Frequently asked questions
Get answers to common questions about Medicare Advantage and our plans.
About Medicare Advantage
If you’re just getting started with Medicare or want more information about Medicare Advantage, you can learn more on the new to Medicare page.
Medicare Advantage is a bundled plan option that adds additional coverage to Original Medicare. Original Medicare (Parts A and B) includes hospital insurance for both inpatient and home health, and medical insurance for doctor visits and some preventive care.
Medicare Advantage (Part C) plans combine Part A and B as well as Part D (drug coverage), to provide you with full-coverage benefits including dental, vision, hearing, and more.
Simply put: you may be missing out. Consider your healthcare needs when comparing Medicare Advantage vs Medicare supplements you may already have. Medicare Advantage plans offer more benefits than traditional Medicare, and premiums start at $0/month.
Plans
Get to know our available plans on the plan comparison page.
Our Medicare Advantage plans have many advantages over Original Medicare. Each plan includes additional benefits like hearing, vision, dental, and a Flexible Benefit Card for qualifying fitness classes, weight-loss programs, over-the-counter products, and more.
Our plans are designed with affordable premiums, annual out-of-pocket maximums, no deductibles, and no referrals needed. Some services, however, will require prior authorization. Learn more about our plans and compare your options here.
Mass General Brigham Advantage plans are currently available in the following Massachusetts counties: Bristol, Dukes, Essex, Middlesex, Nantucket, Norfolk, Plymouth, Suffolk, and Worcester. Our Massachusetts and Boston Medicare Advantage plans are available to eligible residents – learn more about eligibility here.
It’s easy to switch your coverage and enroll in one of our Medicare Advantage plans. After verifying your eligibility, just select one of our three easy enrollment options to sign up for your new plan.
You’re eligible to change plans during a specific time of the year, called the Annual Enrollment Period (AEP). AEP runs from Oct 15 to December 7. During this period you can enroll in Medicare Advantage, switch plans, or leave your plan. You’re also eligible to switch your plan during the Open Enrollment Period (OEP), which runs from January 1 to March 31.
Some people may also qualify for coverage outside of standard enrollment periods, during the Special Enrollment Period (SEP). SEP takes place when certain qualifying events happen, including losing your employer coverage, moving, or retiring.
When choosing a new plan, you should review costs and premiums to find the best fit. Review our Medicare Advantage plan comparison chart for basic information including premiums, copays, out-of-pocket maximums, and coinsurance.
It also helps to get a picture of your current healthcare history by asking yourself the following questions:
- What were your total healthcare costs in the past year, including premiums, deductibles, copays, and coinsurance?
- How often did you visit the doctor or hospital?
- What medications do you take currently, and how often do you need to refill your prescriptions?
You can also confirm if your current doctors are covered in-network, and if your current prescriptions are covered. Review our Benefits page for detailed information about what else is included in our plans.
If you have any questions about Medicare Advantage plans from Mass General Brigham Health Plan, set up a call with one of our dedicated Medicare Advisors. They can review your plan options and help you choose the best option.
Care and coverage
Search our network and see if your current providers are covered on the find a doctor page.
You can search for in-network providers using our 2025 provider directory or online provider search tool.
Our Medicare Advantage plans give you access to Mass General Brigham providers, as well as Mass General Brigham Health Plan’s broader Medicare Advantage network of doctors, hospitals and other providers across the state.
You'll also be covered for non-emergency or routine care from any Medicare-participating provider anywhere in the U.S. – even if they’re not part of our provider network. Out-of-network care and services may require prior authorization and cost more than in-network services.
Benefits and savings
Find more information about the additional benefits included in our plans on our benefits and savings page.
We offer a comprehensive benefit package to provide complete coverage for wherever you are in your health journey. Whether you’re looking to stay fit and healthy or dealing with a chronic condition, Mass General Brigham Health Plan can help you live life to the fullest. Our plans provide benefit coverage including dental, hearing, vision, OTC, fitness, a Flexible Benefit Card, transportation benefits, and meal delivery benefits.
You can review plan documents, including the Evidence of Coverage and Summary of Benefits, for each of our Medicare Advantage plans on their respective plan pages.
