Best Medicare Supplement Plan A Rates & Benefits
Medicare Supplement Plan A (also called Medigap Plan A or Medicare Plan A) is one of 10 Medicare Supplement plans designed to help Medicare beneficiaries cover out-of-pocket health care costs. The 10 Medicare Supplement insurance plans are standardized, which means that Medicare Supplement Plan A has identical benefits regardless of which insurance company offers the Medigap policy. (Standards are different in Massachusetts, Minnesota, and Wisconsin.)
Since the basic benefits are standardized, finding the best Medicare Supplement Plan A involves a close comparison of Medigap Plan A rates. But first, here’s some background to help you understand how Medicare Supplement plans work in conjunction with Medicare.
The Centers for Medicare and Medicaid Services (CMS) coordinates your Medicare benefits through the Federal Medicare Program. There are four parts to the program:
- Medicare Part A (hospital insurance)
- Medicare Part B (medical insurance)
- Medicare Part C (Medicare Advantage Plans, private options that replace Medicare Part A and Part B)
- Medicare Part D (prescription drugs)
Original Medicare (Medicare Part A and Part B) pays 80% of approved health care costs. You’re responsible for paying the remaining 20%. Your 20% typically consists of three types of medical expenses:
- Calender Year Deductibles
Each of the 10 Medigap plans offers a different level of benefits, so it’s important to compare plans before deciding whether Medicare Supplement insurance Plan A is best for you. The following information will help you determine whether Medicare Supplement Plan A best fills that gap in coverage.
Medicare Supplement Plan A Costs, Coverage and Benefits
Medicare Supplement Plan A offers the fewest benefits of the 10 standardized Medicare Supplement plans. It typically offers the lowest premiums. Before deciding whether it’s the best plan for you, you need to evaluate your need for coverage in comparison to premiums.
What is covered by Medicare Supplement Plan A?
Whereas the other nine supplement plans offer varying levels of coverage in addition to basic benefits, Medigap Plan A only offers the four basic benefits:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Original Medicare benefits are used
- Part A hospice care copayment and coinsurance
- Medicare Part B coinsurance and copay
- First 3 pints of blood
What is not covered by Medicare Supplement Plan A?
Because Plan A only offers basic benefits, you will have to pay out-of-pocket costs for services that Medigap Plan A doesn’t cover:
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Skilled nursing facility
- Foreign travel
Medicare Supplement Plan A also doesn’t cover medical services that Original Medicare doesn’t approve, such as cosmetic procedures and vision, dental, and hearing.
How Does Medicare Plan A fill in the gaps of Original Medicare?
Your Medicare benefits don’t cover all of the medical expenses you incur for medical services. Beneficiaries buy Medicare supplement insurance to fill in the coverage gaps for coinsurance, deductibles, and copays. Medicare Supplement Plan A pays for the following coverage gaps:
- Part B coinsurance and copays
- Part A hospice care coinsurance and copays
- Part A coinsurance for 365 additional hospital days
Medicare Supplement Plan A doesn’t cover the following gaps:
- Part A and Part B deductibles
- Skilled nursing care
- Travel outside of the country
How does Medicare Plan A cover Medicare Part A Deductible?
Medicare beneficiaries pay an annual deductible. Plan A does not cover your Part A deductible, so this will be an out-of-pocket expense for you.
How does Medicare Plan A cover Medicare Part A coinsurance?
Original Medicare reimburses 80% of its approved rate for inpatient medical services. You are responsible for the leftover 20%. Medicare Supplement insurance Plan A pays this coinsurance after you meet your yearly Part A deductible.
How does Medicare Plan A cover Medicare Part B deductible?
In 2019, the Part B deductible is $185. Plan A does not cover your Part B deductible.
How does Medicare Plan A cover Medicare Part B coinsurance?
Part B coinsurance is the amount that you pay for outpatient medical services. Plan A pays your Part B coinsurance for the following services:
- Doctor’s office visits
- Durable medical equipment
- Speech therapy
- Medical supplies
- Diagnostic testing
How does Medicare Plan A cover at the doctor office?
Medicare Part B pays 80% of doctor’s office visits. Once you pay your annual Part B deductible, Plan A pays the remaining 20% coinsurance.
How does Medicare Plan A cover at the hospital?
Original Medicare pays 80% of hospital costs, leaving a 20% coinsurance. Here’s the breakdown:
- You pay the deductible each year.
- Days 1-60: You pay no coinsurance.
