Medicare Supplement (Medigap) Plan A?

What is Medicare Supplement Plan A?

Supplemental Medicare insurance helps cover certain out-of-pocket costs that Original Medicare (Part A and Part B) don’t pay. These gaps in Medicare coverage include deductibles, coinsurance, and copayments that make up a beneficiary’s shared costs. Medicare Plan A the most basic of all Medicare supplements available to help cover some of these costs.

Medicare Supplement Plan A is often confused with Medicare Part A, which is the Medicare coverage that pays for your inpatient hospital care. Medicare Supplement Plan A, which is also known as Medigap Plan A, helps pay the most costly out-of-pocket costs from Medicare Part A and Medicare Part B. Only Medicare organizes coverage in “parts”. Private insurance organizes its coverage in “plans”.

There are ten different Medigap plans, labeled A, B, C, D, F, G, K, L, M, and N. These plans are available in most states through private insurance companies. Each lettered plan has a different range of coverage. Massachusetts, Minnesota, and Wisconsin don’t follow the standardized plan system.

All of the Following are Core Benefits of Medicare Supplement Plan A Except…

All insurance companies that sell supplemental Medicare insurance offer Plan A. This plan offers the most essential coverage, which takes care of:

1. Hospital Inpatient Coinsurance
2. First 3 Pints of Blood
3. Hospice Coinsurance
4. Doctor and Outpatient Services Coinsurance

However, this plan leaves its beneficiaries to pay Part A and Part B deductibles, excess charges, and skilled nursing facility coinsurance. And, although you are covered anywhere you go in the United States, this plan does not cover foreign travel emergencies

As you can see, Medicare Plan A is the most basic of the 10 Medicare Supplement insurance plans, but its coverage should not be underestimated. Medigap Plan A covers 100% of four critical 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 Medicare supplement plans cover the hospital inpatient coinsurance at 100%. And, all plans cover blood, the Medicare Part B copayments, and hospice care coinsurance. However, Medicare Plan L only covers these benefits at 75%, while Medicare Plan K covers them at 50%.

The other Medigap plans cover at least one benefit that Plan A does not cover. Medicare Plan F, the most comprehensive plan available, covers five additional benefits. The following Medigap plan comparison chart shows how Plan A compares to all other plans.

What Costs Come with Medicare Plan A Coverage?

If you buy a Medicare Plan A policy you are responsible for paying the Medicare Part A and Part B deductibles. If you are a healthy person this isn’t a big risk. Also, be aware that as of January 2020, seniors turning age 65 can’t buy a policy that covers the Part B deductible, which includes Plan F and Plan C.

You will also be responsible for any skilled nursing facility coinsurance and Part B excess charges. Again, if you’re healthy, the risk is somewhat low. However, if you are aging into Medicare with one or more chronic conditions, you should seriously consider one of the other plans.

Also, if you are an international traveler, be aware that both Medicare and Medicare Supplement Plan A won’t cover you in the event of a medical emergency.  Six of the standardized plans do offer an 80% foreign travel emergency coverage benefit up to the policy limit.

Medicare Plan A is basic coverage. It works for those people who are healthy and don’t want to pay for coverage they are not likely to ever need. That said, Plan A coverage has the potential for much higher out-of-pocket costs if a serious illness or accident occurs.

What Basic Medicare Supplement Plans do Wisconsin, Minnesota, and Massachusetts Offer?

As previously mentioned, Massachusetts, Minnesota, and, Wisconsin have their own Medicare supplement plans that cover Medicare’s gaps differently. These three states specify basic benefits that supplemental  Medicare insurance must cover.

In Massachusetts, basic benefits include:

• Medicare Part A coinsurance payments for inpatient hospital care up to an additional 365 days after Original Medicare benefits are exhausted
• Medicare Part B coinsurance for medical costs (generally 20% of the Medicare-approved amount)
• The first 3 pints of blood each year
• Part A hospice coinsurance or copayment

In Minnesota, basic benefits include:

• Medicare Part A coinsurance for inpatient hospital care
• Medicare Part B coinsurance for medical costs (generally 20% of the Medicare-approved amount)
• The first 3 pints of blood each year
• Part A hospice and respite care copayments
• Part A and Part B home health services and supplies cost-sharing

In Wisconsin, basic benefits include:

• Medicare Part A coinsurance for inpatient hospital care
• Medicare Part B coinsurance for medical costs
• The first 3 pints of blood each year
• Part A hospice coinsurance or copayment

Consult with your insurance agent to see if a Medicare Supplement Plan A policy might be right for you. If you don’t have an agent, call 1-855-728-0510 (TTY 711) and speak with a licensed HealthCompare insurance agent. There’s no obligation, and they offer more plan options than any other national agency.