Medigap Plan A
Medigap Plan A is one of ten standardized Medigap plans available to Medicare beneficiaries. This plan provides basic coverage for a range of healthcare costs, including deductibles, coinsurance, and copayments.
What is Medigap Plan A?
Medigap Plan A is a supplemental insurance plan that provides coverage for certain healthcare costs that are not covered by Original Medicare (Part A and Part B). This plan is designed to help beneficiaries manage their out-of-pocket healthcare expenses, including deductibles, coinsurance, and copayments.
What does Medigap Plan A cover?
Medigap Plan A covers the following healthcare costs:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Medicare Part B coinsurance or copayment
- The first three pints of blood for a medical procedure
In addition to these basic benefits, some Medigap Plan A policies may also offer coverage for emergency medical care received during foreign travel.
What is not covered by Medigap Plan A?
While Medigap Plan A provides basic coverage for certain healthcare costs, there are a number of services that are not covered by this plan. These include:
- Prescription drugs
- Vision or dental care
- Hearing aids
- Long-term care
- Private-duty nursing
- Care received outside the United States
It’s important to note that while Medigap Plan A does not provide coverage for these services, some of them may be covered by other types of insurance, such as Medicare Part D (prescription drug coverage) or Medicare Advantage plans.
How does Medigap Plan A work?
To enroll in Medigap Plan A, beneficiaries must first be enrolled in Original Medicare (Part A and Part B). Once enrolled, beneficiaries can purchase a Medigap Plan A policy from a private insurance company that is licensed to sell Medigap plans in their state.
When a beneficiary receives healthcare services, Medicare will first pay its share of the costs, and then Medigap Plan A will pay its share, up to the plan’s limits. For example, if a beneficiary has a hospital stay and incurs $10,000 in hospital costs, Medicare will pay its share (which will depend on the specific details of the hospital stay and the beneficiary’s coverage), and then Medigap Plan A will pay its share (which in this case would be the Part A coinsurance amount, up to a certain limit).
It’s important to note that Medigap Plan A premiums may vary depending on the insurance company and the location of the beneficiary. Some insurance companies may also offer discounts or other benefits, such as wellness programs or additional coverage options.
Who should consider Medigap Plan A?
Medigap Plan A may be a good option for beneficiaries who want basic coverage for their healthcare costs, but who may not need the more extensive coverage provided by other Medigap plans. This plan may also be a good option for beneficiaries who do not have significant health care expenses or who have other sources of healthcare coverage, such as employer-sponsored health insurance.
It’s important to note that beneficiaries cannot enroll in a Medigap plan if they are enrolled in a Medicare Advantage plan. If a beneficiary wishes to switch from a Medicare Advantage plan to Original Medicare and a Medigap plan, they will need to follow certain rules and timelines to avoid any penalties or gaps in coverage.