Comparing Massachusetts Medicare Supplement Plans: Core vs. Supplement 1A vs. Supplement 1

By Marc Gilman

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Key Takeaways:

Massachusetts is one of only three states — along with Minnesota and Wisconsin — that doesn’t use the standard federal A-through-N lettered Medigap plans. Instead, Massachusetts offers Core, Supplement 1A, and Supplement 1.
Supplement 1 is the most comprehensive option, but it’s closed to anyone who became eligible for Medicare on or after January 1, 2020. If you’re newly eligible, Supplement 1A is the closest available option.
Massachusetts uses community rating, meaning your premium is based on the plan and carrier you choose — not your age. A 75-year-old and a 65-year-old pay the same rate for the same plan.
Massachusetts also allows continuous, year-round guaranteed issue — you can switch Medigap carriers almost any month without medical underwriting, a protection most states don’t offer.
Massachusetts law prohibits Medicare excess charges, so unlike some plans in other states, Medigap coverage here doesn’t need to account for providers billing above the Medicare-approved amount.

If you’ve shopped for Medicare Supplement coverage in another state, or heard friends elsewhere talk about “Plan G” or “Plan N,” Massachusetts is going to look unfamiliar. The state runs its own system, and it’s worth understanding before you compare premiums.

Why Massachusetts Medigap Plans Are Different

Most of the country uses Medicare’s standardized Plan A through Plan N system, where the letter tells you exactly what’s covered no matter which insurance company sells it. Massachusetts is a “waiver state” — along with Minnesota and Wisconsin — meaning it designed its own Medigap structure instead of adopting the federal one. That’s why you won’t see “Plan G” or “Plan N” offered here. Instead, Massachusetts has three plan types: Core, Supplement 1A, and Supplement 1.

What Core Covers

Core is the entry-level plan, and it’s available to everyone. It covers:

Part A hospital coinsurance for days 61–90, and for the 365 additional lifetime reserve days (paid in full)
Part B coinsurance — generally 20% of the Medicare-approved amount
The first 3 pints of blood each year

It doesn’t cover the Part A deductible, skilled nursing facility coinsurance, or foreign travel emergency care.

What Supplement 1A Covers

Supplement 1A includes everything in Core, plus:

The Part A deductible ($1,736 per benefit period in 2026)
Skilled nursing facility coinsurance for days 21–100 ($217/day in 2026)
Foreign travel emergency coverage

It’s the most comprehensive plan available to anyone newly eligible for Medicare — the one gap it leaves is the Part B annual deductible ($283 in 2026), which you’d pay out of pocket.

What Supplement 1 Covers (If You Still Qualify)

Supplement 1 includes everything in Supplement 1A, plus the Part B annual deductible — making it fully comprehensive. The catch: Supplement 1 is closed to anyone who became eligible for Medicare on or after January 1, 2020. If you already have it, you can keep it. If you’re newly eligible, Supplement 1A is your closest option, and the only real difference is that one deductible.

No Medicare Excess Charges in Massachusetts

In many states, some Medigap plans (like Plan N) don’t cover “excess charges” — the extra amount a provider is legally allowed to bill above what Medicare approves. Massachusetts sidesteps this issue entirely: state law prohibits providers from charging Medicare excess charges in the first place, so it’s not something you need to shop around for here.

Community Rating: Your Age Doesn’t Change Your Premium

This is one of the more consumer-friendly features of the Massachusetts system. Premiums are community-rated, meaning everyone pays the same rate for the same plan and carrier, regardless of age. In states with attained-age or issue-age rating, your premium can climb as you get older even if your health doesn’t change. In Massachusetts, a 65-year-old and an 85-year-old enrolled in the same Supplement 1A plan through the same carrier pay the same premium.

Year-Round Guaranteed Issue

Most states only guarantee you the right to buy a Medigap policy without medical underwriting during your 6-month Medigap Open Enrollment Period, right after you first enroll in Part B. After that window closes, insurers can generally ask health questions and deny coverage. Massachusetts is different: it offers continuous, year-round guaranteed issue, meaning you can generally switch Medigap carriers or plans almost any month, without answering health questions. That’s a meaningful protection if your needs or budget change down the road.

What Actually Drives the Price Difference

Since benefits within each plan type are identical no matter which company sells them, the insurance carrier is your main price decision. Premiums for the same plan type can vary significantly between companies. It’s worth comparing quotes for the same plan type across multiple carriers rather than assuming one company’s pricing is representative.

One thing worth knowing if you’re shopping right now: at least one major national carrier has announced it will stop selling new Medicare Supplement policies in Massachusetts starting April 1, 2026. Existing members can stay enrolled, but it’s a reminder that carrier availability can shift — another reason to work with someone who can compare current options across companies rather than shopping just one brand.

Which Plan Is Right for You?

Choose Core if you want the lowest premium and are comfortable paying the Part A deductible and skilled nursing facility coinsurance out of pocket if you need that care.
Choose Supplement 1A if you want broad coverage and don’t qualify for Supplement 1 — this covers nearly everything except the Part B deductible.
Keep Supplement 1 if you already have it and became eligible before 2020 — it’s the most complete option, and it’s no longer open to new enrollees.

What To Do Next

Because benefits are standardized within each plan type, comparing Massachusetts Medigap plans really comes down to comparing carriers and premiums for the plan type that fits your needs.

If you need further information about which Massachusetts Medicare Supplement plan makes sense for your situation, we’re here to help — no cost, no obligation.