- Days 61-90: You pay $341 each day in coinsurance.
- Day 91 and beyond: You pay $682 each day (lifetime reserve day) for each benefit period up to a limit of 60 lifetime reserve days.
- Lifetime reserve days: After you reach your maximum of 60, you pay all costs.
Plan A pays your coinsurance amounts.
How does Medicare Plan A cover a skilled nursing facility?
Original Medicare pays 100% of skilled nursing care for the first 20 days. Medigap Plan A doesn’t cover skilled nursing care. You are responsible for the following expenses:
- Days 21-100: $170.50 coinsurance each day
- Day 101 and beyond: all costs
How does Medicare Plan A cover Blood transfusion?
Plan A pays all costs for the first three pints of blood needed for blood transfusion in each benefit year. After you meet your Part B deductible, Original Medicare pays 80% for any blood needed after the first three pints. Medigap Plan A pays 20% coinsurance.
How does Medicare Plan A cover part b excess charges?
Original Medicare is widely accepted throughout the country, but not all health care providers participate. Non-participating providers can charge up to 15% more than Medicare’s approved amount for a service. This extra fee is called excess charges.
Plan A does not cover excess charges. If you obtain care from a non-participating provider, you will be responsible for paying excess charges.
How does Medicare Plan A cover foreign travel emergancy?
Medicare Supplement Plan A does not cover health care you receive while outside of the country. If you travel extensively, you might want to compare plan options that offer foreign travel coverage: Plans C, D, F, and G.
How does Medicare Plan A cover physical therapy?
Original Medicare covers 80% of physical therapy services. Plan A will pay physical therapy coinsurance after you meet your deductible.
How does Medicare Plan A cover hospice care?
Inpatient hospice care is one of the four basic benefits that Medigap Plan A covers. It does not cover outpatient prescriptions or respite care.
How does Medicare Plan A cover Emergency Room visits?
Part B pays 80% for emergency care visits, leaving a 20% coinsurance. Plan A pays this coinsurance amount.
Are there network restrictions with Medicare Plan A?
There are no network restrictions with Plan A. If you receive care from a non-participating provider, you are responsible for paying excess charges.
Will I have to pay my Medicare Part B Premium as well?
Medicare Supplement health insurance picks up where Original Medicare leaves off. To remain eligible for Plan A, you have to continue paying your Medicare Part B premium.
Medicare Supplement Plan A Rates
The federal government sets premiums for Medicare Part A and Part B. With Medicare Supplement insurance, each insurance company offering Medigap plans sets its rates.
Finding the best Medicare Supplement Plan A can be tricky because it frequently comes down to Medigap Plan A rates. Insurance carriers use one of three methods to calculate Medicare Plan A rates:
- Community-rated: Your age doesn’t affect your monthly premium.
- Issue age: Your age when you buy the Medigap policy determines the premium.
- Attained age: Your current age determines the monthly premium.
It’s essential that you compare which pricing method an insurer uses to compute Medicare Supplement Plan A rates because it affects your future premiums. Using the attained-age method, monthly premiums will rise each year because you’re growing older. Under the attained-age calculation, you might have a lower premium initially, but in five years it could be higher in comparison to premiums calculated under the other two methods.
Even if health insurance providers use the same pricing method, Medicare Supplement Plan A rates can differ widely. That’s because the insurance company considers other factors when setting its Medicare Plan A rates:
- Tobacco use
- High deductible plan options
- Household discounts
- Zip code and state
- Medical underwriting
We encourage Medicare beneficiaries who are shopping for Medicare Supplement plans to give one of our insurance agents a call. We’ll help you compare plans to see if Plan A is the best option and also compare which carrier has the best Medicare Supplement Plan A rates. Our agents can also compare how much each carrier’s Medicare Supplement Plan A rates have increased over the past few years.
Our Best Rated Companies Offering Medicare Supplement Plan A
At My Medigap Plans, we have established relationships with virtually every insurance company offering Medicare Supplement Plan A. From both an insurance agency standpoint and client perspective, we prefer working with the following three providers of Medicare Supplement insurance:
- Mutual of Omaha
There are many reasons that our insurance agents prefer working with these health insurance providers. Here are several of the primary ones:
- Strong ratings and financial strength
- Longevity in the healthcare field
- Outstanding customer service
- Competitive rates
- Long-term stability
Medicare Supplement Plan A vs Medicare Plan F
Medicare Plan F is the most popular Medigap policy among seniors. It is sometimes called the “Cadillac” of Medicare Supplement plans because it offers the most coverage, whereas Plan A offers the least amount of coverage. Here’s how they compare.
