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Medicare Supplement Insurance Plan A

Medigap Plan A  is one of 10 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.

 

Find Medigap Plan A in your area.

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What Is Medigap Plan A?

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.

What Is the Difference Between Plan A vs. Part A?

Medicare Supplement Insurance Plan A should not be confused with Medicare Part A.

  • Medicare Part A is one part of the federally-funded portion of Medicare (along with Part B). Part A covers some of the costs for inpatient hospital stays and other inpatient care.

  • Medigap Plan A works in conjunction with your Medicare Part A and Part B coverage to help pay for some of the deductibles and coinsurance costs associated with Original Medicare. 

What Benefits Does Medigap Plan A Cover?

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 Coinsurance

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.

For 2019, the Medicare Part A deductible is $1,364 per benefit period.

Medicare Part B Coinsurance and Copayment

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 $185 per year in 2019.

First 3 Pints of Blood

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.

Part A Hospice Care Coinsurance or Copayment

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.

Plan A vs. Other Medigap Plans

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.

2019 Medigap plans comparison chart

How Much Does Plan A Cost?

The average Medigap Plan A premium in 2018 was $192.33 per month.1

The cost of Plan A, or any other Medigap plan, can vary based on some of the following factors:

  • Location
    A Medigap Plan A sold in one area might be more or less expensive than a Plan A sold in another area, despite the benefits being exactly the same.

  • Medigap insurance company
    The cost of Medigap Plan A is not standardized by the federal government. Insurance companies that sell Plan A may set their own premium price.

  • Pricing model
    Insurance companies typically use one of three distinct pricing systems to sell Medigap plans, each of which can be influenced by your age.

Your gender, health, smoking status and other factors can affect the cost of your Medigap Plan A options.

Enrollment Statistics

Although insurance companies must offer Plan A in order to sell Medigap coverage, the majority of insured Medicare beneficiaries do not choose this option.

Only 1% of Medigap policyholders had Plan A  in 2017.2

Plan A has become slightly less popular in recent years. The overall number of enrollees with Plan A decreased 4% between 2016 and 2017.2

How Do I Sign Up for Medigap Plan A?

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.

Find Medigap Plan A Where You Live

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.

 

Compare Medigap plans in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.


1 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

2 AHIP. The State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.

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