Plan vs plan · Bristol County, MA · 2027 plan year

Tufts Medicare Preferred HMO Smart Saver Rx (HMO) vs Medicare PPO Blue ValueRx (PPO)

Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.

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Tufts Medicare Preferred HMO Smart Saver Rx (HMO)

Plan premium: $0 a month
Yearly limit, in network: $7,150
2027 star rating: 4 of 5
Prior authorization needed for: 18 services

Medicare PPO Blue ValueRx (PPO)

Plan premium: $108 a month
Yearly limit, in network: $6,600
2027 star rating: 4 of 5
Prior authorization needed for: 18 services

In Massachusetts, you can go back to Medigap later

Massachusetts law makes Medigap companies accept you from February 1 to March 31 each year. Your age and health do not change the price. Coverage from that window starts on June 1. The companies also sell Medigap during the rest of the year. So you can try Medicare Advantage and go back to Original Medicare with Medigap later.

Read about Medigap rights on Medicare.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Massachusetts sets its own Medigap plans: Core and Supplement 1A. Supplement 1 is open only to people who were eligible for Medicare before 2020. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices for these plans, so the totals show Original Medicare without Medigap. Without Medigap you pay 20% of most costs, with no yearly limit. Check Medigap plans and prices for ZIP 02790 on Medicare.gov

Specialist visits a year6Days in the hospital0

Brand-name drugs you fill each month1

Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov

Original Medicare

With no Medigap and Blue MedicareRx Value Plus (PDP)

$6,139 a year

Premiums: $2,820
Medical costs: $1,616
Drugs: $1,703

No yearly limit on what you pay for medical care.

Tufts Medicare Preferred HMO Smart Saver Rx (HMO)

HMO from Tufts Health Plan

$6,154 a year

Premiums: $2,514
Medical costs: $1,760
Drugs: $1,880

Most you can pay in a bad year, before drugs: $9,664.

Medicare PPO Blue ValueRx (PPO)

PPO from Blue Cross Blue Shield of Massachusetts

$6,370 a year

Premiums: $3,810
Medical costs: $840
Drugs: $1,720

Most you can pay in a bad year, before drugs: $10,410.

With these settings, Original Medicare costs about $15 less a year than Tufts Medicare Preferred HMO Smart Saver Rx (HMO).

These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.

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What you pay each time you get care

In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: no Medigap.

Primary doctor visit

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$0
Medicare PPO Blue ValueRx (PPO)
$0 copay

Specialist visit

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$70
Medicare PPO Blue ValueRx (PPO)
$0-$45
Prior authorization

Lab tests

Original Medicare, no Medigap
$0
most Medicare-covered tests
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$0-$70
Prior authorization
Medicare PPO Blue ValueRx (PPO)
$0 copay
Prior authorization

MRI or CT scan

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$195-$350
Prior authorization
Medicare PPO Blue ValueRx (PPO)
$250
Prior authorization

Emergency room

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$130
Medicare PPO Blue ValueRx (PPO)
$130

Urgent care

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$50
Medicare PPO Blue ValueRx (PPO)
$0-$50

Outpatient surgery

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$0-$350
Prior authorization
Medicare PPO Blue ValueRx (PPO)
$150
Prior authorization

Ground ambulance

Original Medicare, no Medigap
20%
after the $292 yearly Part B deductible
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$375
Prior authorization
Medicare PPO Blue ValueRx (PPO)
$325
Prior authorization

Hospital stay, 5 days

Original Medicare, no Medigap
$1,788
Part A deductible each benefit period; $447 a day for days 61-90
Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
$2,750
for a 5-day stay
Prior authorization
Medicare PPO Blue ValueRx (PPO)
$2,165
for a 5-day stay
Prior authorization

