What is Medicare Supplement Plan A?
Supplemental Medicare insurance helps cover certain out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. that Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. (Part A and Part B) don’t pay. These gaps in Medicare coverage include deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. , and copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. that make up a beneficiary’s shared costsAn amount patients pay for their share of the cost of medical service or supply, like a doctor’s visit, hospital inpatient visit, or prescription drug.. Medicare Plan A the most basic of all Medicare supplements available to help cover some of these costs.
Medicare Supplement Plan A is often confused with Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care., which is the Medicare coverage that pays for your inpatient hospital care. Medicare Supplement Plan A, which is also known as Medigap Plan A, helps pay the most costly out-of-pocket costs from Medicare Part A and Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services.. Only Medicare organizes coverage in “parts”. Private insurance organizes its coverage in “plans”.
There are ten different Medigap plans, labeled A, B, C, D, F, G, K, L, M, and N. These plans are available in most states through private insurance companies. Each lettered plan has a different range of coverage. Massachusetts, Minnesota, and Wisconsin don’t follow the standardized plan system.
All of the Following are Core Benefits of Medicare Supplement Plan A Except…
All insurance companies that sell supplemental Medicare insurance offer Plan A. This plan offers the most essential coverage, which takes care of:
- Hospital Inpatient Coinsurance
- First 3 Pints of Blood
- HospiceHospice is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the patient. Coinsurance
- Doctor and Outpatient Services Coinsurance
However, this plan leaves its beneficiaries to pay Part A and Part B deductibles, excess chargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment., and skilled nursing facility coinsurance. And, although you are covered anywhere you go in the United States, this plan does not cover foreign travel emergencies
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As you can see, Medicare Plan A is the most basic of the 10 Medicare Supplement insuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. plans, but its coverage should not be underestimated. Medigap Plan A covers 100% of four critical things:
- Medicare Part A coinsurance payments for inpatient hospital care up to an additional 365 days after Medicare benefits are used up
- Medicare Part B copayment or coinsurance expenses
- The first 3 pints of blood used in a medical procedure
- Part A hospice care coinsurance expense or copayment
All Medicare supplement plans cover the hospital inpatient coinsurance at 100%. And, all plans cover blood, the Medicare Part B copayments, and hospice care coinsurance. However, Medicare Plan LMedigap Plan L offers less coverage than most Medicare supplements, but it's one of two plans that have shared costs and features an annual cap on your out-of-pocket spending. In this way, it's similar to... only covers these benefits at 75%, while Medicare Plan KMedicare Supplement Plan K is one of two unique Medicare supplements with shared-cost coverage and an annual out-of-pocket limit. This is a plan that works for people looking for help with certain Original Medicare costs... covers them at 50%.
The other Medigap plans cover at least one benefit that Plan A does not cover. Medicare Plan FMedicare Supplement Plan F is the most comprehensive Medicare supplement plan available. This plan covers all Original Medicare deductibles, coinsurance, and copayments, leaving you with no out-of-pocket costs on all Medicare-approved services., the most comprehensive plan available, covers five additional benefits. The following Medigap plan comparison chart shows how Plan A compares to all other plans.
What Costs Come with Medicare Plan A Coverage?
If you buy a Medicare Plan A policy you are responsible for paying the Medicare Part A and Part B deductibles. If you are a healthy person this isn’t a big risk. Also, be aware that as of January 2020, seniors turning age 65 can’t buy a policy that covers the Part B deductible, which includes Plan F and Plan C.
You will also be responsible for any skilled nursing facility coinsurance and Part B excess charges. Again, if you’re healthy, the risk is somewhat low. However, if you are aging into Medicare with one or more chronic conditions, you should seriously consider one of the other plans.
Also, if you are an international traveler, be aware that both Medicare and Medicare Supplement Plan A won’t cover you in the event of a medical emergencyWhen you believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.. Six of the standardized plans do offer an 80% foreign travel emergency coverage benefit up to the policy limit.
Medicare Plan A is basic coverage. It works for those people who are healthy and don’t want to pay for coverage they are not likely to ever need. That said, Plan A coverage has the potential for much higher out-of-pocket costs if a serious illness or accident occurs.
What Basic Medicare Supplement Plans do Wisconsin, Minnesota, and Massachusetts Offer?
As previously mentioned, Massachusetts, Minnesota, and, Wisconsin have their own Medicare supplement plans that cover Medicare’s gaps differently. These three states specify basic benefits that supplemental Medicare insurance must cover.
In Massachusetts, basic benefits include:
- Medicare Part A coinsurance payments for inpatient hospital care up to an additional 365 days after Original Medicare benefits are exhausted
- Medicare Part B coinsurance for medical costs (generally 20% of the Medicare-approved amountA Medicare-approved amount is what Medicare will pay for a covered service. Healthcare providers that agree to Medicare assignment accept the approved amount without excess charges. What Does Medicare-Approved Amount Mean? A Medicare-approved amount is...)
- The first 3 pints of blood each year
- Part A hospice coinsurance or copayment
In Minnesota, basic benefits include:
- Medicare Part A coinsurance for inpatient hospital care
- Medicare Part B coinsurance for medical costs (generally 20% of the Medicare-approved amount)
- The first 3 pints of blood each year
- Part A hospice and respite care copayments
- Part A and Part B home health services and supplies cost-sharing
In Wisconsin, basic benefits include:
- Medicare Part A coinsurance for inpatient hospital care
- Medicare Part B coinsurance for medical costs
- The first 3 pints of blood each year
- Part A hospice coinsurance or copayment
Consult with your insurance agent to see if a Medicare Supplement Plan A policy might be right for you. If you don’t have an agent, call 1-855-728-0510 (TTY 711) and speak with a licensed HealthCompare insurance agent. There’s no obligation, and they offer more plan options than any other national agency.
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