In 2018, there were over 11 million Medicare beneficiaries enrolled in Original Medicare, of that over 20% were provided with supplemental coverage from one of the ten Medicare Supplement Plans. Plan A offers benefits to Medicare beneficiaries who decide to purchase the optional plan. The most puzzling parts of supplement plans are knowing when to purchase them, figuring out which ones meet beneficiaries needs and the differences between all plans.

What is Medicare Part A? – (Don’t confuse it with Medicare Plan A)

Many people commonly refer to Medicare Part A as hospital insurance because it is the part of the Original Medicare plan that covers their inpatient stay in a hospital. Medicare Part A also covers skilled nursing facility care, home health care and hospice care. Some basic information to know about Part A include:

  • There are usually no costs associated with Medicare Part A. Medicare explains that under premium-free Medicare Part A, you or your spouse usually do not have to pay a monthly premium for Medicare Part A, so long as you paid Medicare taxes for a certain amount of time during your working years.
  • You receive premium-free Part A benefits if you are 65 years of age or older, if you already receive retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible for Medicare Part A premium-free benefits if you or your spouse had Medicare-covered government employment.
  • Some people under the age of 65 qualify for premium-free Medicare Part A. You qualify if you are under 65 and you have end stage renal disease and meet certain other requirements, or if you already receive Social Security benefits or Railroad Retirement Board benefits for at least 24 months.

What Does Medicare Supplement Plan A Include?

Medicare Supplement Plan A also known as Medigap Plan A bridges the gap between what Medicare covers and some costs that are the responsibility of the Medicare recipient. Medigap Plan A covers the least amount of benefits covered by the ten Medigap or Medicare Supplement Plans.

Medigap Plan A covers:

  • Medicare Part A coinsurance
  • Medicare Part A hospital costs of up to an additional 365 days after Original Medicare benefits are used up
  • Medicare Part B coinsurance or copayment
  • First three pints of blood
  • Part A hospice care coinsurance or copayment

What are the Costs and Benefits of Medigap Plan A?

Private insurance companies sell Medigap plans, including Medigap Plan A. The plans are standardized with the exception of the states of Wisconsin, Minnesota, and Massachusetts. For beneficiaries looking for a Medicare Supplement plan may consider the following:

  • A person in Ohio who purchases Medicare Supplement Plan A from an insurance company has the same benefits as a person who purchases Medicare Supplement Plan A from an insurance company in California. Insurance companies do not have to offer their Medicare Supplement plans at the same cost as other insurance companies.
  • Medicare explains that each insurance company decides how it sets their own premiums for people who purchase Medicare Supplement Plans from that company. Medicare cautions that “There can be big differences in the premiums that different insurance companies charge for exactly the same coverage.”

The way that the policies are priced or “rated” include community-rated, issue-age-related, and attained-age-rated. Insurance companies charge the same monthly premium to everyone who has the community-rated plans, regardless of the age of the person who purchases the Medigap policy. The cost of premiums for the issue-age-related plans are based on your age at the time that you purchase or are issued the policy. Premiums are lower for younger people who purchase their Medigap policy, including a Plan A policy. The cost of premiums does not increase with age. The premiums for the attained-age-rated plans are based on your current age and increase as you get older

What Does Medicare Supplement Plan A Not Cover?

Medicare Supplement Plan A does not cover all costs that are not covered by Original Medicare Part A or Medicare Part B. Examples of some out-of-pocket costs that are not covered by Medicare Supplement Plan A include:

  • Skilled nursing care
  • Long-term care costs
  • Private-duty nursing care costs
  • Dental
  • Vision, or glasses.

Medicare Supplement Plan A also does not cover the Medicare Part A deductible, the Medicare Part B deductible, or Part B excess charges. Medicare Supplement Plan A does not cover any emergency care charges incurred if you need emergency care while traveling outside the U.S.

What Else Do I Need to Know about Medigap Plan A?

Each Supplement Plan operates slightly different from one another. However, it is important to recognize all the details before indulging in a plan. Some details include:

  • If you are enrolled in any Medicare Advantage Plan (Medicare Part C) you may not be allowed to purchase any Medicare Supplement Plan.
  • Medicare Supplement Plans cover only one person, not you and your spouse. Your plan is guaranteed renewable, even if you have health issues.
  • Make sure that you ask questions before purchasing a Medicare Supplement plan, including Medicare Supplement Plan A.

Sources: 

  1. What Part A Covers, Medicare.
  2. Costs of Medigap Policies, Medicare.
  3. Coverage Among Medicare Beneficiaries in 2018, Kaiser Family Foundation.