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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 2026, 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 2026.
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 $325.00. 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
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 features an annual prescription drug deductible of $350. Under this plan, Tier 1 preferred generic drugs have no copay for up to a three-month supply at standard pharmacies and through standard mail order. Tier 2 generic medications require a $5 copay for a one-month supply, which increases to a $15 copay at standard pharmacies or a discounted $10 copay for a three-month mail order. For Tier 3 preferred brand drugs, you will pay a $47 copay for a one-month supply and a $94 copay for a three-month mail-order supply. Tier 4 non-preferred drugs require a 25% coinsurance, while Tier 5 specialty drugs carry a 29% coinsurance for a one-month supply.
Additional Benefits
The Mass General Brigham Advantage Signature (PPO) plan offers exceptional cost savings with no copays and no coinsurance for a wide range of core medical services. This includes comprehensive coverage for inpatient hospital stays, outpatient services, primary and specialist care, and emergency services. Additionally, members benefit from no-cost preventive care, home health services, and skilled nursing facility care. The plan also features robust supplemental benefits, including dental coverage up to a $3,000 annual limit, a $300 annual eyewear allowance, and up to $130 every three months for over-the-counter items with no copay. While routine health-related transportation is covered, please note that ground and air ambulance services as well as cardiac rehabilitation are not covered under this plan. Hearing aids are available with copays ranging from $699 to $999.
Inpatient Hospital See details
Mass General Brigham Advantage Signature (PPO) covers inpatient acute and psychiatric hospital services with no copay and no coinsurance. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Mass General Brigham Advantage Signature (PPO) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and blood services. Although outpatient substance abuse services are technically covered with no copay or coinsurance, individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered under the Mass General Brigham Advantage Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Ambulance and Transportation Services See details
Mass General Brigham Advantage Signature (PPO) does not cover ground or air ambulance services, but provides transportation to any health-related location with no copay and no coinsurance. Covered transportation options include unlimited one-way trips via rideshare, taxi, van, or ferry, up to a maximum benefit of $120 every three months.
Emergency Services See details
Mass General Brigham Advantage Signature (PPO) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency services, including urgent care and emergency transportation, are also covered with no copay or coinsurance up to a maximum plan benefit of $50,000.
Primary Care See details
Mass General Brigham Advantage Signature (PPO) provides primary care, specialist, and therapy services with no copay and no coinsurance, though podiatry is not covered. Some chiropractic, psychiatric, and mental health specialty services are covered, but routine and other chiropractic care, as well as individual and group sessions for psychiatric and mental health services, are not covered.
Preventive Services See details
Preventive services are partially covered by Mass General Brigham Advantage Signature (PPO) with no copay and no coinsurance for covered care, including annual physicals, kidney disease education, fitness programs, and chemotherapy wigs up to $350 annually. Sub-services that are not covered under this plan include health education, in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Mass General Brigham Advantage Signature (PPO), offering one routine hearing exam and unlimited fitting evaluations per year with no copay and no coinsurance. Up to two prescription hearing aids are covered annually with no coinsurance and a copay ranging from $699 to $999, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Mass General Brigham Advantage Signature (PPO) with no copay, no coinsurance, and no deductible. The plan covers one routine eye exam per year and eyewear up to a $300 annual limit, while other eye exam services, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered under the Mass General Brigham Advantage Signature (PPO) plan, featuring no copay and no coinsurance for all covered services up to a $3,000 annual maximum. Sub-services that are not covered under this plan include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Mass General Brigham Advantage Signature (PPO) partially covers Home Infusion bundled Services with no copay and no coinsurance, though prior authorization and step therapy are required. While Medicare Part B insulin is covered, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered under this benefit.
Dialysis Services See details
Dialysis services are covered by the Mass General Brigham Advantage Signature (PPO) plan with no copay and no coinsurance.
Medical Equipment See details
Mass General Brigham Advantage Signature (PPO) covers Durable Medical Equipment (DME) with no copay and no coinsurance, requiring prior authorization and utilizing preferred vendors. While some prosthetic, medical, and diabetic equipment services are covered with no copay or coinsurance, prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Mass General Brigham Advantage Signature (PPO) provides diagnostic and radiological services with no copay and no coinsurance, though prior authorization is required. While some services are covered, diagnostic procedures or tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
Home Health Services are covered by Mass General Brigham Advantage Signature (PPO) 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 Signature (PPO) plan, as all associated sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Mass General Brigham Advantage Signature (PPO) covers Skilled Nursing Facility (SNF) services with no copay and no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. Additional days beyond Medicare-covered SNF services are not covered by the plan.
Other Services See details
Other services under the Mass General Brigham Advantage Signature (PPO) are partially covered, featuring no copay and no coinsurance for over-the-counter (OTC) items and chronic illness meal benefits, while acupuncture is not covered. Eligible members receive up to $130 every three months for OTC items, and the meal benefit has no maximum coverage limit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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