Medicare Supplement Plan A is the most basic Medigap plan available — it covers only the core benefits required of every Medigap plan, with no extras layered on.
What Plan A Covers
- Medicare Part A coinsurance and hospital costs, up to an additional 365 days after Medicare benefits are used up
- Medicare Part B coinsurance or copayment
- The first 3 pints of blood each year
- Part A hospice care coinsurance
Plan A doesn’t cover the Part A or Part B deductibles, skilled nursing coinsurance, or foreign travel emergencies. It tends to appeal to people who want the lowest possible Medigap premium and are comfortable paying more out of pocket if they’re hospitalized.
Why Plan A Is Rarely Sold Today
Plan A represents the minimum benefits every Medigap plan is required to include — every other lettered plan builds on top of it. Because it leaves the Part B deductible, Part A deductible, and skilled nursing coinsurance completely uncovered, carriers often can’t price it enough below Plan N or Plan K to make it the obviously better deal. In our experience, once we run real numbers, Plan N or a cost-sharing plan like K or L usually ends up costing about the same or less than Plan A while covering meaningfully more. That’s not true in every case, which is why we still check it, but it’s worth knowing upfront why Plan A isn’t the plan most agents lead with.
What You’re Exposed To
With Plan A, you’re responsible for the full Part A deductible each benefit period, the full Part B deductible each year, and the full cost of skilled nursing facility coinsurance if you need that kind of care after a hospital stay. None of these are small, occasional costs — a hospital stay is exactly the scenario where the Part A deductible applies, so Plan A’s savings on premium can be offset quickly by a single hospitalization.
When Plan A Might Still Make Sense
Plan A can be worth considering if a specific carrier prices it meaningfully below every other option available to you, or if you have other coverage or savings specifically earmarked to handle the deductibles it leaves open. It’s not a plan we’d recommend by default, but we also won’t rule it out without checking the actual numbers for your situation.
Seeing the Real Cost Difference in Practice
It helps to walk through what Plan A’s gaps actually mean in a real year. If you’re admitted to the hospital, you’d owe the full Part A deductible yourself before Plan A’s coverage of coinsurance and extra hospital days kicks in. If you never set foot in a hospital that year, that particular gap costs you nothing — but the Part B deductible applies regardless, every year, the first time you use outpatient care of any kind. Between those two exposures, most people find the Part B deductible is the one that actually shows up almost every year, while the Part A deductible is the one that shows up rarely but can be more consequential when it does. Understanding which gap is more likely to affect you in a typical year is part of what makes comparing Plan A against Plan N or a cost-sharing plan worthwhile before assuming Plan A’s lower premium is automatically the better deal.
How Plan A Premiums Are Priced
Like other standardized Medigap plans, Plan A premiums are set using community rating, issue-age rating, or attained-age rating, depending on the specific carrier. Attained-age policies often start out cheaper but climb faster as you get older; issue-age and community-rated policies tend to start a bit higher but grow more predictably over time. Because Plan A is one of the lowest-volume plan letters at most carriers, it’s worth specifically asking how that carrier’s Plan A book has trended on rate increases historically, since a thin book of business built around the most price-sensitive buyers can sometimes see sharper adjustments than a carrier’s more popular plan letters.
A Client Example
A client on a tight fixed income asked us specifically about the cheapest Medigap option available, assuming that meant Plan A by definition. When we pulled actual quotes from carriers licensed in his county, a cost-sharing Plan K policy came in only slightly higher in monthly premium than the cheapest available Plan A option, while capping his total annual exposure at a known, fixed amount and covering more of his routine costs along the way. Once he saw both quotes side by side, Plan K was the clearer value for his situation, even though “Plan A” sounds like it should be the budget option by name alone. That’s not universally true — a different carrier or a different county might have produced the opposite result — which is exactly why we pull real numbers rather than assuming the lowest letter is the lowest cost.
Plan A and Medicare Advantage Aren’t a Combination
Worth stating plainly, since it comes up often: Plan A, like every Medigap plan, only works alongside Original Medicare, not a Medicare Advantage plan. You wouldn’t hold a Plan A policy on top of Medicare Advantage coverage, and it wouldn’t add any benefit even if you tried, since the two aren’t designed to stack together. If you’re currently on a Medicare Advantage plan and considering a move to Original Medicare plus a Medigap policy, that’s a genuinely bigger decision involving your specific doctors, your prescriptions, and your current plan’s network — worth a separate, dedicated conversation rather than folding it into a simple plan-letter comparison.
What Happens if You Move
Plan A is guaranteed renewable and works the same way nationwide, since Medigap fills gaps in Original Medicare rather than operating through a local provider network. If you relocate to another state, your existing Plan A policy continues working wherever Medicare is accepted, though premiums for the same plan letter can vary meaningfully by state and county — worth having us re-shop your coverage after a move, even though nothing requires you to switch.
Guaranteed Issue Rights
Like other standardized Medigap plans, Plan A is available without medical underwriting during your 6-month Medigap Open Enrollment Period, which starts the month you’re 65 or older and enrolled in Part B, and during certain other guaranteed-issue situations. Outside those windows, applying typically involves medical underwriting.
Plan A vs. the Cost-Sharing Plans, Side by Side
Because Plan A, Plan K, and Plan L all tend to attract budget-conscious buyers, we usually run all three together rather than looking at Plan A in isolation. Plan A leaves the Part A deductible, Part B deductible, and skilled nursing coinsurance completely uncovered, with no cap on how much of that you could owe in a genuinely bad year involving multiple hospital stays. Plan K and Plan L, by contrast, cover a percentage of most of those same costs and cap your total annual exposure at a known, fixed limit. In nearly every comparison we’ve run, that cap is worth more to a budget-conscious client than Plan A’s marginally lower premium, since it protects against the specific worst-case scenario that a low-premium plan is otherwise most exposed to. Plan A can still win out in some very specific worst circumstances — like if a particular carrier’s Plan A happens to be genuinely and substantially cheaper than its own Plan K in a given county — but that’s the exception, not the rule.
Enrollment Timing in More Detail
Your 6-month Medigap Open Enrollment Period starts the month you’re both 65 or older and enrolled in Medicare Part B, whether or not you’re still working — delaying Part B because you have employer coverage simply delays the start of this window until you actually enroll. Applying during that window generally means a carrier can’t deny you coverage or charge more because of your health history, which matters especially for a bare-bones plan like Plan A, since anyone choosing it purely to save money would want to lock in that guaranteed acceptance while it’s available rather than risk needing medical underwriting later if their health changes and they want to upgrade to broader coverage.
Common Questions
Is Plan A the cheapest Medigap plan?
Not always. Because it covers so little, some carriers price cost-sharing plans like K or L, or even Plan N, close to or below Plan A’s premium. We’ll compare actual quotes rather than assume the “most basic” plan is automatically the cheapest.
Does Plan A cover foreign travel?
No. If foreign travel emergency coverage matters to you, Plans C, D, F, G, M, and N all include it, while Plan A does not.
Is Plan A ever the smart choice?
Occasionally, yes — usually when a specific carrier prices it meaningfully below every cost-sharing alternative in your county. We check the actual numbers every time rather than ruling it out automatically.
Before choosing Plan A based on premium alone, let us run it against Plan N and the cost-sharing plans for your specific carrier options in Bethel, Cincinnati, and the rest of Hamilton, Clermont, Butler, and Warren County.