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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. (Massachusetts, Minnesota, and Wisconsin have different options.) Learn more about how Medigap Plan A could help with your out-of-pocket health care costs.

Medigap Plan A: Overview

Medicare Supplement Insurance Plan A should not be confused with Medicare Part A, which covers hospital and other inpatient care under the public Medicare program.

Plan A has the fewest benefits out of the 10 Medigap plan options. It also tends to be among the most affordable of all the Medigap plans, according to the Kaiser Family Foundation.1

Every Medigap insurer must sell Plan A in order to sell policies in a certain state. But despite its wide availability, only 2% of Medigap beneficiaries had Plan A in 2014, according to America’s Health Insurance Plans’ (AHIP).2

Plan A Benefits

Plan A has the fewest individual benefits, but it is also one of the most affordable Medigap plan options.

Standard Medicare Supplement Insurance benefits

Plan A

Medicare Part A co-insurance and hospital costs

Medicare Part B co-insurance or co-payment

First 3 pints of blood

Part A hospice care co-insurance or co-payment

Co-insurance for skilled nursing facility

 

Medicare Part A deductible

 

Medicare Part B deductible

 

Medicare Part B excess charges

 

Foreign travel emergency

 

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days.  Medigap Plan A pays for all of these co-insurance 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.3

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a co-insurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% co-insurance in most cases. Plan A pays the 20% co-insurance or co-payment costs. With Plan A, you still have to pay the Medicare Part B deductible, which is $185 in 2019.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond if you require a blood transfusion. Medigap plans, including Plan A,  cover the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care. Plan A covers these costs completely.

For more detailed information, read our page about Medicare Supplement insurance benefits.

Plan option comparison

Plan A doesn’t cover as many benefits as other plans, such as Plans F, G, and C. It’s a suitable option for healthy Medicare beneficiaries looking for lower premiums. But if you anticipate needing health services frequently, this plan may not be the best option.

To see the difference between Medigap Plan A and the other standardized plans, review the chart below.

Plan A vs. other Medigap plan options

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility 50% 75%
Medicare Part A deductible 50% 75% 50%
MedicarePart B deductible
Medicare Part B excess charges
Foreign travel emergency 80% 80% 80% 80% 80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything. 2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

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 2% of Medigap policyholders had Plan A  in 2014, according to AHIP.

Plan A has become slightly more popular in recent years, according to AHIP. The overall number of enrollees with this plan increased 4% between 2013 and 2014.


1 https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8412-2.pdf

2 https://www.ahip.org/wp-content/uploads/2016/04/MedigapEnrollmentReport_Linked.pdf

3 https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

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