Navigating the complexities of Medicare can be daunting, but understanding Medigap Plan A is a crucial first step. This plan offers essential coverage for basic hospital and medical expenses, but it’s important to know where gaps remain. As your trusted Medicare Supplement Insurance Representatives, we’re here to guide you through these details, ensuring you’re informed and confident in your coverage choices—read on to discover how Medigap Plan A could work for you.
Information Provided by a Medicare Supplement Insurance Representative
Medicare with Plan A
The chart below describes the common Medicare benefits along with gaps left by Medicare for you to pay.
| I. In patient | Gap (you pay) | Plan A | |
| days 1-60 | deductible* | $1,632.00 | ✖ Not Paid |
| days 61-90 life time reserve | coinsurance | $408.00 | ✔ Paid |
| days 91-150 | coinsurance | $816.00 | ✔ Paid |
| after 150 days Medicare quits paying | next 365 paid in full | ✔ Paid |
| II. Skilled Nursing | Gap (you pay) | Plan A | |
| Medicare pays 20 days in full | |||
| days 21-100 | $204.00 | ✖ Not Paid |
| Gap (you pay) | Plan A | |
| Annual Deductible | $240.00 | ✖ Not Paid |
| Medicare Covers 80% | 20% | ✔ Paid |
| Part B Excess | 100% | ✖ Not Paid |
| 50,000 emergency medical outside USA $250.00 deductible 80/20 | ✖ Not Paid |
*The hospital benefit period is reset by Medicare 60 days from your previous hospital release date.
It is mandated that each insurance company selling Medigap or Medicare Supplement Insurance Plans must offer the Plan A in their selection of plans. This is the only Medicare Supplement plan that must be offered. Medigap Plan A offers the basic services standardized by Medicare, the plan offers the least benefits of any Medicare Supplement Insurance Plan that one could purchase.
Medicare Supplement Insurance Plan A includes basic benefits which include:
- Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses: Part B coinsurance (generally 20% of Medicare-approved expenses) or co-payments for hospital outpatient services. Plans K, L, and N require insured to pay a portion of Part B coinsurance or co-payments.
- Blood: First 3 pints of blood each year. Hospice: Part A coinsurance.
Hospice Care will be included in all Medicare Supplement Insurance Plans as of June 2010. However, Medicare Supplement Plan A does not provide comprehensive coverage for many of Medicares gaps. For example Medicare Supplement Plan A does not cover skilled nursing care, Medicare Part A (Hospital) deductible, Medicare Part B (Medical) deductible, foreign travel, or Medicare Part B (Medical) excess. The excess can be very important because you would be responsible for the medical bills above the amount approved by Medicare.
All plans were standardized by the federal government in 1992 for your protection. This means that you are to go by the letter I.D. of the plan to determine what benefits each plan will cover.
The only 2 things that an insurance company who offers a Medicare Supplement Plan A can have any control of are:
Underwriting
Premium price
We have only briefly touched on one Medicare Supplement Insurance Plan, and as you can see it can be very confusing and somewhat overwhelming. We deal with Medicare daily and your Medicare Specialist here at MedicareMall.com can “Take the Mystery Out of Medicare” by walking you through the maze every step of the way. We are committed to you by shopping the best plans from the top companies available. We will do what it takes to make sure you become a very happy, satisfied MedicareMall.com client. To find out more if a Medicare Supplement Plan A is right for you, contact a Medigap Plan Representative now or talk to one of our licensed Medicare Specialists by entering your zip code and clicking the ‘Go’ button.