Medicare Supplement (Medigap) Plan A

Not to be confused with Medicare Part A, Medicare Supplement Plan A, or Medigap Plan A, is the most basic of the 10 Medigap Plans. As a supplemental plan, Medigap Plan A helps cover some of the costs not covered by your Original Medicare Part A and Part B.

What Does Medigap Plan A Cover?	Jump to
Medigap Plan A for Disabled Under 65	Jump to
Medigap Plan A vs Medicare Part A	Jump to
Is Medigap Plan A Right for Me?	Jump to

What does Medigap Plan A Cover?

As the most basic of the 10 plans, Medigap Plan A covers 4 out of 9 of the standard Medigap benefits, including:

• Medicare Part A coinsurance & hospital costs 
• Medicare Part B coinsurance or copayments 
• First 3 pints of a blood transfusion 
• Part A hospice care coinsurance or copayments 

The 4 standard Medigap Plan A benefits explained:

1. Medicare Part A coinsurance and hospital costs
   Medigap Plan A covers your Part A coinsurance and hospital costs for days 61 through 150. In addition,
   
   this benefit covers up to 365 more hospital days after your Medicare benefits are used up.ⁱ  
   
   Note: Medicare Part A coinsurances don’t kick in until after you’ve paid your deductible for the year.
   With Medigap Plan A, you are still required to pay your Part A deductible.
2. Medicare Part B coinsurance or copayment
   Medigap Plan A covers your Part B coinsurances and copayments which are typically 20% of the Medicare-approved amount for most doctor services, outpatient therapy and durable medical equipment.ⁱ  This benefit oftentimes saves beneficiaries the most out of all benefits.
   
   Note: Medicare Part B coinsurances and copayments don’t kick in until after you’ve paid your Part B deductible. With Medigap Plan A, you are still required to pay your Part B deductible.
3. First 3 pints of a blood 
   Medigap Plan A covers the first three prints of blood per year. 
4. Medicare Part A hospice care coinsurance or copayment
   Medigap Plan A covers your 5% coinsurance for palliative drugs and respite care under the Part A hospice benefit. ⁱ  

What doesn’t Medigap Plan A cover?
As the most basic of the plans, there are several benefits that Medigap Plan A does NOT cover that other Medigap Plans do, including: 

• Medicare Part A deductible 
• Medicare Part B deductible 
• Medicare Part B excess charges 
• Foreign travel emergency 
• Medicare Part B preventative coinsurance 

Regardless of which Medigap Plan you buy, it will not cover:

• Routine dental, vision or hearing services
• Eyeglasses or contacts
• Hearing aids
• Long-term care or custodial care
• Prescription drugs

How Much Does Medigap Plan A Cost?

Like any Medigap Plan, Plan A comes with monthly premiums. These premiums are set by the insurance company selling the plan and can vary widely by region. There are also several other factors that impact rates like your age, your gender, whether you use tobacco products, if you qualify for any discounts and more. 

It’s best to compare Medigap plans in your area from as many insurance companies as possible. Carriers can offer the same exact plans at different rates. So, comparison shopping will help you find the best rate available to you.   

Note: You’ll still be responsible for paying your monthly Medicare Part A and Part B premiums – although most people don’t have Part A premiums. Make sure to factor in these costs when considering Medigap premiums.

Medigap Plan A for Disabled Under 65 

If you’re under the age of 65 and on Medicare due to a disability, Plan A may be one of the few Medigap Plans available to you. If this applies to you, you may be eligible to purchase a plan during your Open Enrollment Period with no underwriting required.  

Be aware, though, in most cases, the monthly premium for Plan A for someone under 65 can be double, even triple, what it would be for someone over 65. This is because most people who qualify for Medicare under 65 due to a disability usually have higher medical costs.  

Instead, you may want to consider Medicare Advantage (Part C) as an alternative to Medigap. With Medicare Advantage Plans, the rate is typically the same for anyone enrolled, regardless of their age or health status.

Medigap Plan A vs Medicare Part A: Are they the same?

Medigap Plan A and Medicare Part A are not the same thing. People often confuse the two because the names are so similar, but it’s important to understand the difference.  

The Medicare program consists of Part A, Part B, Part C and Part D. Together, Part A and Part B make up Original Medicare. So, when talking about Part A, it’s always in reference to Original Medicare.  

Medigap Plans, on the other hand, supplement Original Medicare. In fact, Medigap Plan A covers some of the costs not covered by Medicare Part A. So, you could have both Medicare Part A and a Medigap Plan A at the same time.

Is Medigap Plan A Right for Me?

Whether Medigap Plan A is right for you is going to depend on your health status, budgetary restrictions and lifestyle. It’s also going to depend on how often you visit the doctor, whether you travel abroad, if you prefer to pay less up front for your healthcare in turn for more out-of-pocket costs and more. It’s also going to depend on where you live. For example, if your state allows Part B excess charges, you may want to consider a different Medigap Plan that covers these. 

A Medigap Plan A might be right for you if you: 

• Are looking for a lower monthly premium 
• Are in good health 
• Don’t travel outside the country 
• Aren’t concerned with out-of-pocket hospital costs 
• Live in a state that doesn’t allow Medicare Part B excess charges 

If you need help determining which plan is best for you, Ensurem has licensed agents ready to answer your questions. They can also help you compare Medigap plans available in your area from some of the nation’s top-rated carriers.  

Education is crucial in finding the right Medicare solution for you. With so many Medicare resources out there, it can be difficult finding a source you can trust. That’s why Ensurem has a Compliance Program dedicated to ensuring our Medicare content meets CMS regulations. So, you can rest assured you’re getting the information you need to make the right coverage decisions. Learn more here.