Medicare Plan A
Medigap Made Easy
Please do not confuse Medicare plan A with the Part A of Medicare.
Some people have gotten confused about whether Plan A is the same thing as Part A. They are not the same. Medicare Supplement Plan A is one of the Supplement plans that help to fill in the gaps in Medicare. (Medicare Part A, on the other hand, is your original Medicare hospital coverage.)
Often overlooked, Medicare Supplement Plan A is also referred to as Medigap Plan A, has fewer benefits than other Medigap insurance plans.
Medigap Plan A is for the Disabled Under age 65
Medicare supplement Plan A is also the insurance policy that is made available to people under age 65 in most states. If you happen to qualify for Medicare early due to a disability, this policy is available for purchase during your Open Enrollment Period without underwriting.
However, the cost of this plan for people under age 65, can be as much as three times what a 65-year old will pay. This is because people who qualify for Medicare due to a disability oftentimes have higher medical costs than an average 65 or older person. The expenses are higher and those costs get passed on to you in the form of rate increases.
For this reason, people with Medicare disability may want to look into Medicare Advantage plans. Why? Because on Medicare Advantage plans the rate is the same for anyone enrolled, regardless of age, gender, etc. Down the road when you turn 65, you can use your turning 65 Open Enrollment Period to change to a Supplement if you would like.
For people over age 65, Medigap Plan A will be priced just as any other Supplement, but not many people over age 65 do choose it. Generally, they choose more comprehensive plans like Plan F and Plan G that provide fuller coverage.
What is covered under Medicare Supplement insurance Plan A?
Plan A is the most basic of the 10 Medicare Supplement insurance plans, covering the fewest benefits.
Medicare Supplement insurance Plan A covers 100% of four 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 10 standardized Medicare Supplement insurance plans cover hospital care coinsurance at 100%. All 10 plans cover the other three categories as well (Medicare Part B copayments, 3 pints of blood, and hospice care coinsurance), although Plan L covers these benefits at 75% and Plan K covers them at 50%. The nine plans other than Part A cover at least one benefit that Plan A does not cover; some plans cover up to five additional benefits.
What are the costs associated with Medicare Supplement insurance Plan A coverage?
Medicare Supplement insurance Plan A policyholders are responsible for paying their Medicare Part A and Part B deductibles. They must also pay for skilled nursing facility care coinsurance, Part B excess charges, and foreign travel emergency costs. These five categories may be covered by other Medicare Supplement insurance plans. Plan A might be the ideal plan for those who don’t wish to pay costly premiums for benefits they might never use. However, Plan A coverage has the potential for higher out-of-pocket costs if the need for the uncovered categories arises.
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Ashford Insurance is an independent health insurance agency specializing in Texas Medicare insurance and has been helping seniors since 2005. Ashford Insurance is here to help you understand Medicare and health insurance in simple, plain terms that anyone can grasp. We specialize in assisting folks who are Medicare eligible to learn about the coverage options available through the Medicare Health Insurance Program.
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