Plan A is the baseline Medigap plan, available from every Medigap carrier. It covers the four core benefits required by federal law and nothing extra. Premiums are typically the lowest available.
Best for
- Beneficiaries on a tight budget
- Anyone wanting just the federal baseline benefits
Watch out for
Does not cover Part A deductible - the biggest exposure under Original Medicare.
What Plan A covers
- Part A coinsurance & 365 extra hospital daysCovered in full
- Part B coinsurance or copaymentCovered in full
- Blood (first 3 pints)Covered in full
- Part A hospice coinsurance / copayCovered in full
- Skilled nursing facility coinsuranceNot covered
- Part A deductibleNot covered
- Part B deductibleNot covered
- Part B excess chargesNot covered
- Foreign travel emergency (up to plan limits)Not covered
Compare to other Medigap plans
- Plan BPlan A plus the Part A deductible.
- Plan CComprehensive coverage - closed to anyone newly eligible after Jan 1, 2020.
- Plan DPlan G minus Part B excess. Modest savings, modest reduction in benefit.
- Plan FThe 'everything' plan - closed to newly eligible after Jan 1, 2020.
- Plan GToday's most popular Medigap plan - comprehensive coverage minus only Part B deductible.
- Plan KLower premium, partial coverage with out-of-pocket cap.
- Plan LLike Plan K but covers more - 75% of most cost-sharing.
- Plan MSplits the Part A deductible 50/50 between you and the plan.
- Plan NLower premium than Plan G in exchange for office and ER copays.
What Does Medigap Plan A Actually Cover?
Plan A is the entry point for Medicare Supplement insurance. Every company that sells Medigap in California has to offer it. Federal law sets the benefits, so Plan A covers the same four items everywhere.
The four gaps Plan A fills
Part A hospital coinsurance
Original Medicare stops paying hospital costs after a set number of days. Plan A picks up your share. It also adds 365 extra hospital days for life.
Part B coinsurance and copays
Medicare pays most of each doctor bill. Plan A pays the share that would otherwise land on you.
The first three pints of blood
Medicare bills blood separately from the rest of your care. Plan A covers the first three pints each year.
Part A hospice coinsurance
Hospice care carries small charges for drugs and respite care. Plan A covers those amounts for you.
Standardized means identical
Two carriers can quote very different rates for the same Plan A.
The benefits do not change. You are shopping on price, service, and how a company has raised rates over time.
What Does Plan A Leave You to Pay?
This is where Plan A gets thin. It skips five benefits that richer letters include. Four of those gaps are manageable. One of them is not.
- The Part A hospital deductible. You pay this yourself for every benefit period. It is the largest single gap Original Medicare leaves.
- Skilled nursing coinsurance. Daily charges begin after the first 20 days of a covered rehab stay. Plan A pays none of them.
- The Part B deductible. You pay a set amount each year before Part B starts paying its share.
- Part B excess charges. A small number of doctors bill above the Medicare approved amount. That extra is yours.
- Foreign travel emergency care. Original Medicare rarely covers care abroad. Plan A adds nothing for trips.
Benefit periods are not calendar years
A benefit period ends 60 days after you leave a hospital or a rehab facility.
Go back in later that same year and a new one begins. You could owe the Part A deductible more than once in twelve months.
Who Is Plan A Really Right For?
Who this is for
Plan A tends to fit you if:
- Your budget has a hard ceiling and premium is the deciding factor.
- You want doctor and hospital coinsurance covered, and you accept the deductible risk.
- You keep savings that could absorb a hospital deductible twice in one year.
- You travel inside the United States and do not need coverage abroad.
- You are leaving a group health plan and want the lowest priced supplement for now.
Plan A is a poor fit if one hospital bill would strain your savings. It is also a weak choice if you expect rehab after surgery. Skilled nursing charges add up quickly, and Plan A covers none of them.
Plan A or Plan B: What Actually Changes?
Plan B is Plan A plus one benefit: the Part A hospital deductible. Nothing else moves. That makes this the cleanest comparison in the whole Medigap lineup.
