Advantage and Medigap plans throughout the state.

Overall, 2026 Medicare Advantage plan premiums have increased in Massachusetts, but people may still find options that work for them and their circumstances, and various programs are available to help with costs.