Understanding Medicare Supplement Plan A
Medicare Supplement Insurance Plan A, not to be confused with Medicare Part A, is the most basic of Medicare Supplement Insurance plans. Plan A can be the ideal plan for those who don’t wish to pay costly premiums for benefits they might never use. However, Medicare Plan A coverage has the potential for higher out-of-pocket costs if the need for the uncovered categories occurs. Also referred to as Medigap, Medicare Supplement Insurance plans are standardized plans that are available in most states (Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans).
What does Medicare Supplement Plan A cover?
Medicare Supplement Plan A attempts to fill the gap in basic costs not covered by Original Medicare Parts A and B, such as copayments and coinsurance, without going overboard with extras you may not need.
Covered
Hospital Expenses: Supplement Insurance Plan A pays Original Medicare Part A coinsurance and provides coverage for 365 additional days once your Medicare benefits end.
Hospital Expenses
Supplement Insurance Plan A pays Original Medicare Part A coinsurance and provides coverage for 365 additional days once your Medicare benefits end.
Medical Expenses: This plan pays Original Medicare Part B copayments and coinsurance (generally 20% of Medicare-approved expenses).
Medical Expenses
This plan pays Original Medicare Part B copayments and coinsurance (generally 20% of Medicare-approved expenses).
Transfusions: Pays for the first three pints of blood you receive in a medical procedure.
Transfusions
Pays for the first three pints of blood you receive in a medical procedure.
Hospice Care: If this type of care is needed, Medicare Supplement Insurance Plan A will cover your Original Medicare Part A coinsurance or copayment.
Hospice Care
If this type of care is needed, Medicare Supplement Insurance Plan A will cover your Original Medicare Part A coinsurance or copayment.
Not covered
Skilled Nursing Facility Coinsurance: Skilled Nursing Facility coinsurance is an amount you may be required to pay as your share of the cost for services after you pay any deductibles.
Skilled Nursing Facility Coinsurance
Skilled Nursing Facility coinsurance is an amount you may be required to pay as your share of the cost for services after you pay any deductibles.
Part A Deductible: The Medicare Part A deductible is $1,600 in 2023 for each benefit period.
Part A Deductible
The Medicare Part A deductible is $1,600 in 2023 for each benefit period.
Part B Deductible: The Medicare Part B deductible for 2023 is $226. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Part B Deductible
The Medicare Part B deductible for 2023 is $226. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Part B Excess Charges: Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Part B Excess Charges
Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Foreign Travel Medical Emergencies: In most cases, Medicare won’t pay for health care or supplies you get outside of the U.S.
Foreign Travel Medical Emergencies
In most cases, Medicare won’t pay for health care or supplies you get outside of the U.S.
Prescription Drugs: Medigap Plan A does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Prescription Drugs
Medigap Plan A does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Who can benefit from this type of supplement plan?
Medicare Supplement Plan A can be a good fit for those who don’t want to pay costly premiums for benefits they may never use. Medicare Supplement Plan A can help ease the burden of out-of-pocket costs that aren’t covered with Original Medicare.
Meet Joan, a Medicare Supplement Plan A User
Joan is a healthy 68-year old who exercises regularly, eats well and takes only one prescription medicine. She gets regular medical checkups and screenings and has never been hospitalized for a serious condition.
Though Joan doesn’t anticipate any increased needs for healthcare in the coming year, she didn’t want to pay for extras she felt she wouldn’t need.
Additionally, due to her age, Joan wanted a little more peace-of-mind added to her Original Medicare coverage “just in case.”
She wanted a way to ensure she could handle the extra expenses should she need unexpected medical care.
For these reasons, Joan chose Medicare Supplement Plan A.
Advantages to Medicare Plan A
- Fills the gap for basic costs not covered by Original Medicare Parts A & B, such as copayments and coinsurance.
- Doesn’t go overboard with extra benefits you may not need.
Drawbacks to Medicare Plan A
- Has the potential for higher out-of-pocket costs if the need for the uncovered categories occurs.
- Has the fewest individual benefits of the eight standardized Medicare Supplement insurance plans.
