by Russell Noga | Updated June 4th, 2024
Are you looking through Medigap plans and analyzing their coverage and premiums? It’s common for people to look at the most affordable options when assessing them.
Many people assume that Medigap plans all offer the same benefits in one way or another, but that’s not the case.
Medigap plans all come with varying levels of coverage, and you get what you pay for.
Despite this, many people choose the cheapest option because they assume they don’t need comprehensive coverage. After all, nothing bad happened to their health in the past, so why start worrying about it now.
The reality is supplemental Medigap plans are forward-looking. That means you need to make a plan based on what you expect to happen to your health in the future, not past events. Plan A is a good example of this.
What does Medicare supplement Plan A cover? It’s affordable, so does it offer sufficient coverage?
This article looks at Plan A benefits and premiums and why you should avoid it and consider other options.
What Does Medicare Supplement Plan A Cover?
Medigap policies offer you coverage for the gaps left in the Original Medicare reimbursements for your healthcare. Original Medicare only covers 80% of costs; you can pay the rest with coinsurance and copayments.
Medigap policies cover you for the balance of medical expenses, and these policies come in ten different options, from Plan A to Plan L.
Each Medigap plan has a different level of coverage, and Plan A offers you the bare minimum to assist in covering most of the shortfalls in Medicare Part A.
It’s not a comprehensive Medigap policy by any means, and you’ll have to make copayments and coinsurance on many of your medical expenses.
Here’s the coverage you receive with a basic Plan A Medigap policy.
- 100% of Medicare Part A coinsurance and hospital costs.
- 100% of Medicare Part B coinsurance and copays.
- The first three pints of blood in medical procedures.
- 100% of Part A hospice care.
What Medigap Plan A Doesn’t Cover
Plan A doesn’t cover several other costs involved in Original Medicare, including the following.
- Care at skilled nursing facilities.
- Your Part A deductible ($1,600 in 2023).
- Your Part B deductible ($226 in 2023).
Medigap Plan A also doesn’t cover the excess charges associated with care from medical providers, like your doctor, who doesn’t charge Medicare-approved rates. That means you’ll have a copayment covering the balance of what the provider charges.
Plan A also doesn’t cover medical expenses incurred in foreign travel outside the United States. Original Medicare might cover 20% of these costs, depending on the circumstances.
The Federal government standardizes the benefits in Plan A. That means the Plan A policy you get from any insurer offering the policy in the US is the same, with no exceptions.
While Plan A is affordable, the coverage it provides is limited, and there are many other better choices for enhanced benefits.
What are the Best Alternatives to Medigap Plan A?
Medigap Plan G
If you’re looking for a fully-comprehensive Medigap Plan, it’s best to go with Plan G.
Plan G covers all inpatient and outpatient medical treatment and care costs. The only thing it doesn’t cover is the Part B deductible of $226.
Plan F offers to cover the Part B deductible, but it’s no longer available for people eligible for Medicare after January 1, 2020.
You get the following benefits with Medigap Plan G.
- Part A Hospital Coinsurance.
- Days 61-90 of hospital stays in each Medicare benefit period.
- Days 91-150 of hospital stays.
- Additional Part A Hospital Benefits.
- Part B Coinsurance.
- Part A and B Blood Coverage.
- Part A Hospice Coinsurance.
- Part B excess charges.
Like all Medigap Plans, Plan G doesn’t cover the cost of preventative treatments and services, such as those involved with hearing, dental, and vision. It also doesn’t cover prescriptions.
It’s also the most expensive option for new enrollees to Medigap, but you get peace of mind and total predictability of your annual healthcare expenses.
Plan G is also available as a high-deductible option. This version of Plan G increases the annual Part A deductible to $2,700, but you have much lower monthly premiums and all the coverage you need in a healthcare emergency.
Medigap Plan N
If you’re a healthy senior and don’t see the doctor much, consider Plan N.
You get a decent level of coverage, but you’ll make copayments of up to $20 on doctor visits and up to a $50 copayment on trips to the emergency room where you’re not admitted into the hospital.
Medicare supplement Part N offers the following benefits.
- Medicare Part A deductible.
- Medicare Part A coinsurance and hospital stays up to 365 days.
- Medicare Part B coinsurance for outpatient care and procedures.
- Medicare Part B copays at doctors’ offices.
- The first 3 pints of blood in procedures.
- Skilled nursing facility and hospice coinsurance.
- 80% coverage of healthcare costs incurred while traveling outside the US.
What’s the Difference Between Medigap Plan N & G?
The main difference between Plan G & N is the copays and coinsurance requirements in Plan N. Both Plan N & G also allow you to see any doctor in the national Medicare network, but Plan G covers your excess charges for Part B, while Plan N doesn’t.
However, Plan N is more affordable and the better choice for healthy seniors. If you see the doctor often or have a pre-existing health condition when signing up for Medigap, go with Plan G for the best coverage.
Plan N & G are the best alternatives to Plan A, and we highly recommend them. Contact us for more information, and we’ll walk you through the specifics of all Medigap plans.
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Frequently Asked Questions
What is Medicare Supplement Plan A, and what does it cover?
Medicare Supplement Plan A is a standardized insurance plan designed to fill gaps in Original Medicare coverage. It covers certain out-of-pocket expenses such as coinsurance and copayments for Medicare Part A hospital and Part B medical services.
What medical costs related to hospital stays does Medicare Supplement Plan A cover?
Medicare Supplement Plan A covers the Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted.
Does Medicare Supplement Plan A cover skilled nursing facility care?
Yes, Plan A covers the Part A coinsurance for skilled nursing facility care, ensuring you have financial assistance for extended stays.
Does Medicare Supplement Plan A include coverage for Medicare Part B excess charges?
No, Plan A does not cover Medicare Part B excess charges. You may need to explore other plans, such as Plan F or Plan G, for that coverage.
What about coverage for hospice care under Medicare Supplement Plan A?
Plan A covers the Part A coinsurance for hospice care, offering support during end-of-life medical services.
Does Medicare Supplement Plan A provide coverage for outpatient services?
Yes, Plan A covers the Part B coinsurance or copayments for outpatient services, helping you manage costs for doctor visits and other medical services.
Are foreign travel emergency medical benefits included in Medicare Supplement Plan A?
Yes, Plan A provides coverage for foreign travel emergency care up to 80% of the billed charges, with a lifetime limit of $50,000.
What prescription drug coverage does Medicare Supplement Plan A offer?
Plan A does not include prescription drug coverage. You may want to enroll in a separate Medicare Part D plan to address your prescription medication needs.
Can I keep my preferred doctors and hospitals with Medicare Supplement Plan A?
Yes, Plan A allows you to choose any healthcare provider that accepts Medicare patients, giving you the freedom to continue seeing your preferred doctors and hospitals.
How can I determine if Medicare Supplement Plan A is the right choice for me?
To decide if Plan A is suitable, assess your healthcare needs, budget, and preferences. Consider consulting an insurance expert who can provide personalized guidance based on your circumstances.
Get Professional Advice on the Right Medigap Cover for You
If you need someone to advise you on the right Medigap plan to suit your healthcare needs, speak to us. We’re a team of fully licensed Medigap agents who know how to match you to the Medigap plan.
Reach out to us at 1-888-891-0229 for a free consultation.
Our website has a premium calculator offering you an automated quote for the plan you’re interested in taking. Alternatively, you can complete the contact form, and we’ll have a Medigap expert call you back to discuss your healthcare needs and how Medigap can help cover costs.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.