Your Guide to Medigap Plan A
In the alphabet soup that is Medicare — the federal health insurance program designed primarily for adults ages 65 and older — some of the names and letters can be confusing. Medigap Plan A is one such piece of the puzzle that is sometimes confused for Medicare Part A.
Medigap Plan A is a supplemental insurance plan that covers some of the “gaps” in original Medicare coverage, or expenses that would otherwise cost beneficiaries money out of pocket. It’s sold by private insurance companies approved by Medicare and used alongside your original Medicare coverage to lower overall health care costs.
So what’s original Medicare? It includes Medicare Part A, which covers hospital stays, and Medicare Part B, which covers outpatient care. Original Medicare is available to adults over the age of 65 and some younger individuals with disabilities who meet qualifying criteria.
You don’t have to buy a supplemental Medigap plan, but for some people it can be a smart move, says Whitney Stidom, vice president of sales enablement with eHealth Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
[READ What Is the Medigap Birthday Rule and Which States Have It?]
What Is Included in Medigap Plan A?
The supplemental Medicare insurance plan called Medigap Plan A covers 100% of several benefits not covered by original Medicare, including:
— Medicare Part A hospital coinsurance
— Hospital costs for up to an additional 365 days after Medicare benefits are exhausted
— Part A hospice care coinsurance or copayment
— Part B coinsurance or copayment
— First three pints of blood per calendar year
Other Medigap plans also cover these items and may include additional benefits not covered under Medigap Plan A, such as:
— Medicare Part A and B deductibles
— Emergency care during foreign travel
— Skilled nursing facility care coinsurance
[READ: Medigap Coverage: When Do You Need It?]
How Much Does Medigap Plan A Cost?
How much you’ll pay for Medicare Medigap Plan A will vary depending on several factors, including:
— Geographic location
— Insurance provider
— Which plan you select
— When you enroll
Monthly premiums can range from approximately $100 to $500, but Stidom notes the average is around $200 per month, according to eHealth data.
[READ Medigap vs. Medicare Advantage: Which Should You Buy?]
What Is Not Covered Under Medigap Plan A
Medigap Plan A provides less coverage than other Medigap plans, Stidom says. However, it may be more affordable than other Medigap plans.
Medigap Plan A, and indeed other Medigap supplement plans, don’t offer coverage for OTC medications, such as cough syrup.
Therefore, if you enroll in a Medigap plan, you will need to purchase a separate Part D prescription drug plan, Stidom says. Medicare Part D is a voluntary prescription drug benefit you can purchase alongside original Medicare to offset the cost of your prescribed medications.
The average premium cost for a stand-alone Medicare Part D plan in 2025 was $36 per month, according to research from eHealth. Medicare Part D plans also often have a deductible, which could not exceed $590 in 2025.
Should I Buy Medigap Plan A?
Deciding whether to buy a Medigap Plan A policy, or any Medigap policy, is a highly personal question that will depend on your specific situation. You may want to consult a licensed insurance agent or elder law attorney to help you wade through your options and determine the best path for you.
While Medigap Plan A typically comes in at the lower end of the cost range, it’s not an especially popular Medigap plan, Stidom notes. This is because it provides very basic coverage, and many beneficiaries find that a Medicare Advantage plan suits their needs better for a lower monthly premium.
[SEE: Preventing Costly Medicare Mistakes: Tips and Strategies]
Medicare Advantage vs. original Medicare plus a Medigap plan
When choosing Medicare coverage, Medicare Advantage plans are also an option to consider. Medicare Advantage plans are different from Medigap plans and original Medicare, and for some people, may be more cost effective.
“Medicare Advantage, also known as Medicare Part C, are coverage plans approved by Medicare but run by private companies,” explains Martha Santana-Chin, CEO of L.A. Care Health Plan, the largest publicly operated health plan in the nation.
By law, Medicare Advantage plans must cover the same basic services that original Medicare does, but they often include additional benefits and perks. Costs can vary depending on the carrier administering the policy, geographic location and the specific plan selected.
Medicare Advantage plans typically include prescription drug coverage at a lower monthly premium, while Medigap plans do not, Stidom notes. Because of those added benefits, Medicare Advantage tends to be a more popular choice for many older adults than original Medicare plus a Medigap plan, but it really all depends on your specific situation.
Which doctor you can see is another consideration when deciding between Medicare Advantage and original Medicare with a Medigap plan, Stidom adds. “Medigap plans typically allow people to see any doctor who accepts Medicare. By contrast, with Medicare Advantage people typically need to stay within their private insurance company’s provider network for the highest level of coverage.”
For this reason, Medigap plans may be a good choice for people who:
— Want more freedom to choose their doctor
— Are willing to pay a higher monthly premium
— Want to avoid high copays
“If the monthly premium is not a barrier, and comprehensive, flexible medical coverage is a top priority, Medigap may be a great choice,” Stidom says.
By contrast, Medicare Advantage plans tend to be great for people who don’t mind:
— Seeing doctors within the plan’s network
— Want low to no additional monthly premiums
— Don’t mind having copays when they access care
It’s a lot to consider, so Stidom again encourages you to work with a licensed health insurance agent that offers both Medicare Advantage and Medigap plans to help you make the right choice. Agents can help you understand your options and find the best match based on your personal budget, preferences and health care needs.
How to Buy Medigap Plan A Coverage
If you’ve opted for original Medicare with a Medigap policy, you must first pick your policy. Search your zip code on the Medicare.gov page dedicated to Medigap plans and see what’s available in your area.
All Medigap Plan A options offer the same coverage; the only difference is the price, which can be set by the company offering the policy.
Once you’ve found a Medicare supplemental plan that makes sense for you, contact the company for an official quote. Prices can change depending on when you buy, your health conditions and other factors.
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Your Guide to Medigap Plan A originally appeared on usnews.com