You can find the plan pages at the links below.
Mass General Brigham Advantage Secure (HMO-POS)
Mass General Brigham Advantage (PPO)
Mass General Brigham Advantage Premier (PPO)
Mass General Brigham Advantage Signature (PPO)
As a Mass General Brigham Health Plan Medicare Advantage member, you are covered anywhere for emergency and urgent care. This includes the hospitals and centers in your community and any place around the world.
Yes. Our plans include coverage with no cost sharing for vaccine services covered under Medicare Part B. These include:
- The pneumonia vaccine
- Flu shots, once each flu season in the fall and winter, with additional flu shots if medically necessary.
- Hepatitis B vaccine if you are at high or intermediate risk of getting Hepatitis B.
- Other vaccines if you are at risk and they meet Medicare Part B coverage rules.
We also cover some vaccines under our Part D prescription drug benefit at no cost to you. Your costs for a Part D vaccination depend on the type of vaccine, where you get the vaccine, and who gives you the vaccine. You can find more details about Part D vaccines in the Evidence of Coverage documents available on our plan pages.
Eligibility and enrollment
Visit our eligibility page for more information about who qualifies for our Medicare Advantage plans and when you can enroll.
Most people become eligible for Medicare Advantage after turning 65 and enrolling in Original Medicare (Part A and B).
Medicare is also available for some people with disabilities under 65. To qualify for this coverage, individuals need to meet specific criteria with the Social Security Administration which can be verified on their website.
You can only enroll in Medicare during specific enrollment periods, or under special circumstances. Individuals with disabilities may be able to enroll before they turn 65 and outside of standard enrollment periods. You may also be able to enroll based on certain qualifying events, including losing employer coverage or retiring.
Medicare Advantage has several enrollment periods throughout the year with different requirements for eligibility.
Initial Enrollment Period (IEP) typically begins 3 months before the month of your 65th birthday and ends 3 months after.
Annual Enrollment Period (AEP) runs from October 15 to December 7. You can enroll in a new Medicare Advantage plan, switch plans, or leave a plan.
Open Enrollment Period (OEP) runs from January 1 to March 31. You can switch plans during this time or return to Original Medicare but can’t enroll in a new plan.
Some people under 65 may also qualify for Medicare based on disability. IEP for someone who qualifies based on disability begins 3 months before their 25th month of disability benefits and ends 3 months after. Learn more about Medicare eligibility based on disability on the Social Security Administration website.
If you're going to keep your (or your spouse's) current employer coverage:
- Find out if you need to enroll in Part B to avoid penalties—it may be necessary if your employer has fewer than 20 employees.
- Ask your employer if your plan’s prescription drug coverage is as good as Medicare’s coverage (it’s called “creditable coverage”). If not, enroll in Part D to avoid penalties.
If you're not keeping your employer coverage:
- Talk to your employer to see if there are other options or plans available to people 65 and older.
- Enroll in Parts A and B once you’re eligible.
- Consider Part C (Medicare Advantage) or supplemental plans for additional coverage. Medicare Advantage plans often feature no deductibles on medical services and offer benefits that go above and beyond Part A and Part B coverage.
- Sign up for Part D prescription drug coverage. Many Medicare Advantage plans are offered with Part D drug coverage included.
For all other qualified health plans, you will need to enroll in Medicare Part A and Part B and have prescription drug coverage that’s as good as Medicare’s standard plan (or enroll in Part D) to avoid penalties. A Medicare Advantage plan is a great way to get all the parts of Medicare in one plan. If you choose to keep your current coverage once you turn 65, you will lose any premium tax credits or other savings you are currently receiving. Since you will still need to enroll in Medicare Part A and B, a Medicare Advantage plan may be a better alternative.
If you have an Essential Plan, your plan will end at age 65 and you will need to enroll in Medicare for health coverage.
© 2024 Mass General Brigham Health Plan, Inc. Mass General Brigham Health Plan is an HMO-POS/PPO organization with a Medicare contract. Enrollment in Mass General Brigham Health Plan depends on contract renewal. Other providers/pharmacies are included in our network.
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Last updated: 10/1/2024 - Pending CMS approval