Medicare Supplement Plan A is generally the most affordable Medigap option available, but the price is reflected in the benefits offered. It is the least complete of all the supplemental insurance options, covering the bare minimum required by Medicare law.
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In fact, federal regulations stipulate that any insurance provider who wishes to offer Medigap must offer Plan A. In this way, Plan A can be thought of as the most basic of Medicare supplemental insurance plans.
This table outlines the specific benefits and limitations of Medicare Supplement Plan A, helping you understand what is and isn’t covered under this plan.
What does Medicare Supplement Plan A Cover?
Medicare Supplement Plan A is one of the standardized Medigap plans available to Medicare beneficiaries. It provides coverage for some of the basic gaps in Original Medicare, helping to reduce out-of-pocket costs.
Specifically, Plan A covers Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. This is crucial for those who require extended hospital stays, as it provides a significant extension of coverage beyond what Original Medicare offers.
In addition to hospital coverage, Plan A also covers Medicare Part B coinsurance or copayment. This helps pay for outpatient services such as doctor visits, lab tests, and preventive services. By covering the 20% coinsurance that beneficiaries would otherwise have to pay out of pocket, Plan A makes it more affordable to receive necessary medical care.
Plan A also includes coverage for the first three pints of blood each year, which are not covered by Original Medicare. This can be particularly beneficial in situations where blood transfusions are needed, as the cost of blood can be substantial.
However, it is important to note that Plan A does not cover certain other costs, such as the Part A and Part B deductibles, skilled nursing facility care coinsurance, and foreign travel emergency care, which are covered by some of the other Medigap plans.
| Coverage Type | Plan A Coverage |
|---|---|
| Medicare Part A Coinsurance and Hospital Costs (up to an additional 365 days after Medicare benefits are used up) | Covered |
| Medicare Part B Coinsurance or Copayment | Covered |
| Blood (First 3 Pints) | Covered |
| Part A Hospice Care Coinsurance or Copayment | Covered |
| Skilled Nursing Facility Care Coinsurance | Not Covered |
| Medicare Part A Deductible | Not Covered |
| Medicare Part B Deductible | Not Covered |
| Medicare Part B Excess Charges | Not Covered |
| Foreign Travel Emergency Care | Not Covered |
This table outlines the specific benefits and limitations of Medicare Supplement Plan A, helping you understand what is and isn’t covered under this plan.
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MEDICARE SUPPLEMENT PLAN A
IS NOT MEDICARE PART A
When it comes to Medicare, terms can get confusing. Medigap Plan A is completely different from Medicare Part A.
Medicare Part A is one piece of your Original Medicare. It covers services such as hospital stays and skilled nursing facility care. Medigap Plan A is one of ten supplemental insurance plans that are meant to extend your Original Medicare benefits. It is optional and purchased separately from Medicare Part A.
What is not Covered in Plan A Medicare Supplement?
Plan A policyholders will remain responsible for paying the Original Medicare Part A deductible and Part B deductible. Plan A policyholders will also have to pay out-of-pocket for skilled nursing facility coinsurance, emergency foreign travel medical expenses, and Part B excess charges.
Most of these expenses can be covered under other standardized Medigap plans but typically, the more coverage you have, the higher your monthly premium will be.
Additionally, seniors who are comparing Medicare Supplement Plans need to remember that they will still be responsible for their monthly Medicare Part B premiums unless they qualify for “extra help” from Medicare.
Who Is the Medicare Supplement Plan A Best Suited For?
While it might not offer as much coverage as the other plans, Medigap Plan A is still a very nice addition to your Original Medicare. Remember that these are benefits you would not have if you stuck with just the traditional plan. Plan A.
Therefore, it is ideal for anyone on a very strict budget who still wants to extend their Medicare benefits to avoid some of the most common and expensive out-of-pocket expenses. You’ll still need to meet your deductibles, but after that, your coinsurance and copayments for most services are completely covered.
Medigap Plan A For Those Under Age 65
While most recipients are retirees age 65 or older, Medicare is also available to younger citizens who are diagnosed with certain disabilities or health conditions.
While federal law doesn’t require private insurers to provide Medicare supplement plans to recipients under 65, most states states do have such a requirement (though the specific terms vary from state to state). Because any company that sells Medigap must offer Plan A, it is the plan most commonly available to Medicare recipients under age 65.
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How to Enroll in Medigap Plan A
To enroll in Medigap Plan A, you must first be enrolled in both Medicare Part A and Part B. The best time to purchase a Medigap policy is during your Medigap Open Enrollment Period, which is a six-month period that starts the first month you are 65 or older and enrolled in Part B.
During this time, you have a guaranteed issue right to buy any Medigap policy sold in your state, regardless of any pre-existing health conditions. This means insurance companies cannot deny you coverage or charge you higher premiums based on your health.
To enroll, you can contact private insurance companies that are licensed to sell Medigap policies in your state. It is advisable to compare different insurance providers and plans to ensure you get the best coverage and price.
You can do this by visiting the insurance companies’ websites, calling them directly, or using resources like the Medicare Plan Finder tool on the official Medicare website. Once you have selected a plan and insurance company, you will complete an application and, upon approval, your coverage will begin.
Conclusion
Medicare Supplement Plan A provides essential coverage that can significantly reduce out-of-pocket expenses for those enrolled in Original Medicare. By covering crucial gaps such as Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayment, and the first three pints of blood each year, Plan A ensures that beneficiaries can access necessary healthcare services without facing overwhelming medical bills.
Although it does not cover all potential expenses, its straightforward and essential benefits make it a valuable option for many Medicare recipients. As with any healthcare decision, it is important to carefully consider your personal needs and compare different plans to ensure that you select the best coverage for your situation. With the right Medigap plan, you can achieve greater financial stability and peace of mind in managing your healthcareÂ
Frequently Asked Questions
No. Medicare Part A is the hospital coverage provided by traditional Medicare and Medigap Plan A is a supplement to Medicare provided by private insurance companies.
Typically, seniors who purchase a Medigap Plan A are on a very tight budget or are in excellent health and rarely need healthcare services.
Unfortunately, excess charges from a physician who does not accept Medicare assignment are not covered by Medigap Plan A.
You can enroll in a Medicare supplement policy during your open enrollment period, which starts when you’re at least 65 years old and enrolled in Medicare Part B.
If you have been receiving Social Security disability benefits for at least two years, you may be eligible for Medicare due to disability.
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