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Mass General Brigham Advantage Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Mass General Brigham Advantage Signature (PPO). 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 Signature (PPO) in 2025, please refer to our full plan details page.
Mass General Brigham Advantage Signature (PPO) is a PPO 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 2025.
It's important to know that Mass General Brigham Advantage Signature (PPO) 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 Signature (PPO).
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 Signature (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $299.00. 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below 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 Signature (PPO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay a copay depending on the drug tier and pharmacy. For example, you will pay a $5 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you will pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D will be $3.20.
Additional Benefits
The Mass General Brigham Advantage Signature (PPO) plan provides comprehensive coverage, including inpatient and outpatient services, with no copays for emergency services, ambulance services, and many diagnostic services. The plan covers a wide range of preventive services, vision, hearing, and dental services, with specific limits and cost-sharing for each. The plan also offers additional benefits like home health services, home infusion, and medical equipment with no copay, along with coverage for OTC items and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered stay for Inpatient Hospital Psychiatric are not covered. Additional Days for Inpatient Hospital-Acute are covered.
Outpatient Services See details
Outpatient Services are covered, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services, but individual and group sessions for outpatient substance abuse are not covered. Outpatient blood services include an enhanced benefit where the three-pint deductible is waived.
Partial Hospitalization See details
Partial Hospitalization is covered by the Mass General Brigham Advantage Signature (PPO) plan, but requires prior authorization. There is no information about the cost of this service.
Ambulance and Transportation Services See details
The Mass General Brigham Advantage Signature (PPO) plan covers ambulance and transportation services. All ambulance services are covered with no copay or coinsurance, but ground and air ambulance services are not covered; transportation services to any health-related location are covered, with a maximum plan benefit coverage amount of $120 every three months, and there is no copay or coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Mass General Brigham Advantage Signature (PPO) plan, with no copay or coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are also covered.
Primary Care See details
The Mass General Brigham Advantage Signature (PPO) plan covers primary care physician services, occupational therapy, physician specialist services, other health care professional services, physical therapy, speech-language pathology, and opioid treatment program services. Chiropractic services, mental health specialty services, and psychiatric services are partially covered; routine chiropractic care, individual sessions for mental health specialty services, individual sessions for psychiatric services are not covered.
Preventive Services See details
The Mass General Brigham Advantage Signature (PPO) plan covers a range of preventive services, including annual physical exams, additional preventive services, kidney disease education services, and other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. Weight Management Programs, Remote Access Technologies, and Fitness Benefits are also covered. However, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, and several other services are not covered. Wigs for hair loss related to chemotherapy are covered up to $350 per year.
Hearing Services See details
The Mass General Brigham Advantage Signature (PPO) plan covers hearing exams and fitting/evaluation for hearing aids with no deductible or coinsurance. Routine hearing exams are covered once per year, while prescription hearing aids are covered with a copay between $699 and $999, depending on the type. Prescription hearing aids are limited to two per year, and inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
The Mass General Brigham Advantage Signature (PPO) plan covers vision services, including routine eye exams with one visit per year, and eyewear with a combined maximum of $300 per year for both in-network and out-of-network services, but does not cover eyeglass lenses, eyeglass frames, and upgrades. Contact lenses and eyeglasses (lenses and frames) are covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $3,000 per year for both in-network and out-of-network services. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are covered, each with a limit of two visits per year, and restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered, but some services require prior authorization. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Mass General Brigham Advantage Signature (PPO) plan. Medicare Part B Insulin Drugs are covered, but Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered with this plan.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefit, both with no copay and no coinsurance, but Durable Medical Equipment for use outside the home is not covered, and Prosthetic Devices and Medical Supplies are not covered. Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Mass General Brigham Advantage Signature (PPO) plan, but none of the sub-services are covered, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services. There is no copay for these services.
Home Health Services See details
Home Health Services are covered by the Mass General Brigham Advantage Signature (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, however, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered. Prior authorization is required for this benefit.
Other Services See details
The Mass General Brigham Advantage Signature (PPO) plan's "Other Services" benefit includes Over-the-Counter (OTC) Items with a maximum benefit coverage of $130.00 every three months, and Meal Benefits for chronic illness; however, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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