Medigap Plan A Coverage and Information
What is Medicare Supplement Plan A?
Although complementary to Medicare Part A, this policy is a separate coverage sold by private insurance carriers. Part A of Medicare covers inpatient hospital care and makes 50% of what is known as Original Medicare (Part A & Part B). Medigap was designed to help Medicare beneficiaries pay for out-of-pocket expenses that are not fully covered under Medicare Part A coverage
Supplemental Medicare Plan A is one of 10 standardized Medigap plans. These plans offer the same base benefits nationwide (with the exception of Massachusetts, Minnesota, and Wisconsin) regardless of where they are sold or which insurance carrier sells them. For example, Insurance Carrier X selling Plan A Medicare supplement in Georgia must offer the same benefits as Insurance Carrier Y, selling Plan A in Texas. The key difference between the policies sold by these carriers is the cost of the premium. Some carriers prefer to charge more for extra benefits and services offered with their Medigap policies. However, basic benefits must stay uniform across all companies. This is why it’s important to keep the pricing paired with extra services in mind when you decide which carrier you will purchase from.
Medicare Part A Eligibility
Before getting further into the Medigap Plan A benefits, here are the general eligibility requirements for Medicare Supplement 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?
Medicare Supplement insurance Plan A coverage covers the fewest expenses, offering the most basic benefits. It will cover 100% of the following expenses:
– Coinsurance payments for Medicare Part 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:
– Copayments for Medicare Part B
– First thee (3) pints of blood
– Hospice care coinsurance
Medicare Supplement Part A Costs
Medicare Supplement Plan A policyholders must pay for their deductibles under Original Medicare. Additionally, this will leave them responsible for paying the coinsurance associated with skilled nursing facility care, as well as the excess charges of Part B. While Medigap plans may cover travel emergency travel, Plan A will leave you responsible for any costs associated with foreign emergency travel. You should consider a more comprehensive Medigap policy if you are looking for a plan to cover all these non-covered benefits.
Is Medigap Plan A a good choice for you?
Medicare Supplement Insurance Plan A would be good for you if you do not want to pay more expensive premiums for benefits you may never end up using. However, you should note that if a need arises for any of the uncovered categories outside of the Medicare supplement Plan A benefits covered by Plan A, you might end up paying more in out-of-pocket expenses than what you would pay for a more expensive premium that covers those services.