Compare Hampden County Massachusetts
Medicare Advantage Plans

A Medicare Advantage Plan in Hampden County, MA can provide additional benefits above and beyond Original Medicare. There are 50 Medicare Advantage Plans (Part-C) available in Hampden County from 10 different health insurance providers to compare in 2023. 20 of these Medicare Advantage Plans offer additional gap coverage to help avoid the “donut hole”. The plan with the lowest out-of-pocket expense is $3400 and the highest out-of-pocket is $7550. Hampden County Massachusetts qualifying beneficiaries can also pick from 13 Medicare Special Needs Plans. The highest rated Medicare Advantage Plan in Hampden County Massachusetts received a 5 overall star rating from CMS.



Most Popular Plans by Enrollment in Hampden County, Massachusetts

Plan Name Plan ID Marketing Name Monthly
Premium
Enrollment
AARP Medicare Advantage Choice (PPO)
H3442-004
UnitedHealthcare $0 31544
Medicare PPO Blue ValueRx (PPO)
H2230-018
Blue Cross Blue Shield of Massachusetts $75.00 31263
CCA One Care (Medicare-Medicaid Plan)
H0137-001
Commonwealth Care Alliance Massachusetts $0 29400
Tufts Medicare Preferred HMO Saver Rx (HMO)
H2256-028
Tufts Health Plan $0 22951
Medicare PPO Blue SaverRx (PPO)
H2230-017
Blue Cross Blue Shield of Massachusetts $0 21410


2023 Medicare Advantage Plans in Hampden County, MA

(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)


Name ⇅ Monthly
Premium
Deductible MOOP Gap 2023 Plan
Stars
Rating
Wellcare Premium Enhanced Open (PPO)
(H9761-004)

$60.00 $0 $4,700 NoToo New
Wellcare No Premium Open (PPO)
(H9761-001)

$0 $0 $6,500 NoToo New
Wellcare No Premium (HMO)
(H6193-001)

$0 $0 $6,500 NoToo New
Wellcare Giveback Open (PPO)
(H9761-002)

$0 $350.00 $7,550 YesToo New
UnitedHealthcare Connected? for One Care (Medicare-Medica
(H9239-001)

$0 $0 $- YesToo New
Tufts Medicare Preferred HMO Value Rx (HMO)
(H2256-018)

$97.00 $0 $3,650 Yes
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
(H2256-046)

$0 $100.00 $5,900 Yes
Tufts Medicare Preferred HMO Saver Rx (HMO)
(H2256-028)

$0 $250.00 $7,550 Yes
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
(H2256-001)

$137.00 $0 $3,650 Yes
Tufts Medicare Preferred HMO Prime Rx (HMO)
(H2256-015)

$117.00 $0 $3,650 Yes
Tufts Medicare Preferred HMO Basic Rx (HMO)
(H2256-026)

$48.00 $225.00 $3,650 Yes
Tufts Medicare Preferred Access (PPO)
(H9907-001)

$0 $150.00 $6,700 YesToo New
Medicare PPO Blue ValueRx (PPO)
(H2230-018)

$75.00 $0 $4,900 No
Medicare PPO Blue SaverRx (PPO)
(H2230-017)

$0 $0 $5,600 No
Medicare PPO Blue PlusRx (PPO)
(H2230-002)

$254.00 $200.00 $3,400 No
Medicare HMO Blue ValueRx (HMO)
(H2261-022)

$35.00 $320.00 $3,450 No
Medicare HMO Blue SaverRx (HMO)
(H2261-024)

$0 $300.00 $5,600 No
Medicare HMO Blue PlusRx (HMO)
(H2261-005)

$258.00 $200.00 $3,400 No
Medicare HMO Blue FlexRx (HMO-POS)
(H2261-023)

$95.00 $260.00 $3,900 No
HumanaChoice H5216-250 (PPO)

$19.00 $250.00 $5,400 Yes
HumanaChoice H5216-249 (PPO)

$0 $295.00 $5,600 Yes
HumanaChoice H5216-138 (PPO)

$0 $275.00 $4,800 Yes
Health New England Medicare Value (HMO)
(H8578-012)

$0 $380.00 $6,700 No
Health New England Medicare Premium (HMO)
(H8578-001)

$168.00 $250.00 $4,400 Yes
Health New England Medicare Plus (HMO)
(H8578-004)

$113.00 $250.00 $4,900 No
Health New England Medicare Compass Premier (PPO)
(H2737-002)

$99.00 $250.00 $4,900 NoToo New
Health New England Medicare Compass (PPO)
(H2737-001)

$0 $380.00 $6,700 NoToo New
Health New England Medicare Choice (HMO)
(H8578-017)

$46.00 $350.00 $5,900 No
Health New England Baystate Health Preferred (HMO)
(H8578-018)

$0 $270.00 $6,500 No
Fallon Medicare Plus Super Saver HMO (HMO)
(H9001-040)

$52.00 $505.00 $7,550 No
Fallon Medicare Plus Orange HMO (HMO)
(H9001-038)

$0 $200.00 $7,550 No
Fallon Medicare Plus Green HMO (HMO)
(H9001-030)

$66.00 $250.00 $5,200 No
Fallon Medicare Plus Blue HMO (HMO)
(H9001-031)

$115.00 $0 $3,400 No
CCA One Care (Medicare-Medicaid Plan)
(H0137-001)

$0 $0 $- YesNA
CCA Medicare Value (PPO)
(H9414-002)

$20.00 $200.00 $5,000 NoToo New
CCA Medicare Preferred (PPO)
(H9414-001)

$0 $0 $6,500 NoToo New
Aetna Medicare Value Plan (HMO-POS)
(H5793-014)

$0 $195.00 $6,700 Yes
Aetna Medicare Explorer Plan (PPO)
(H5521-160)

$0 $0 $6,700 Yes
AARP Medicare Advantage Plan 2 (HMO-POS)
(H1944-006)

$47.00 $175.00 $4,900 Yes
AARP Medicare Advantage Plan 1 (HMO-POS)
(H1944-005)

$0 $195.00 $5,700 Yes
AARP Medicare Advantage Choice (Regional PPO)
(R7444-001)

$53.00 $295.00 $7,550 Yes
AARP Medicare Advantage Choice (PPO)
(H3442-004)

$0 $0 $6,700 Yes






Massachusetts Part-C Plans Without Drug Coverage





Medicare Special Needs Plans in Hampden County Massachusetts

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special
Needs
Type
2023 Plan
Stars
Rating
WellSense Senior Care Options (HMO D-SNP)
(H9585-001)
   $36.30 $505.00  No Dual-Eligible
UnitedHealthcare Senior Care Options NHC (HMO D-SNP)
(H2226-003)
   $17.80 $505.00  No Dual-Eligible
UnitedHealthcare Senior Care Options (HMO D-SNP)
(H2226-001)
   $20.90 $505.00  No Dual-Eligible
Tufts Health Plan Senior Care Options CW (HMO D-SNP)
(H8330-002)
   $36.30 $505.00  No Dual-EligibleToo New
Tufts Health Plan Senior Care Options (HMO D-SNP)
(H8330-001)
   $36.30 $505.00  No Dual-EligibleToo New
Senior Whole Health NHC (HMO D-SNP)
(H2224-003)
   $36.30 $505.00  No Dual-Eligible
Senior Whole Health (HMO D-SNP)
(H2224-001)
   $36.30 $505.00  No Dual-Eligible
NaviCare (HMO D-SNP)
(H8928-001)
   $36.30 $505.00  No Dual-EligibleToo New
Longevity Health Plan (HMO I-SNP)
(H9940-001)
   $36.20 $505.00  No InstitutionalToo New
CCA Senior Care Options (HMO D-SNP)
(H2225-001)
   $36.30 $505.00  No Dual-Eligible
Align Thrive (HMO I-SNP)
(H1277-001)
   $0 $505.00  No InstitutionalNA
Align Premier (HMO I-SNP)
(H1277-003)
   $36.30 $505.00  No InstitutionalNA
Align Connect (HMO C-SNP)
(H1277-002)
   $0 $505.00  No Chronic or Disabling ConditionNA



Types of MA Plan in MA


HMO - Health Maintenance Organization. A Health Maintenance Organization manages your Part A and Part B health insurance benefits. In most cases you need to choose a primary care doctor. Health Maintenance Organization's offers services through a network of contracted hospitals, doctors and other providers, and the plan pays the providers directly. You generally must receive all Healthcare from the plan providers or through referrals from the plan provider. Emergency care, and out-of-area urgent care is still covered. An HMO-POS plan allows you to get some services out-of-network.

PPO - Preferred Provider Organization. A Preferred Provider Organization offers a network of doctors, hospitals, and other providers you can choose from. Because providers are preferred, you can save money by using in network providers or usually pay a higher cost to use out-of-network providers. A primary care doctor is not required.

PFFS - Private Fee For Service. A Private Fee For Service plan allows you greater flexibility in choosing a Massachusetts provider. You may obtain covered services from any Medicare eligible provider who is willing to accept the plan's terms. The Healthcare provider must agree to accept the plan's terms before each visit. Some of these plans have a network of approved providers that have agreed to treat plan members.

SNP - Special Needs Plan. A Special Needs Plan is for individuals who receive Medicare and Medicaid, have specific severe or disabling chronic conditions or reside in a licensed nursing home or skilled facility. SNP plans must provide prescription drug coverage to Hampden County Massachusetts residents.

Cost - Cost Plan. A cost plan doesn't replace your Original Medicare. It offers additional benefits to Original Medicare. If the cost plan doesn't include prescription drug coverage, you can enroll in a Part-D plan separately.





