Medicare Supplement Plan A
Not to be confused with Medicare Part A, which is the part of Original Medicare covering inpatient hospital care, Medicare Plan A helps pay for your Original Medicare out-of-pocket costs. Any health insurance company selling Medigap (Medicare Supplement) plans are legally required to offer Plan A. Since health care policies are standardized in most states, Plan A in New York provides the same benefits as Plan A in Texas, regardless of the carrier. They differ primarily in the price of the premium.
What do I get from Plan A?
Plan A is the bare bones Medigap plan with the fewest benefits, covering all the costs of these 4 items:
- Your Part A (for an inpatient hospital visit) coinsurance expenses up to an extra 365 days after Medicare benefits are exhausted
- Your Part B (for doctor and outpatient medical facilities) copayment or coinsurance costs
- The initial 3 pints of blood needed for a medical procedure
- Part A hospice care coinsurance expense or copayment
There is redundancy in Medigap, and every standardized Medigap plan covers 100% of hospital coinsurance. All 10 plans take care of Part B copayments, 3 pints of blood, and coinsurance for hospice care. Plan L covers 75% of these expenses, and Plan K covers 50% of them.
What is Plan A going to cost me?
With Plan A you’re going to be responsible for your Medicare Parts A and B deductibles. You also must cover any skilled nursing facility coinsurance, as well as emergency care costs outside of the U.S., and Part B surcharges. Other Medigap plans will help you meet these expenses. If you don’t expect to use a lot of benefits that come with expensive premiums, Plan A may make sense for you. But if the need for the uncovered items comes up unexpectedly, your out-of-pocket costs may be pricier than you’d like.
Is Medigap the same in all the states?
Medicare Supplement plans are uniform everywhere but Massachusetts, Minnesota, and Wisconsin. These three states all require every Medigap plan to cover these different levels of “basic benefits” at a minimum:
In Massachusetts, you’re covered for:
- Part A coinsurance payments for an inpatient hospital visit up to an extra 365 days after Original Medicare benefits are used up
- Part B coinsurance for medical outlays (as a rule 20% of the Medicare-approved amount)
- The first 3 pints of blood annually
- 60 days per year of inpatient care in mental health hospital
In Minnesota, you’re covered for:
- Part A coinsurance for inpatient hospital care
- Part B coinsurance for medical costs (usually 20% of the Medicare-approved amount)
- The first 3 pints of blood annually
- Part A and Part B cost sharing for home health services and supplies
- Part A hospice and respite care copayments
In Wisconsin, you’re covered for:
- Part A coinsurance for inpatient hospital care
- Part B coinsurance for medical costs
- The first 3 pints of blood annually
- Part A hospice coinsurance or copayment
- Medicare Part A coinsurance costs for inpatient hospital care up to an extra 365 days after Original Medicare benefits are used up
- Medicare Part B coinsurance for medical costs (generally 20% of the Medicare-approved amount)
- The first 3 pints of blood annually
- Part A hospice coinsurance or copayment
What about my eligibility for Plan A?
First, you have to be enrolled in Original Medicare (Part A and Part B) to buy Plan A. You must be a U.S. citizen and meet one of these criteria or more:
- You’re 65 or older
- You have a disability
- You’ve been diagnosed with End-Stage Renal Disease (ESRD)
What disqualifies you is being enrolled in a Medicare Advantage plan, which you can’t have at the same time you have a Medigap policy. If you have one, be sure to cancel your Medicare Advantage plan before your new coverage starts.
Be aware that you’re entitled to switch Medigap plans every year, any time you want. In certain states you may be required to answer medical questions, and depending on your health evaluation, you could be denied coverage. This is when it could really pay to have a medigapcoverage.com powered by pollen specialist at your back.
Still confused? Call us!
We’re here at 833-245-0614 to answer any questions, and ready to help with any issues you might have with an insurer through the enrollment process.
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FAQs
In general, what type of beneficiary is going to get the most out of Plan A?
Plan A has the bare minimum of benefits and makes the most sense for a senior in good health who doesn’t expect to need many doctor or hospital visits in the near future.
Are Plan A’s benefits unique to this policy?
No. You can get these 4 benefits from any of the 10 Medigap plans.
What is Plan A going to cost me?
You’re going to be responsible for your Medicare Parts A and B deductibles, any skilled nursing facility coinsurance, as well as emergency care costs outside of the U.S., plus Part B surcharges.
I’m moving to Massachusetts. Will I be able to buy Plan A there?
