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Mass General Brigham Advantage Secure (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Mass General Brigham Advantage Secure (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Mass General Brigham Advantage Secure (HMO-POS) in 2026, please refer to our full plan details page.
Mass General Brigham Advantage Secure (HMO-POS) is a HMO-POS plan offered by Mass General Brigham Incorporated available for enrollment in 2025 to people living in Eastern Massachusetts. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Mass General Brigham Advantage Secure (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Mass General Brigham Advantage Secure (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Mass General Brigham Advantage Secure (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $62.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $350.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $7000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Mass General Brigham Advantage Secure (HMO-POS) plan features an annual drug deductible of $350. For Tier 1 preferred generic drugs, you will pay no copay for one-month, two-month, or three-month supplies at standard pharmacies and mail-order services. Tier 2 generic drugs are highly affordable, with standard pharmacy and mail-order copays starting at $5 for a one-month supply. Tier 3 preferred brand drugs require a $47 copay for a one-month supply at standard pharmacies and through standard mail order. For higher-tier prescriptions, Tier 4 non-preferred drugs carry a 25% coinsurance, while Tier 5 specialty drugs require a 29% coinsurance for a one-month supply.
Additional Benefits
The Mass General Brigham Advantage Secure (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits, preventive services, and home health care. Specialist visits require a $45 copay, while emergency services are subject to a $130 copay with no coinsurance. For inpatient hospital stays, members pay a $250 daily copay for the first five days and no copay for days six through ninety. Ancillary benefits include no copay for most preventive and comprehensive dental services up to a $2,000 yearly limit, alongside a $250 annual allowance for eyewear. Routine eye exams require a $45 copay, while hearing aid fitting evaluations have no copay. Additionally, durable medical equipment and dialysis services are covered with a 20% coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital services under the Mass General Brigham Advantage Secure (HMO-POS) plan are covered with no coinsurance, requiring a $250 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, as unlimited additional days are included for acute care, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Mass General Brigham Advantage Secure (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services with a copay of $0 to $200 and outpatient substance abuse sessions with a $20 copay. Ambulatory surgical center services and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by the Mass General Brigham Advantage Secure (HMO-POS) plan with a $40.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Mass General Brigham Advantage Secure (HMO-POS) covers ground and air ambulance services with a $300 copay and no coinsurance. Transportation services are partially covered, offering rides to any health-related location with no copay or coinsurance up to a $120 limit every three months, though transportation to plan-approved health-related locations is not covered.
Emergency Services See details
Mass General Brigham Advantage Secure (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted within 24 hours, and urgent care with a $50 copay, both with no coinsurance. Worldwide emergency services are also covered up to a $50,000 maximum with no coinsurance, requiring copays of $130 for emergency care, $50 for urgent care, and $300 for emergency transportation.
Primary Care See details
Mass General Brigham Advantage Secure (HMO-POS) covers primary care and opioid treatment services with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Physical, occupational, and speech therapies have a $15 copay and no coinsurance, mental health and psychiatric sessions have a $20 copay and no coinsurance, and podiatry is not covered. Some chiropractic services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Mass General Brigham Advantage Secure (HMO-POS) offers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and various screenings. Additional preventive benefits are partially covered, offering fitness programs, remote access technologies, and chemotherapy-related wigs (up to $350 annually), while excluding services such as health education, nutritional therapy, and home safety assessments.
Hearing Services See details
Hearing services are partially covered by Mass General Brigham Advantage Secure (HMO-POS), excluding OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids. Routine exams require a $45 copay and no coinsurance, while fitting evaluations are covered with no copay and no coinsurance. Up to two covered prescription hearing aids are allowed per year with a copay of $699 to $999 and no coinsurance.
Vision Services See details
Mass General Brigham Advantage Secure (HMO-POS) provides partially covered vision services with no deductibles, requiring a $45 copay and no coinsurance for one annual routine eye exam. Eyewear is covered with no copay or coinsurance up to a $250 yearly maximum for contact lenses and eyeglasses, though other eye exams, individual lenses, individual frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Mass General Brigham Advantage Secure (HMO-POS), featuring no copay and no coinsurance for most preventive and comprehensive care up to a $2,000 annual maximum, while Medicare-covered dental requires a $45 copay and no coinsurance. Non-covered services under this plan include other diagnostic services, other preventive services, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Mass General Brigham Advantage Secure (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Mass General Brigham Advantage Secure (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Mass General Brigham Advantage Secure (HMO-POS) covers medical equipment with no copay and a 20% coinsurance, subject to prior authorization. While durable medical equipment, prosthetics, and diabetic therapeutic shoes are covered, diabetic supplies are not covered under this plan.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by Mass General Brigham Advantage Secure (HMO-POS) with no coinsurance, though lab services are not covered and prior authorization is required. Covered diagnostic procedures require a $20 copay, while radiological copays are $10 for X-rays, at least $60 for therapeutic services, and at least $75 for diagnostic radiological services.
Home Health Services See details
Home Health Services are covered under Mass General Brigham Advantage Secure (HMO-POS) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Mass General Brigham Advantage Secure (HMO-POS) plan. This includes standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services, which are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Mass General Brigham Advantage Secure (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and days 45 through 100, and a $160 daily copay for days 21 through 44. Prior authorization is required, and additional days beyond the Medicare-covered 100-day limit are not covered.
Other Services See details
Mass General Brigham Advantage Secure (HMO-POS) partially covers other services, providing over-the-counter (OTC) items and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture is not covered under this plan benefit, but eligible members receive up to $95 every three months for OTC items.
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