Medicare Supplement plans are also known as Medigap insurance. These plans act as supplemental insurance to Medicare Part A and Part B, which you’re required to have to qualify for a Medicare Supplement plan.
Medigap Plan A does offer coverage for some of the out-of-pocket expenses that remain after Original Medicare has paid their portion. Of all the Medicare supplements, Plan A includes the least amount of benefits. However, it also has the lowest premiums and one of its benefits it does cover is the one that would otherwise cost the most out-of-pocket.
Core Policy Benefits in Medigap Plan A
Plan A includes the least amount of benefits of all the Medicare supplements. It offers coverage for what are called the core policy benefits. Core policy benefits are included in all Medicare supplements. Plan A doesn’t cover more benefits than it does cover.
In other words, this plan covers just the common things that are required by Original Medicare benefits.
Therefore, 100% of coverage includes:
- Part A coinsurance
- hospital stay costs up to 365 days after Medicare benefits reach their limit
- Part B coinsurance or copayment
- First three blood prints
- Part A coinsurance and copayment for hospice care
Coverage Not Included in Plan A
Plan A does not offer coverage for the Part A or B deductible, the coinsurance for skilled nursing care, the Part B excess charges, or any coverage for foreign travel emergencies.
Individuals Who Benefit from Plan A
Plan A is well-suited for individuals who need a low monthly premium and are not concerned about out-of-pocket hospital costs. This plan is not recommendable for people who travel regularly out of the U.S. or need to go to the hospital very often. This is because your out-of-pocket costs could be much higher even with the lower premiums.
Medigap Plan A Premiums
Individual premiums will vary based on which state the individual is seeking coverage in, which carrier they’re purchasing from, and also individual factors like gender, age, tobacco use, and a few other details. The average cost for Plan A ranges from $110-$180 each month. In general, Plan A premiums are higher in states who have a higher cost of living.
Plan A for Individuals Younger than 65
Not all Medicare supplements are available to individuals who are eligible for Medicare but are still under 65 years old. Sometimes, Plan A is the only option and the premium is often double or triple what it is for Medicare beneficiaries who are 65 and older. The reason for the higher premium is that Medicare beneficiaries who have become eligible due to a disability often have higher medical costs.
Individuals who are receiving Social Security disability benefits are the one individuals who are eligible for a second open enrollment period without having to pass medical underwriting. When they turn 65, the second open enrollment window begins and they will have the opportunity to choose a different Medicare supplement.
Medigap Plan A versus Medicare Part A
While this can be confusing, “plans” and “parts” mean different things in Medicare. “Parts” refer to benefits of Original Medicare and “plans” refer to Medicare supplements.
Medicare Part A includes hospital coverage – your “room and board” for hospital stays. Medigap Plan A is the supplemental coverage you can purchase to fill in the gaps in coverage of Medicare Parts A and B.Medicare Supplement plans are offered by private insurance companies and at their core, they’re meant to help with some of the out-of-pocket costs associated with Original Medicare, such as copayments, coinsurance, and deductibles.