No, Massachusetts has it’s own version of Medigap, and the Core plan is closest to Plan A. It offers this coverage: Part A coinsurance payments for an inpatient hospital visit up to an extra 365 days after Original Medicare benefits are used up Part B coinsurance for medical outlays (as a rule 20% of the Medicare-approved amount) The first 3 pints of blood annually 60 days per year of inpatient care in mental health hospital
What are the best Medicare supplement plans?
- Best overall Medicare supplement for new enrollees: Plan G.
- Best overall Medicare supplement before 2020: Plan F.
- Best low cost Medicare supplement: Plan K.
- Best alternative to Plan G Medicare supplement: Plan N.
What is a Medicare supplement plan?
Medicare Supplement policies are private health insurance designed to cover gaps in Original Medicare. They are also known as Medigap plans. These take care of costs such as copays, coinsurance, and deductibles which can become expensive if you need regular care from a doctor or hospital. If you need medical care while traveling outside the U.S., you can buy Medigap policies to help cover those costs. As a supplement to Original Medicare, you’re required to have Part A and Part B before you canget a Medigap policy. This way, Medicare is responsible for the Medicare-approved costs of the covered care, and the remainder is covered by your Medigap plan.
What is the most expensive Medicare supplement plan?
Optimal coverage comes with higher costs, making Plan F the most expensive Medigap plan. Plan F is known as “first-dollar coverage” and it takes care of everything provided during a doctor or hospital visit. Your only responsibility is for dental, vision, medications, and equipment, such as hearing aids.
Why is Plan F being discontinued?
The Federal government ended the Plan F option for new enrollees last year to keep the healthcare system from being overused by patients who had their deductibles covered. The next best coverage after Plan F is Plan G.
Is Plan G better than Plan F?
Medigap Plan G offers every advantage of Plan F except for the deductible, which you have to cover. Because it isn’t as comprehensive as Plan F, Plan G is more affordable.
What is the best and cheapest Medicare supplement insurance?
For people who don’t go to the doctor often, Plan K is worth considering. It is the most affordable because it provides just 50% of Medicare Part B coinsurance, the Part A deductible, blood, skilled nursing, and Part A hospice costs. For comparison, Plan G and others offer full coverage of these expenses, and more.
Is Medicare supplemental insurance worth it?
It’s hard to argue against plans which cut your traditional Medicare costs. For most people, having the extra coverage these supplemental plans provide is common sense, unless they want the specific features of a Medicare Advantage plan.
Do I really need supplemental insurance with Medicare?
Most people would benefit from not having to pay out-of-pocket to stay healthy. Medicare supplement insurance or a Medicare Advantage plan offer vital savings now, but are indispensable should a catastrophic health issue occur.
What is the most popular UnitedHealthcare Medicare Supplement plan?
Of the 10 Medicare-approved Medigap plans, Plan G and Plan N are the most popular. Plan F is no longer available to new Medicare enrollees as of 2020, but it is still popular among people who bought this plan prior to 2020.
How much does Medigap insurance cost?
- Plan F$128–$342
- Plan F (high deductible)$22–$88
- Plan G$106–$325
- Plan G (high deductible)$29–$58
Who qualifies for Medigap?
Before getting a Medicare supplement plan, you need to be enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance). People with Medicare Advantage Plans who want to go back to Original Medicare can buy a Medigap policy prior to switching.
Is Medigap insurance worth the cost?
The security of having lower or no out-of-pocket healthcare costs can offset the premiums you’ll have to pay for whichever Medigap plan you choose, which vary depending on the benefits offered.
How Much Is Medigap per month?
The national average cost for Medicare Supplement Plan F is $1,824 annually, which is $152/month; Medigap Plan G will cost you around $143 per month.
Is Plan G the best Medigap plan?
Since Plan F was discontinued for new enrollees as of 2020, Plan G offers the most coverage for people 65 and older. It has a lower premium than Plan F and duplicates its benefits, except for the Part B deductible.
Is it better to have Medicare Advantage or Medigap?
It depends on your specific needs, but for most people a Medigap plan is very useful in supplementing the coverage of Medicare Part A and Part B. A Medicare Advantage plan is an affordable way to get healthcare coverage not offered by Original Medicare.
What is the most popular Medicare supplement plan?
Historically, Plan F has been the most popular because it covers all the out-of-pocket costs Medicare does’t pay for. This includes the 15% extra charge billed by providers who do not take Medicare as full payment.
Does Medigap cover prescription drugs?
Since January 1, 2006, no Medigap policy came with prescription drug coverage. You have two options to get covered, enrolling in either a Medicare Prescription Drug Plan (Part D) or a Medicare Advantage plan.