Can I get help in the coverage gap in Hampden County, MA?


Yes. 20 Medicare Advantage Plans in Hampden County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

Are there Medicare Advantage Plans in Hampden County, MA?


There are 50 Medicare Advantage Plans available in Hampden County, Massachusetts from 10 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare. Medicare beneficiaries who are interested in a Part-C policy may choose among many plans to compare versus Hampshire County Medicare Advantage Plans.



How much is a Medicare Plan in Hampden County, MA?


Individuals who are interested in a Medicare Advantage Plan in Massachusetts may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $258. The deductibles in Hampden County range from $0-$505. The plan with the lowest out-of-pocket (MOOP) expense is $3400 and the highest out-of-pocket is $7550.



Things to consider when choosing a MA Plan in Hampden


  • Are you eligible for a Medicare Advantage Plan?

  • How much are the premiums, deductibles, and other costs?

  • Is there a yearly limit on what you could pay out-of-pocket?

  • Does the plan cover your prescription drugs?

  • Will you hit the prescription drug coverage gap?

  • Is your pharmacy in the plan’s network?

  • Will your prescription drugs require prior authorization?

  • How well does the plan cover the services you need like vision, hearing, or dental?

  • Are your doctors in-network?

  • Will you need to be referred to see a specialist?

  • Does the plan cover services from out-of-network providers?

  • How does the plan compare to your current coverage?

  • Do you want to juggle multiple Medicare plans?


Special Needs Plan in Hampden County Explained


C-SNP - Chronic Condition SNP. These plans help individuals receive customized care to fit their unique health care needs. You may qualify for C-SNP if you have one or more specific severe or disabling chronic conditions like:

  • Stroke
  • Certain neurologic disorders
  • Certain chronic and disabling mental health conditions
  • HIV/AIDS
  • Certain chronic lung disorders
  • Diabetes mellitus
  • End-Stage Renal Disease (ESRD)
  • End-stage liver disease
  • Certain severe hematologic disorders
  • Chronic alcohol and other drug dependence
  • Certain cardiovascular disorders
  • Cancer
  • Chronic heart failure
  • Certain autoimmune disorders
  • Dementia

I-SNP - Institutional SNP. These plans require 90 days or longer stay in a facility, or are expected to need the level of services provided in a long-term care (LTC) skilled nursing facility (SNF), a LTC nursing facility (NF), an intermediate care facility for individuals with intellectual disabilities, or an inpatient psychiatric facility.

D-SNP - Dual Eligible SNP. Massachusetts Medicare and Medicaid enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid. Eligibility is based on a percentage of Federal Poverty Levels.


When to sign up for a Massachusetts Medicare Advantage Plan?


Below mentioned are the types of the enrollment period, along with the instructions on what to do during this period:

Initial Enrollment Period (IEP). This period starts 3 months prior to the month you will turn 65. It ends after 3 months you have turned 65. At this stage, you can sign up for a Massachusetts Medicare Advantage Plan.

Annual Enrollment Period (AEP). Also known as the Open Enrollment Period, it starts on the 15th of October and ends on the 7th of December. At this stage, you can either sign up for the plan, switch or leave your current plan.

Special Enrollment Period (SEP). This enrollment period depends on the personal circumstances of the beneficiaries, like if you move or lose insurance coverage. Check to determine if you qualify to modify your plan.

Open Enrollment Period. Jan 1 – Mar 31. If you’re enrolled in a Massachusetts Medicare Advantage Plan, you can switch to a different Medicare Part-C Plan in Hampden County, MA or switch to Original Medicare once during this time.

5-star Special Enrollment Period. Dec 8 - Nov 30. If a Centers for Medicare and Medicaid Services (CMS) 5-star plan is available in your area you can switch to the 5-star plan once during this period.



Check for CMS Star Ratings

Centers for Medicare & Medicaid Service (CMS) assesses the quality of medical services of Medicare Advantage Plan using a 5-star rating system. A report is released yearly for the public to assess the quality of healthcare services. Thus, if you are searching for the highest Medicare Advantage Plan in your state, research the CMS ratings and costs of the plans report for further information.


Can I get a Medicare Advantage Plans in Hampden County, MA?

Yes. There are 50 Medicare Advantage Plans available in Hampden County, Massachusetts from 10 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare.

How much is a Medicare Plan in Hampden County, Massachusetts?

Massachusetts residents who are interested in a Medicare Advantage Plan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $258. The deductibles in Hampden County range from $0-$505

Can I get help in the coverage gap in Hampden County, MA?

Yes. 20 Medicare Advantage Plans in Hampden County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

What is the most popular plan in Hampden, MA?

The most popular plan by enrollment in Hampden is the AARP Medicare Advantage Choice (PPO) with 31544 enrollment.



Source: CMS. Data as of Oct 1, 2022.
Plans are subject to change as contracts are finalized.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2023, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.