Plan A vs Plan B
Medigap Plan A
The federal baseline. Lowest premium, largest hospital exposure.
- Part A coinsurance and 365 extra days
- Covered in full
- Part B coinsurance and copays
- Covered in full
- First three pints of blood
- Covered in full
- Part A hospice coinsurance
- Covered in full
- Part A hospital deductible
- Not covered
- Skilled nursing coinsurance
- Not covered
- Part B deductible
- Not covered
- Part B excess charges
- Not covered
- Foreign travel emergency
- Not covered
- Typical premium
- The lowest of any Medigap letter
Medigap Plan B
The same four core benefits, plus the hospital deductible.
- Part A coinsurance and 365 extra days
- Covered in full
- Part B coinsurance and copays
- Covered in full
- First three pints of blood
- Covered in full
- Part A hospice coinsurance
- Covered in full
- Part A hospital deductible
- Covered in full
- Skilled nursing coinsurance
- Not covered
- Part B deductible
- Not covered
- Part B excess charges
- Not covered
- Foreign travel emergency
- Not covered
- Typical premium
- A modest step above Plan A
If you can afford the difference, Plan B removes the gap that worries people most. If you cannot, Plan A still shields you from the daily coinsurance that piles up during a long stay.
How Do the Birthday Rule and Trial Rights Work?
California gives supplement holders a yearly chance to shop with no health questions. Most states do not. This one rule is why a Medigap policy can stay affordable here for years.
Using the California birthday rule
- 01
Your window opens 30 days before your birthday
It stays open for 60 days in total, so it closes 30 days after your birthday.
- 02
You must already hold a Medigap policy
The rule moves you from one supplement to another. It cannot move you out of a Medicare Advantage plan and into a supplement.
- 03
You may switch to equal or lesser benefits
Keep Plan A with a new company, or move to a letter that covers less. You cannot use this window to move up to richer coverage.
- 04
No health questions apply
The new carrier takes you at its standard rate for your age. Your health history does not change the answer.
Trial rights are a separate protection
Try a Medicare Advantage plan when you first turn 65 and you get twelve months to change your mind. During that year you can buy any Medigap plan sold in California.
Drop a supplement to test Advantage for the first time and the same twelve month clock applies. Plan A sits on the guaranteed list you can return to.
Both protections have hard deadlines. Missing one by a week can mean answering health questions instead. An annual review keeps those dates on your calendar.
What Does Underwriting Look Like Outside a Protected Window?
Outside your one time open enrollment, the birthday rule, or a guaranteed issue right, carriers may ask about your health. In California they usually do.
- A health questionnaire covering the last few years of treatment
- A review of your prescription history through a pharmacy database
- Questions about pending surgery, recent hospital stays, or tests you have not finished
- Height and weight measured against the carrier's published limits
- A short follow up call to confirm anything the application flagged
A common myth about Plan A
People assume the cheapest letter is the easiest to qualify for. It is not. Underwriting looks at your health, never at the letter you picked. A carrier that would decline you for Plan G will decline you for Plan A.
So timing matters more than shopping. If you are inside a protected window, use it. If you are outside one, we read each carrier's health rules first, so you apply where you have a real chance.
How Do You Compare Plan A Quotes in Orange County?
Because the benefits are identical, all the work sits in the numbers and the carrier's habits. We run every company licensed in your county, not a short list of favorites.
What we check on every quote
Today's rate for your age and ZIP code
Premiums move with both. Two neighbors born a year apart can see different numbers.
How the carrier raises rates
Most California supplements use attained age pricing, so the premium climbs as you get older. A carrier's history tells you how steeply.
Household and payment discounts
Some carriers reduce the rate when two people in one home enroll, or when you pay by bank draft.
Your drug plan alongside it
No supplement includes drug coverage. We price a Part D plan at the same time so you see the full monthly cost.
We are an independent agency in Orange, and we meet in person, by video, or by phone. Reviews are at no cost to you. Call (714) 922-0043 or start with a short conversation.