See every cost in one table

What you pay in network	Original Medicare, no Medigap	Tufts Medicare Preferred HMO Smart Saver Rx (HMO)	Medicare PPO Blue ValueRx (PPO)
Monthly premium	Part B $209.50 + drug plan $25.50	$0 + Part B $209.50	$108 + Part B $209.50
Yearly limit on what you pay	No yearly limit	$7,150 in network	$6,600 in network; $10,000 in and out of network
Medical deductible	$292 Part B; $1,788 Part A each benefit period	$0	$0
Primary doctor visit	20%, after the $292 yearly Part B deductible	$0 copay	$0 copay
Specialist visit	20%, after the $292 yearly Part B deductible	$70 copay	$0-$45 copayPrior authorization
Lab tests	$0, most Medicare-covered tests	$0-$70 copayPrior authorization	$0 copayPrior authorization
MRI or CT scan	20%, after the $292 yearly Part B deductible	$195-$350 copayPrior authorization	$250 copayPrior authorization
X-rays	20%, after the $292 yearly Part B deductible	$0-$70 copayPrior authorization	$10 copayPrior authorization
Emergency room	20%, after the $292 yearly Part B deductible	$130 copay	$130 copay
Urgent care	20%, after the $292 yearly Part B deductible	$50 copay	$0-$50 copay
Outpatient hospital	20%, after the $292 yearly Part B deductible	$0-$450 copayPrior authorization	$300 copayPrior authorization
Surgery center	20%, after the $292 yearly Part B deductible	$0-$350 copayPrior authorization	$150 copayPrior authorization
Ground ambulance	20%, after the $292 yearly Part B deductible	$375 copayPrior authorization	$325 copayPrior authorization
Hospital stay	$1,788, Part A deductible each benefit period; $447 a day for days 61-90	$550 per day for days 1-5; $0 per day for days 6-90Prior authorization	$433 per day for days 1-7; $0 per day for days 8-90Prior authorization
Skilled nursing facility	$0, days 1-20, then $223.50 a day for days 21-100	$0 per day for days 1-20; $221 per day for days 21-100Prior authorization	$10 per day for days 1-20; $221 per day for days 21-100Prior authorization
Mental health visit	20%, after the $292 yearly Part B deductible	$0-$30 copay	$0-$30 copayPrior authorization
Physical therapy	20%, after the $292 yearly Part B deductible	$30 copayPrior authorization	$30 copayPrior authorization
Home health care	$0, Medicare-covered home health	$0 copayPrior authorization	$0 copay
Medical equipment	20%, after the $292 yearly Part B deductible	0%-50% coinsurancePrior authorization	20% coinsurancePrior authorization
Part B drugs	20% after the $292 Part B deductible	0%-20% coinsurancePrior authorization	0%-20% coinsurancePrior authorization
Drug deductible (Part D)	$700 with Blue MedicareRx Value Plus (PDP)	$700	$500
Drug tiers (one month, retail)	Preferred Generic: $0 copayGeneric: $3 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 35% coinsuranceSpecialty Tier: 25% coinsurance	Preferred Generic: $0 copayGeneric: $2 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 25% coinsuranceSpecialty Tier: 25% coinsuranceVaccines: $0 copay	Preferred Generic: $0 copayGeneric: $6 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 31% coinsuranceSpecialty Tier: 27% coinsurance

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A higher drug plan premium is not, by itself, a reason to switch

With Original Medicare, you buy a separate drug plan. In Massachusetts, 10 drug plans are for sale for 2027, from $13.30 to $284.70 a month. Half of them cost $114.75 a month or less.

Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules.
If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov

Doctors, referrals, and prior authorization

Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.

Original Medicare

Any doctor or hospital in the U.S. that takes Medicare
No referrals
Prior authorization only for a short list of services

Tufts Medicare Preferred HMO Smart Saver Rx (HMO)

HMO

You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
You need a referral to see a specialist.

Prior authorization for 18 services

Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Physical therapy, Occupational therapy, Home health, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs

Medicare PPO Blue ValueRx (PPO)

PPO

The plan has a network. You can go outside it, but you pay more.
No referral needed to see a specialist.

Prior authorization for 18 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Partial hospitalization, Medical equipment, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefit	Original Medicare	Tufts Medicare Preferred HMO Smart Saver Rx (HMO)	Medicare PPO Blue ValueRx (PPO)
Dental	No	Comprehensive, up to $750 a year	Comprehensive, up to $575 a year
Eye exam	No	Yes	Yes
Glasses or contacts	No	Yes, $150 allowance	Yes, $200 allowance
Hearing aids	No	Yes, copays from $250	Yes, up to $1,700
Over-the-counter allowance	No	No	No
Fitness benefit	No	Yes	Yes
Rides to care	No	No	No
Meals after a hospital stay	No	No	Yes
Emergency care abroad	No, unless your Medigap plan pays for it	Yes	Yes
Part B premium giveback	No	No	No

What changed for 2027

Tufts Medicare Preferred HMO Smart Saver Rx (HMO)

Consolidated Renewal Plan; New Plan · 2026 plan H2256-046-0

In-network out-of-pocket maximum up from $6,400 to $7,150
Drug deductible up from $615 to $700
Specialist visit: $50 copay to $70 copay
Diagnostic radiology (MRI, CT): $100-$200 copay to $195-$350 copay
Outpatient hospital: $0-$370 copay to $0-$450 copay
Ground ambulance: $350 copay to $375 copay
Inpatient hospital: $425 per day for days 1-6; $0 per day for days 7-90 to $550 per day for days 1-5; $0 per day for days 6-90
Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
Dental maximum down from $1,500 to $750
Eyewear allowance down from $250 to $150
OTC allowance removed

Medicare PPO Blue ValueRx (PPO)

Renewal Plan with SAR · New for 2027

No change found in the fields we track.

More 2027 plans in Bristol County

County guide: 2027 plans in Bristol County State guide: Massachusetts

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Sources and method

Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Massachusetts sets its own Medigap plans: Core and Supplement 1A. Supplement 1 is open only to people who were eligible for Medicare before 2020. These plans are not the plans with letters, such as Plan G and Plan N. We have no prices or cost model for these plans, so the totals show Original Medicare without Medigap. You can look up Medigap plans and prices for ZIP 02790 on Medicare.gov. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.

Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

See all comparisons

Tufts Medicare Preferred HMO Smart Saver Rx (HMO) vs Medicare PPO Blue ValueRx (PPO)

Your yearly cost, side by side

What you pay each time you get care

A higher drug plan premium is not, by itself, a reason to switch

Doctors, referrals, and prior authorization

Extra benefits

What changed for 2027

More 2027 plans in Bristol County

Questions about your choice? Text us.

Sources and method

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