Can You Get More Medicare Benefits in Massachusetts?

If you have Medicare in Massachusetts, you may be eligible for more help than you realize.

Depending on your circumstances, programs may be available that can help pay some of your Medicare costs, lower prescription drug expenses, or provide additional services such as dental, vision, hearing, transportation, and care coordination.

The challenge is that these benefits come through different programs with different eligibility rules. It is easy to overlook help that may be available to you.

What Kind of Help Could Be Available?

Depending on the program you qualify for, benefits may include:

• Payment of your Medicare Part B premium
• Help with Medicare deductibles, copays, and coinsurance
• Extra Help with Part D prescription drug costs
• Dental care, including exams, cleanings, fillings, extractions, and dentures
• Vision services and eyeglasses
• Hearing services and hearing aids when approved
• Transportation to eligible medical appointments
• Care coordination and certain home and community-based services

Some people may qualify for only help with Medicare costs, while others may qualify for broader MassHealth benefits and services.

Could You Be Missing Benefits You Qualify For?

Eligibility depends on factors such as your age, household size, income, and – in some situations – countable assets.

Several Different Programs May Provide Help

There is no single “extra Medicare benefits” program in Massachusetts. Depending on your situation, assistance may come through programs such as:

Medicare Savings Programs

Medicare Savings Programs can help eligible Medicare beneficiaries with costs such as the Part B premium. Some programs can also help with Medicare deductibles, copays, and coinsurance. Qualifying for certain Medicare Savings Programs also provides automatic eligibility for Extra Help with Medicare Part D prescription drug costs.

MassHealth

Some Medicare beneficiaries may qualify for MassHealth coverage that provides broader assistance, including dental, vision, hearing, transportation, and certain home and community – based services in addition to help with Medicare costs.

Senior Care Options and One Care

People who have both Medicare and qualifying MassHealth coverage may also have access to integrated programs.

Senior Care Options (SCO) is available to eligible Massachusetts adults age 65 and older, while One Care serves certain eligible adults ages 21–64 who have both Medicare and MassHealth.

These programs coordinate Medicare and MassHealth benefits through one plan.

Don't Assume You Don't Qualify

Many people never check because they assume:

• Their income is too high
• They have too much in savings
• Medicare already provides everything available to them
• MassHealth is only for people who do not have Medicare
• All MassHealth programs have the same eligibility requirements

Those assumptions can be wrong.

Eligibility rules vary considerably by program. Even the way income is counted can be more complicated than simply looking at the amount deposited into your bank account each month.

That is why it can be worthwhile to check rather than assuming you do—or do not—qualify.

Want to Check Your Eligibility Yourself?

We created a detailed step – by – step screening tool that asks a few questions about your circumstances and shows which Massachusetts programs may be worth investigating.

WANT TO SEE WHAT YOU MAY QUALIFY FOR?

Check Your Medicare Benefits Eligibility

The screening tool provides general guidance. MassHealth, Medicare, Social Security, or the applicable program makes the official eligibility determination.

Getting Benefits Is Only Part of the Picture

If you qualify for additional assistance, the next question may be how that assistance works with your Medicare coverage.

For example, people considering Senior Care Options, One Care, or another Medicare plan should still check whether their:

• Doctors and specialists participate
• Preferred hospitals are included
• Prescription drugs are covered
• Pharmacy works with the plan
• Current benefits and healthcare needs are a good fit

Choosing coverage based only on a list of additional benefits can lead to problems if the rest of the plan does not fit your healthcare needs.

Let Us Help You Review Your Options

You do not have to sort through Medicare, MassHealth, Medicare Savings Programs, Extra Help, and plan options by yourself.

At Hesteon Solutions, we help Massachusetts Medicare beneficiaries understand their current coverage, identify programs or benefits that may be worth exploring, and review Medicare options based on their individual healthcare and prescription needs.