Medigap Plan A

A Medicare Supplement insurance plan can be used to help cover certain out-of-pocket costs that Medicare Part A and Medicare Part B (Medicare) don’t pay. The “gaps“ in Medicare that Medicare Supplement insurance plans help cover may include coinsurance, copayments, and deductibles. Ten different Medicare Supplement insurance plans, labeled A, B, C*, D, F*, G, K, L, M and N, are available in most states through private health care insurers. Each standardized plan has a different level of coverage. (Massachusetts, Minnesota, and Wisconsin have their own standardized Medicare Supplement insurance plans.)

Medigap Plan A is not to be confused with Medicare Part A. Medicare Part A covers inpatient hospital care and is one half of Medicare (Part A and Part B). Medicare Supplement insurance Plan A refers instead to coverage that helps pay for out-of-pocket costs from Medicare Part A and Part B.

Health insurance providers that sell Medicare Supplement insurance plans are required by law to offer Plan A. In most states, Medicare Supplement insurance policies are standardized, meaning that all plans with the same name must offer the same basic benefits regardless of which insurance company is offering it. For example, Medicare Supplement insurance Plan A offered by Company 1 in Arizona has the same basic benefits as Plan A from Company 2 in Texas. The main difference between plans offered by different insurance companies is the premium cost. Some companies may offer extra benefits with their Medicare Supplement insurance plans.

*Medicare Supplement Plans C and F aren’t available to those who qualify for Medicare on January 1, 2020 or later. You can generally keep a Plan C or Plan F that you already have. You may be able to buy a Plan C or Plan F if you qualify for Medicare by the end of 2019.

What is covered under Medigap Plan A?

Plan A is the most basic of the 10 Medicare Supplement insurance plans, covering the fewest benefits.

Medicare Supplement insurance Plan A covers 100% of four things:

  • Medicare Part A coinsurance payments for inpatient hospital care up to an additional 365 days after Medicare benefits are used up
  • Medicare Part B copayment or coinsurance expenses
  • The first 3 pints of blood used in a medical procedure
  • Part A hospice care coinsurance expense or copayment

All 10 standardized Medicare Supplement insurance plans cover hospital care coinsurance at 100%. All 10 plans cover the other three categories as well (Medicare Part B copayments, 3 pints of blood, and hospice care coinsurance), although Plan L covers these benefits at 75% and Plan K covers them at 50%. The nine plans other than Part A cover at least one benefit that Plan A does not cover; some plans cover up to five additional benefits.

What are the costs associated with Medigap Plan A coverage?

Medicare Supplement insurance Plan A policyholders are responsible for paying their Medicare Part A and Part B deductibles. They must also pay for skilled nursing facility care coinsurance, Part B excess charges, and foreign travel emergency costs. These five categories may be covered by other Medicare Supplement insurance plans. Plan A might be the ideal plan for those who don’t wish to pay costly premiums for benefits they might never use. However, Plan A coverage has the potential for higher out-of-pocket costs if the need for the uncovered categories arises.

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