Medicare Supplement Plan A
Medicare Supplement insurance Plan A is the most basic of the eight standardized Medigap plans currently available. Medigap Plan A is different from Medicare Part A hospital insurance. Medigap Plan A policies are sold by private insurers and help pay your out-of-pocket costs if you are on Medicare.
What Is Medicare Supplement Plan A?
Medicare Supplement Plan A — also called Medigap Plan A — is the most basic Medigap plan. It is one of eight Medigap plans currently available to new Medicare enrollees in most states.
Don’t confuse Medigap Plan A with Medicare Part A hospital insurance. These are two very different things, but they work together.
- Medicare Part A
- Medicare Part A hospital insurance is federal health insurance that covers your hospitalization costs. You sign up for it when you become eligible, generally do not pay a premium, and have a deductible as well as potential coinsurance and copayments if you are admitted to a hospital.
- Medigap Plan A
- Medigap Plan A — and other Medigap plans — are sold by private insurers. You purchase it in addition to your Medicare coverage. Medigap Plan A helps cover any out-of-pocket costs Medicare Part A and Part B does not cover — meaning some, but not all, coinsurance and copayments. Medigap is called Medicare Supplement insurance because it supplements your Medicare coverage.
Available in most states, Medicare Supplement Plan A is the only Medigap plan that does not cover your Medicare Part A hospital insurance deductible, which is $1,556 in 2022.
What Does Medicare Supplement Plan A Cover?
Medicare Supplement Plan A offers only basic coverage of out-of-pocket expenses not covered by Original Medicare — Medicare Part A and Part B.
- Medicare Part A coinsurance and hospital costs for up to 365 days after Medicare benefits are exhausted
- Medicare Part B medical insurance coinsurance and copayment costs
- First 3 pints of blood used for a medical procedure in a calendar year
- Medicare Part A coinsurance or copayment costs for hospice care
Of all the available supplement insurance plans, Medigap Plan A offers the fewest benefits and covers minimal out-of-pocket costs. If you’re comparing Medigap plans, it’s important to note that Medigap plans typically don’t cover long-term care or dental, hearing and vision services.
- Medicare Part A hospital insurance deductible
- Medicare Part B medical insurance deductible
- Medicare Part B excess charge — the amount over the Medicare-approved cost that a doctor is legally allowed to charge you for an item or service under Part B
- Coinsurance for skilled nursing facility care
- Foreign travel emergency costs (up to plan limits)
The out-of-pocket limit does not apply to Medicare Supplement Plan A.
All insurance companies that offer a Medigap plan have to offer Medicare Supplement Plan A. Plan A offers the same, standardized benefits in all states except Massachusetts, Minnesota or Wisconsin. Those three states have their own standardized plans.
How to Find a Medicare Supplement Plan A
Carefully consider your current and future medical conditions and health care needs before selecting a Medicare Supplement plan. You may not be able to switch to a different policy later.
It’s also important that you compare Medigap plans that are available to you before you buy. Each of the eight standardized plans offer different benefits. If you live in Massachusetts, Minnesota or Wisconsin, your plans will be different from those offered in other states.
Even though plans are standardized, prices for Medicare Supplement Plan A vary from company to company. It’s important to compare plans offered by different insurers before selecting a Medigap plan.
- Decide which benefits you want and zero in on the Medigap plan that best meets your needs.
- Find out which insurance companies sell Medigap policies in your states.
- Contact the insurance companies that sell the Medigap policies you are interested in and compare costs.
- Watch out for illegal practices. Remember that you may have a guaranteed issue right to purchase a Medigap policy if you are eligible for Medicare.
- Buy your Medigap policy. If you don’t receive the policy within 30 days, call the insurance company. If you don’t receive it within 60 days, call your state insurance department.
Remember: Once you’re enrolled in Medicare, you can buy a Medigap policy any time. But to avoid the medical underwriting requirement, you must buy your policy within the window of time allotted for your specific situation.
You can ask your State Health Insurance Assistance Program (SHIP) if it has a Medigap rate comparison shopping guide. Many SHIP offices provide these guides to help you compare plans, companies and costs in their state.
6 Cited Research Articles
- U.S. Centers for Medicare & Medicare Services. (2020). Medicare & You 2021. Download. Retrieved from https://www.medicare.gov/sites/default/files/2020-12/10050-Medicare-and-You_0.pdf
- Bunis, D. (2020, July 6). Medigap Plans Help Bridge Gap of Original Medicare Costs. Retrieved from https://www.aarp.org/health/medicare-insurance/info-2017/choosing-right-medigap-plan.html
- U.S. Centers for Medicare & Medicare Services. (2020, February). Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://www.medicare.gov/sites/default/files/2022-03/02110-medigap-guide-health-insurance.pdf
- National Association of Insurance Commissioners. (n.d.). Insurance Departments. Retrieved from https://content.naic.org/state-insurance-departments
- U.S. Centers for Medicare & Medicare Services. (n.d.). How to Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
- U.S. Centers for Medicare & Medicare Services. (n.d.). What’s Medicare Supplement Insurance (Medigap)? Retrieved from https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap