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Medigap Plan A

Medigap Plan A explained! Discover how benefits, coverage & pricing work in our helpful, 2019 Medigap Plan A Guide.

Author: @bselfors

medigap plan a

Maybe you’ve heard some information about Medigap Plan A from friends & family but what exactly are Plan A anyway & how does it fit within Medicare Insurance benefits? We consolidated & simplified all the important details for you by answering common questions to help save you time, money & energy!

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2019 Medigap Plan A Benefits
Benefits Amount
✔ Part A Co-Insurance (ie:Co-Ins.) 100%
✔ Part B Co-Ins. 100%
✔ Blood (First 3 Pints) 100%
✔ Hospice Care Co-Ins. 100%
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What is Medigap Plan A?

Plan A is considered the foundation or “core” of all Medicare Supplemental Insurance Plans. In fact, Insurance companies who offer any Medigap Plan must offer Plan A. Plan A should not be confused with Part A which is part of Original Medicare (ie: Government Senior Health Insurance). Plan A is considered a private insurance policy. From the image above, we can get a basic idea of what Medigap Plan A covers but we review the plan in more detail below.

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What does Medigap Plan A cover?

Plan A (hospital insurance) covers the following items;

  • 100% Medicare Part A Coinsurance.
  • 100% Medicare Part B Coinsurance.
  • 100% First Three (3) Pints of Blood.
  • 100% Part A Hospice Coinsurance.

The National Association of Insurance Commissioners (NAIC), standardized all Medigap Plans which must adhere to the following guidelines;

  • Must cover costs for both Original Medicare Part A & Part B.
  • Must reflect statutory changes in Medicare.
  • Cannot deny preexisting conditions after a policy has been active for 6-months.
  • Must include a 30-day look back period.

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What does Medigap Plan A not cover?

Medigap Plan A does not cover the following benefits which are included in some other Medigap Plans;

  • Skilled Nursing Facility Care Coinsurance.
  • Part A Deductible.
  • Part B Deductible.
  • Part B Excess Charges.
  • Plan A does not cover foreign travel emergency.
  • Foreign Travel Emergency Insurance.

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How do I compare Medigap Plan A?

Comparing Medigap Plan A policies can be confusing and time consuming when vetting multiple carriers. It takes more than reading a 2019 Medigap PDF Guide to get the Medicare FAQs! Simplify the process by speaking with a Bridge Agent who can answer your questions & run all your Medigap comparisons for you at no cost!

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Is Medigap Plan A worth buying?

Plan A is normally not the most popular plan among seniors since it offers the least amount of benefits among all other Medigap plans. We recommend speaking with a Bridge Agent to review your options and get a comparison quote to fit your needs.

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How much does Medigap Plan A cost in 2019?

As with all Medigap Plans, since they are federally standardized the only differentiating factor is based on the price you pay. Since Medigap plans vary in price, availability and carrier, we suggest you contact a Bridge Agent to get a free, no-obligation quote!

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How do I enroll in Medigap Plan A?

Enrolling in Plan A is simple. Once you have enrolled in Original Medicare, you can contact a Bridge Agent to help assist you in shopping a plan to fit your needs. We walk you through the entire application process and keep you informed in the future.

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What is the difference between Part A and Plan A?

Most people can get confused between the two since they have very similar names but Parts and Plans are not the same! Medicare Part A & Part B comprise what is called, “Original Medicare” which covers hospital and medical insurance. Unlike Part A, (Plan A) works “with” Original Medicare as a “supplemental insurance” which covers the services depicted above. To better help explain this conundrum, refer to the page, “Medicare Options Redefined” to help clarify the subject.

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How does Medigap Plan A compare with Part C Medicare Advantage (MA)?

Plan A may offer more comprehensive coverage when paired with Original Medicare & a Part D drug plan. In comparison, Plan A is a supplemental health insurance plan unlike Medicare Advantage (Part C) which is an “all encompassing health plan”. For example, Part C may contain a drug plan within it called MA-PD vs. PDPwhich is a stand alone drug plan. Comparing Medigap vs Medicare Advantage Plans can be difficult going at it alone. Afterall, they are similar in that both are considered private health plans but you cannot be enrolled in both Original Medicare and a Medicare Advantage at the same time. Read about comparing Original Medicare vs Medicare Advantage.

But wait…although, Medicare Advantage Plans are appealing based on price, they can also come with a few Medicare Pitfalls that may have you reconsider the real “advantage”. For example;

  1. Prices have been historically unstable.
  2. Your coverage will change annually.
  3. You could be locked-in without the future option for a Medigap Plan
  4. You’re responsible for out-of-network, Physician costs.
  5. No coverage beyond your service area.
  6. Must use in-network providers.
  7. No travel coverage.
  8. May need a referral to see a specialist.

Additionally, If you have a MA plan & diagnosed with a critical illness such as cancer, heart attack or stroke, costs for treatment if the hospital is out-of-network may not be covered in your plan. The max out-of-pocket only applies to covered services and could require a specialist referral. People with MA plans, think they have more coverage than they actually do unlike Medigap plans, which is considered more comprehensive senior health coverage plan.

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How does Medigap Plan A work with Medicare Part D prescription drug coverage?

Since Plan A is compatible with Original Medicare, enrollees who choose this plan will also need to enroll separately in a Part D drug plan. Enrollees have a guaranteed eligibility for a Part D plan when they enroll in Plan D (on-time). It’s best to avoid the Part D Enrollment Penalty by enrolling during your initial enrollment period (also known as, IEP). Did you know that drugs administered in a Hospital setting are generally covered under your Medicare Part A? For more information on enrollments, visit the Medicare Enrollment Periods page.

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How does Dental, Vision & Hearing Insurance (DVH) work with Medigap Plan A?

Good news! Plan A is compatible with DVH plans however since they are considered standalone plans, DVH’s would need to be purchased separately. By working with a Bridge Agent, we can help you find an affordable DVH insurance plan to fit your needs.

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How does Medigap Plan A work with a Critical Illness Insurance for cancer, heart-attack & stroke coverage (CHAS)?

Plan A is compatible with CHAS insurance / cancer plans however since they are considered standalone plans, they would need to be purchased separately. By working with a Bridge Agent, we can help you find an CHAS and/or affordable critical illness insurance plans to fit your needs.

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How does Medigap Plan A work with a Long Term Care Insurance (LTC)?

Medigap Plan A is compatible with LTC plans however, since they are considered standalone plans, they would need to be purchased separately. There is talk about developing a new Medigap plan to include LTC coverage. By working with a Bridge Agent, we can help you find an affordable LTC insurance plan to fit your needs(LTC).

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How does Plan A work with a Health Savings Account (HSA)?

As with all Medigap Plans, Medigap Plan A is not considered a qualified expense to pay out of your Health Savings Account (HSA). However, your HSA can pay for Medicare Parts A, B, C & D. Once enrolled in Medicare, enrollees are no longer able to contribute to their Health Savings Account. However, the funds can be used to pay for qualified Medicare costs stated above. If one postpones Medicare enrollment they may still contribute to their Health Savings but enrolling late will also be subject to a Medicare Late Enrollment Penalty which is a percentage increase of costs per year. Speak with your Financial Advisor to determine what works best for you!

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In Conclusion

Plan A is the foundation of all Medigap Plans ie: Medicare Supplement Plans by offering the minimum required benefits and as such, Plan A is a less popular plan because it lacks comprehensive coverage. Plan A is private insurance that “supplements” Original Medicare. The cost of Plan A is dependent upon carrier & availability. All carriers must offer plan a, and adhere to standardized federal guidelines. If you would like to speak with a licensed Bridge Agent about Plan A options to see if this fits your needs, please contact us today for a free, no-obligation Quote! Get Quote

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