What is Medicare Supplement Plan A?

Although complementary to Medicare Part A, this plan is separate coverage sold by private insurance carriers. Medicare Part A coverage includes inpatient hospital care and is 50% of Original Medicare (Part A & Part B). On the other hand, Medigap provides coverage to help pay for out-of-pocket expenses that are not fully covered under Medicare Part A.

These plans are standardized nationwide, meaning it is mandatory by law that insurance carriers who sell Medigap insurance policies to offer the same coverage benefits in all states, with the exception of Massachusetts, Minnesota, and Wisconsin. For example, Insurance Carrier X selling Supplement Medicare Plan A in Texas has to offer the same basic benefits as Insurance Carrier Y selling Medicare Supplement Plan A in Georgia. The key difference between policies sold by different insurance carriers is the premium cost. Some carriers may offer extra benefits with their policies, which would result in higher premiums, however, base benefits must be uniform across all companies. With that being said, the best plan for you may be determined by its premium cost paired with extra benefits offered by the insurance carrier you decide to purchase your policy from.

Medicare Part A Eligibility

Before getting further into the benefits, here are the general eligibility requirements for Medigap Plan A:

– You are at least 65 years of age, a U.S. citizen or permanent legal resident for at least five consecutive years
– You are currently receiving retirement benefits.
OR
– You are disabled and receiving disability benefits
– You have End-Stage Renal Disease (ESRD)
– You have Lou Gehrig’s Disease (ALS).

What does Plan A Medicare Supplement Cover?

Of the 10 Medigap Plans, Plan A Medicare supplement coverage offers the most basic benefits. Medigap Plan A benefits will fully cover 100% of the following expenses:

– Coinsurance payments for Medicare Plan A towards inpatient hospital care up to 365 days after Medicare benefits have been depleted
– Copayment or coinsurance costs for Medicare Part B
– The first 3 pints of blood needed for a medical procedure
– Coinsurance costs or copayment for Part A hospice care

All Medigap policies, including Plan A, offer 100% coverage for hospital care coinsurance, as well as the 3 main categories:

– Medicare Part B copayments
– First 3 pints of blood
– Coinsurance for hospice care

How much does Medicare Supplement Insurance Plan A cost?

Plan A Medicare Supplement policyholders must pay for their deductibles under Medicare Part A & B. They are also responsible for paying for coinsurance associated with skilled nursing facility care, excess charges, as well as any costs associated with foreign emergency travel. If you require coverage for any of the non-covered benefits, there are other Medigap plans to fill these gaps.

Is Medigap Plan A a­­ good choice for you?

Medigap Plan A could be the right choice for you if you would prefer not to pay more expensive premiums for benefits that you may never end up using. You should note that if a need arises for any of the uncovered categories outside of Medicare supplement Plan A benefits, you might end up paying more costly out-of-pocket expenses. This is why it’s important to think about what do and do not need thoroughly before you decide to settle for Medicare Supplement insurance Plan A coverage.