How much does Medicare Supplement Plan A cost?
Monthly premiums are set by the private insurance companies who offer Medicare Supplement Insurance plans and are based on age, health status, gender and various other factors. Depending on these factors including location, insurance companies may charge different premiums for the same Medicare Supplement Plan A.
That’s why it is in your best interest to shop around to ensure you are paying the lowest amount possible for your Medigap Plan A coverage. Companies will not cancel your coverage unless you don’t pay the plan premium, you weren’t truthful on the application, or the Medigap insurance company becomes bankrupt or insolvent.
How Pricing Works For This Plan
Pricing for Medicare Supplement Plan A varies widely by company. Medigap policies can be priced in 3 ways: community-rated, issue-age-rated, and attained-age-rated.
- Community-rated: Generally, the same monthly premium is charged to everyone who has the Medigap plan, regardless of age. Premiums may go up because of inflation and other factors, but not because of your age.
- Issue-age-rated: The premium is based on the age you were when you bought the Medigap plan. Premiums are lowered for people who buy at a younger age and won’t change when you get older. Premiums may go up because of inflation and other factors, but not because of your age.
- Attained-age-rated: The premium is based on your current age, increasing your premium as you get older. Premiums are lower when you are younger, but continually increase as you age. Premiums may also increase because of inflation or other factors.2
When to Enroll in Medicare Supplement Plans
When you’re first eligible: The best time to enroll in a Medicare Supplement plan is when you’re first eligible, which is on the first day of the month in which you turn 65. This day marks the beginning of your Medigap Open Enrollment Period, which lasts for six months. To enroll in a Medigap plan at this time, you must already be enrolled in Original Medicare (Medicare Part A and B).
Outside open enrollment: While it’s often better to get coverage when you’re first eligible, you can still apply for Medigap coverage after your initial enrollment period. However, if you apply for coverage after your initial enrollment period, there’s no guarantee that an insurance company will sell you a policy if you don’t meet the medical underwriting requirements.
FAQs About Medicare Supplement Plan A
Below are answers to common questions about Medicare Supplement Plan A.
Is Medicare Supplement Plan A the same as Medicare Part A?
Medicare Supplement Plan A is not the same as Medicare Part A. Medicare Part A is the hospital insurance portion of Original Medicare. Medicare Supplement Plan A is a supplemental plan that helps fill the gap for basic costs not covered by original Medicare Parts A and B.
How can I lower the costs of my Medigap Plan A?
It’s possible to reduce your Medigap costs for the same exact coverage. Although Medigap plans are standardized, costs vary widely between companies. Shopping around is the best way to find the right Medigap plan at the right price.
Do Medigap plans vary by state?
Medigap plans are standardized, meaning they offer the same benefits, across most of the states, except for Wisconsin Medicare Supplement Plans, Minnesota Medicare Supplement Plans, and Massachusetts Supplement Plans.
Do Medicare Supplement plans cover pre-existing conditions?
While insurance companies can’t typically make you wait for your coverage to start, they may make you wait for coverage if you also have a pre-existing condition. Coverage for pre-existing conditions can be excluded if the condition was treated or diagnosed within six months before the coverage starts under the Medicare Supplement plan.
After the six-month period, the Medicare Supplement plan will cover the condition that was excluded. However, it is possible to avoid or shorten the waiting period for a pre-existing condition if you buy a Medicare Supplement plan during your Medigap open enrollment period to replace “creditable coverage” Medigap plan.3
Compare Medicare Supplement Plans
In most states, there are eight Medicare Supplement plans to choose from and all policies have been standardized. At SelectQuote, we can help you navigate your Medigap plan options, answering any questions you have to help you find the right plan for your needs and budget. Learn more about other Medicare Supplement plan options below.
Find the Right Medicare Supplement Plan For You With SelectQuote
It can be hard to determine what Medicare plan is best for you, your healthcare needs and your budget. At SelectQuote, we’ll take the time to learn about your specific needs, shopping and comparing all of the Medicare plans available to you to find the right Medicare plan for your situation.