Benefits under Plan A include coinsurance and copayments for Part A, Part B, and hospice care plus the first three pints of blood if you need a transfusion. Plan F features these benefits plus it covers the following medical expenses:
- Part A and Part B deductibles
- Part B excess charges
- Foreign travel (80% up to plan limits)
- Skilled nursing facility care
Medicare Supplement Plan F offers two options: regular Plan F and a high deductible option. Medicare Supplement Plan A rates are lower than regular Plan F rates but higher than the high deductible option.
Access to Care
There are no network restrictions. However, if a non-participating provider delivers your care, you might be subject to excess charges. Plan F covers excess charges; Plan A does not.
Medicare Supplement Plan A vs Medicare Plan G
Medicare Supplement Plan A offers fewer benefits than Plan G but also features lower monthly premiums. Here’s a comparison of the two plans.
Benefits under Plan A include coinsurance and copayments for Part A, Part B, and hospice care as well as covering the first three pints of blood if you need a transfusion. Plan G features these benefits plus covering the following medical expenses:
- Part A deductible
- Part B excess charges
- Foreign travel (80% up to plan limits)
- Skilled nursing facility care
Medicare Supplement Plan A rates are lower than Plan G rates. Depending on your demographic factors, monthly Plan A rates can range between $10 and $125 lower than Plan G rates.
Access to Care
There are no network or referral restrictions, but if a non-participating provider delivers your care, you might be subject to excess charges. Plan G covers excess charges; Plan A does not.
Does Medigap Plan A cover Prescription Drug Coverage?
Original Medicare does not cover outpatient prescription medicine, so Medicare Supplement Plan A won’t cover it, either. To get coverage for medication, Medicare beneficiaries need to buy a stand-alone Medicare Part D Drug Plan from an independent insurance company approved by Medicare.
Keep in mind that prescription drug plans differ in what medicine they cover, so it’s best to compare plan options before choosing a policy. Also be aware that if you decide to go without Part D coverage while being Medicare eligible, you can be penalized when you do finally enroll in a prescription drug plan.
When can you enroll in Medicare Supplement Plan A?
The best time to enroll in Medicare Supplement Plan A is during your six-month open enrollment period. This OEP starts when you are both 65 and enrolled in Medicare Part B.
Your OEP is the best time because you’re guaranteed coverage. You don’t have to answer health questions or undergo a physical examination. Pre-existing conditions are automatically covered.
You can apply for coverage outside of your OEP, but the insurance company can require medical underwriting and coverage is not guaranteed. For help choosing the best Medicare Supplement insurance plan, the Medicare Supplement specialists at our insurance agency can help you compare plans, rates, and insurance companies.
Medicare Supplement Plan A Review?
Here’s a quick review of Medicare Supplement Insurance Plan A:
- Plan A offers the minimum coverage level and lowest monthly premiums.
- Plan A might be best for beneficiaries who don’t want to pay high premiums for benefits they won’t use.
- There’s the potential for higher out-of-pocket medical expenses if you need unexpected health care services.
Will Medicare Supplement Plan A become Guaranteed Issued in 2020?
If you are eligible for Medicare after Jan. 1, 2020, you won’t be able to buy Medicare Supplement Plans C, F, and high deductible F. If you enroll in these plans before that date, you can keep your policy. However, because no new enrollees are joining these plans, monthly premiums might rise.
After Jan. 1, 2020, Plan G becomes the plan offering the broadest benefits. In many cases, rates for Plan G are not significantly higher than Medigap Plan A rates. Beneficiaries interested in Plan A should carefully weigh the trade-off between slightly higher premiums and more comprehensive benefits.
Keep in mind that Medicare Supplement Plan A is not the same as a Medicare Advantage Plan. Here’s how Medicare Advantage Plans differ from Medicare Supplement plans:
- Medicare Advantage plans replace your Original Medicare benefits.
- They typically have physician network rules related to being a PPO or HMO.
- They frequently offer additional benefits such as vision, hearing, and dental.
- They often include a prescription drug plan.
If you’re perplexed as to what type of Medicare Supplement insurance fits your needs, don’t hesitate to give us a call. Our insurance agents will help you compare Plan A in addition to, Plan N, Plan B, and Plan K to help guide you through the learning process and help you find the best Medicare Supplement Plan A.