Medigap Plan A is one of the standardized Medicare Supplement Insurance plan types options available in most states.
Learn more about how Medigap Plan A could help with your out-of-pocket health care costs and find out if Plan A is the best plan for your needs.
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Medigap Plan A is sold by private insurance companies and provides coverage for some of the out-of-pocket expenses that Medicare Part A and Part B (together known as Original Medicare) don't pay for.
These costs can include things such as certain Medicare deductibles, coinsurance and more.
Plan A has the fewest benefits out of the 10 standardized Medigap plan options.
Every Medicare Supplement Insurance company must sell at least Plan A in a given state in order to sell other Medigap policies in the same state.
Medicare Supplement Insurance Plan A should not be confused with Medicare Part A.
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The table below shows what is covered by Medigap Plan A.
The benefits that have a check mark are covered by Plan A. Any benefits without a check mark are not covered by Plan A.
|
Standard Medicare Supplement Insurance benefits |
Plan A |
|---|---|
|
Medicare Part A coinsurance and hospital costs |
✓ |
|
Medicare Part B coinsurance or copayment |
✓ |
|
First 3 pints of blood |
✓ |
|
Part A hospice care coinsurance or copayment |
✓ |
|
Coinsurance for skilled nursing facility |
|
|
Medicare Part A deductible |
|
|
Medicare Part B deductible |
|
|
Medicare Part B excess charges |
|
|
Foreign travel emergency |
Medicare Part A is known as hospital insurance and it includes cost-sharing measures like coinsurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if they exceed 60 days.
Medigap Plan A pays for all of your Part A coinsurance fees.
It’s important to note that Plan A does not cover the Medicare Part A deductible. You will need to meet the Part A deductible before Medicare covers inpatient hospital care.
In 2023, the Medicare Part A deductible is $1,600 per benefit period.
Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care.
After you meet your Part B deductible, Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving you to pay 20% coinsurance costs in most cases.
Medigap Plan A covers your Part B coinsurance or copayment costs in full.
With Plan A, you still have to pay the Medicare Part B deductible, which is $226 per year in 2023.
If you need a blood transfusion as part of any medical care, Original Medicare only covers the fourth pint of blood and beyond.
Medigap Plan A provides full coverage for the cost of the first 3 pints of blood.
Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it typically requires copayments.
These copayments include $5 for each prescription drug used for symptom and pain relief, and 5% of the Medicare-approved amount for inpatient respite care.
Medigap Plan A fully covers your Part A hospice coinsurance and/or copays.
Learn more about common procedures that Medicare covers.
Plan A doesn't cover as many benefits as other plans, such as Plan F, Plan G and Plan C.
If you anticipate needing health services frequently and want a Medigap plan that can cover a wider range of out-of-pocket Medicare costs, Plan A may not be the best option.
To see the difference between Medigap Plan A and the other standardized plans, review the chart below. Use the scroll bar at the bottom to view all plans and information.
The cost of Plan A, or any other Medigap plan, can vary based on some of the following factors:
Your gender, health, smoking status and other factors can affect the cost of your Medigap Plan A options.
Although insurance companies must offer Plan A in order to sell Medigap coverage, the majority of insured Medicare beneficiaries do not choose this option.
1% of Medigap policyholders have Plan A.1
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In order to sign up for Medigap Plan A, you must be at least 65 years old, enrolled in Medicare Part A and Part B and reside in the area that is serviced by a Plan A policy.
The best time to apply for Medigap Plan A is during your Medigap Open Enrollment Period.
Your Medigap Open Enrollment Period lasts for six months and begins when you are both 65 years old and enrolled in both Part A and Part B of Medicare.
If you apply for a Medigap plan during this time, Medigap insurance companies will not be allowed to use medical underwriting to determine the cost of your premium. This means you cannot be denied a policy or charged higher premiums based on your health.
If you do not apply for coverage during your Open Enrollment Period but later decide to do so, you may be subject to underwriting and may be charged a higher rate based on your health.
If you are under 65 years old, you may not be able to enroll in a Medigap plan, even if you have Medicare because of a qualifying disability. Some states have laws that require insurance companies to sell Medigap plans to people under age 65, but not all states have this requirement.
A licensed insurance agent can help you find Medicare Supplement Insurance plans that are available where you live.
Call to speak with a licensed agent today to get help comparing plan benefits and costs so you can find a plan that fits your needs.
Medigap plans like Plan A is sold and serviced by private insurance companies that are regulated by the Centers for Medicare & Medicaid Services (CMS).
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