Get matched with the right plan

World-class Medicare Advantage plans for everyone

2025 plans | 2024 plans

Did you know

Our Medicare Advantage plans include coverage for dental, vision, and hearing. Members also get a Flexible Benefit Card with allowances for wellness, transportation, and over-the-counter purchases. 

 

Explore plan benefits

Advantage (PPO)

Advantage Secure (HMO-POS)

Advantage Premier (PPO)

Advantage Signature (PPO)

You pay

$0 per month $52 per month $140 per month $299 per month

Primary Care (IN/OUT)

 $0 / $20 copay  $0 / $20 copay  $0 / $10 copay $0 / $0 copay 

Specialist (IN/OUT)

 $50 / $65 copay  $45 / $50 copay  $25 / $40 copay $0 / $0 copay

Emergency room (In/Out)

 $90   $105   $90   $0 

Urgent care (In/Out)

$50  $50  $30  $0 

Ambulance (In/Out)

$275  $200  $200  $0 

Inpatient hospital stays (In/Out)

 $350 days 1-5; $0 days 6-90 / 30% coinsurance  $250 days 1-5; $0 days 6-90 / 30% coinsurance  $150 days 1-3; $0 days 4-90 / 20% coinsurance  $0 copay / $0 copay

Outpatient hospital (In/Out)

 $0-$300 copay / 40% coinsurance  $0-$200 copay / 30% coinsurance  $0-$125 copay / 20% coinsurance  $0 copay / $0 copay

Outpatient physical, occupational, and speech therapy (In/Out)

$40 copay / $65 copay  $15 copay / $50 copay  $20 copay / $40 copay  $0 copay / $0 copay

Cardiac rehabilitation (In/Out)

 $0 copay / $65 copay $0 copay / $0 copay $0 copay / $0 copay $0 copay / $0 copay

Comprehensive dental services allowance / preventative services

 $1,500 / $0 copay  $2,000 / $0 copay  $2,500 / $0 copay  $3,000 / $0 copay

Hearing aids / routine eye exam

 $699-$999 copay per hearing aid per year  / $0 copay  $699-$999 copay per hearing aid per year  / $0 copay  $699-$999 copay per hearing aid per year  / $0 copay  $699-$999 copay per hearing aid per year  / $0 copay

Eyewear allowance / routine eye exam

 $200 per year / $0 copay  $250 per year / $0 copay  $300 per year / $0 copay  $300 per year / $0 copay

Fitness, weight loss, and prescription hearing aid allowance (Flexible Benefit Card)

 $450 per year  $450 per year  $450 per year  $450 per year

Transportation allowance (Flexible Benefit Card)

 $120 every 3 months  $120 every 3 months  $120 every 3 months  $120 every 3 months

Over-the-counter purchases (Flexible Benefit Card)

 $85 every 3 months  $95 every 3 months  $120 every 3 months  $130 every 3 months

Out-of-pocket maximum (In / In + Out combined)

 $5,500 / $9,550  $3,350 / $7,000  $3,150 / $5,450  $0 /$0
This is the most you pay for covered medical services in a calendar year (does not include Part D drug costs). If you reach the maximum amount, Mass General Brigham Health Plan pays 100% of the cost of covered services, including part B drugs, through December 31.

Initial coverage: When your coverage begins, you pay your cost share for covered prescription drugs. Your cost for a 30-day supply from a participating retail pharmacy is below. Or save money using the CVS Caremark Mail Service Pharmacy. Get a three-month supply of many medications with a copay for only two. Refer to the Mass General Brigham Health Plan Formulary for details.

Tier 1: $0 copay
Tier 2: $5 copay
Tier 3: $47 copay
Tier 4: $100 copay
Tier 5: 33% coinsurance

Catastrophic coverage: Beginning in 2025, if your out-of-pocket cost for Part D drugs reaches $2,000, you reach the Catastrophic Coverage Stage and pay nothing for covered Part D drugs. You may have cost sharing for drugs that are covered under our enhanced benefit.

