Medigap Plan A: What It Covers and Who It Fits Best

What Medigap Plan A Covers

Medigap Plan A is the most basic standardized Medigap policy available. It helps pay for some of the health care costs that Original Medicare (Part A and Part B) does not cover. Plan A covers Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. It also covers the first three pints of blood you need in a calendar year, the Part A hospice coinsurance or copayment, and coinsurance or copayments for Part B health care services. Plan A does not cover the Part A deductible or the Part B deductible.

Because Plan A is the most stripped-down option, it generally has the lowest monthly premium among standardized Medigap plans. This makes it attractive to people who want basic protection without paying for extra benefits they may not use.

Who Should Consider Medigap Plan A

Plan A is often a good fit for people who want to keep their monthly premiums as low as possible and are comfortable with higher out-of-pocket costs when they use care. It may work well for someone who rarely visits the doctor or hospital, or for a person on a fixed income who needs help with the most significant Medicare cost-sharing gaps, like the Part A coinsurance for extended hospital stays.

Plan A is also a baseline choice if you are comparing Medigap plans side by side. It gives you a floor of coverage that all other standardized plans build on, so you can see exactly what you are paying extra for when you move to Plan B, Plan C, or Plan G.

What Medigap Plan A Does Not Cover

• The Medicare Part A deductible for each benefit period
• The Medicare Part B annual deductible
• Part B excess charges, if your doctor does not accept Medicare assignment
• Skilled nursing facility coinsurance
• Foreign travel emergency care (unless it qualifies under Part A)

Because Plan A leaves these gaps uncovered, people who want more complete protection often turn to Plan G, which covers everything Plan A does plus the Part B deductible and excess charges, or Plan N, which covers similar benefits with copays for certain office visits and emergency room trips.

How Medigap Plan A Compares to Other Plans

Plan G typically has a higher premium than Plan A, but many people find the extra coverage worth the cost because it shields them from most Medicare cost-sharing. Plan N offers a middle ground with lower premiums than Plan G but includes small copays.

When to Enroll in Medigap Plan A

The best time to buy any Medigap policy, including Plan A, is during your Medigap Open Enrollment Period. This six-month window starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this period, insurers cannot deny you coverage or charge you a higher premium based on health history. If you wait until after this window, you may face medical underwriting, which could mean higher premiums or a denial.

How Medigap Plan A Works with Medicare Advantage

If you are enrolled in a Medicare Advantage plan, you generally cannot use a Medigap policy, including Plan A, to cover your costs. Medigap plans are designed to supplement Original Medicare, not Medicare Advantage. If you switch from Medicare Advantage back to Original Medicare, you will have a separate Medigap Open Enrollment Period during which you can buy Plan A or another Medigap plan.

Finding Medigap Plan A Coverage

Plan A is available from most private insurance companies that sell Medigap policies. Premiums vary by insurer and location, even though the benefits are standardized. When shopping, compare premiums, look for companies with high financial strength ratings, and confirm the policy is guaranteed-issue or medically underwritten as needed. A licensed insurance broker can help you compare quotes from multiple carriers side by side.