Please note: Drugs purchased outside the U.S. are not Medicare approved and are not covered.

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Ready to enroll? Sign up online, over the phone, or via mail. Learn more about your enrollment options and get started today.  

 

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2024 plans | 2025 plans

AdvantagePPO-1
SecureHMO
PremierPPO

Advantage (PPO)

Advantage Secure (HMO-POS)

Advantage Premier (PPO)

You pay

$0 per month $52 per month $140 per month

Primary Care (IN/OUT)

 $0 copay / $20 copay  $0 copay / $20 copay  $0 copay / $10 copay

Specialist (IN/OUT)

 $45 copay / $65 copay  $40 copay / $50 copay  $20 copay / $40 copay

Emergency room (In/Out)

 $90 copay  $105 copay  $90 copay

Urgent care (In/Out)

 $50 copay  $50 copay  $30 copay

Ambulance (In/Out)

 $275 copay  $200 copay  $200 copay

In-patient hospital stays (In/Out)

 $335 days 1-5; $0 days 6-90 / 40% coinsurance  $230 days 1-5; $0 days 6-90 / 30% coinsurance  $125 days 1-3; $0 days 4 and beyond / 20% coinsurance

Outpatient hospital (In/Out)

 $0-$300 copay / 40% coinsurance  $0-$200 copay / 30% coinsurance  $0-$125 copay / 20% coinsurance

Outpatient physical, occupational, and speech therapy (In/Out)

 $40 copay / $65 copay  $15 copay / $50 copay  $20 copay / $40 copay

Cardiac rehabilitation (In/Out)

 $0 copay / $65 copay  $0 copay / $0 copay  $0 copay / $0 copay

Comprehensive dental services allowance / preventative services

 $1,500 / $0 copay  $2,000 / $0 copay  $2,500 / $0 copay

Hearing aids / routine eye exam

 $699-$999 copay per hearing aid per year  / $0 copay  $699-$999 copay per hearing aid per year  / $0 copay  $699-$999 copay per hearing aid per year  / $0 copay

Eyewear allowance / routine eye exam

 $200 per year / $0 copay  $250 per year / $0 copay  $300 per year / $0 copay

Over-the-counter purchases

$85 every three months  $95 every three months  $120 every three months

Out-of-pocket maximum (In + Out combined)

 $6,400 / $9,700   $3,350 / $7,000  $3,150 / $5,450
This is the most you pay for covered medical services in a calendar year (does not include Part D drug costs). If you reach the maximum amount, Mass General Brigham Health Plan pays 100% of the cost of covered services, including part B drugs, through December 31.

Initial Coverage: When your coverage begins, you pay your cost share for covered prescription drugs. Your cost for a 30-day supply from a participating retail pharmacy is below. Or save money using CVS Caremark Mail Service Pharmacy. A three-month supply of many prescriptions is available for only two co-pays. Refer to the Mass General Brigham Health Plan Formulary for details.

Tier 1: $0 copay
Tier 2: $3 copay
Tier 3: $37 copay
Tier 4: $100 copay
Tier 5: 33% coinsurance

Coverage Gap: If your total drug costs in 2024 reach $5,030, your cost for prescription drugs changes. You pay:

25% for generic drugs and 25% for contracted brands

Catastrophic Coverage: Beginning in 2024, if you reach the Catastrophic Coverage Stage, you pay nothing for Part D drugs. You may have cost sharing for excluded drugs that are covered under our enhanced benefit.

Please note: Drugs purchased outside the U.S. are not Medicare approved and are not covered.

 

Ready to talk with a Medicare Advisor? 

We’re here to help. Our Medicare Advisors can answer any questions about plan options, benefits, and coverage.

Call 855-486-3097 (TTY 711)
Or schedule a consultation.

October 1-March 31
8 AM-8 PM ET, Mon-Sun

April 1-September 30
8 AM-8 PM ET, Mon-Fri

Frequently asked questions

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.