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Plan letter

Plan A

The federal-baseline Medigap plan — every insurer must offer it

Plan A is the basic federal Medigap policy. By federal rule, any insurer that sells Medigap in a state must offer Plan A. It covers the core federal benefits: Part A coinsurance and hospital costs (plus an additional 365 days after Medicare benefits are exhausted), Part B coinsurance, the first three pints of blood, and Part A hospice coinsurance. It does not cover the Part A or Part B deductibles, skilled nursing facility coinsurance, Part B excess charges, or foreign travel emergency.

A donut chart showing how Plan A covers the ten federally-defined Medigap benefit categories: 4 fully covered; 6 not covered.APLAN

Coverage of the 10 federal benefits

  • 4 · Fully covered
  • 6 · Not covered

What Plan A covers (federal CMS standardization)

The covered-benefits matrix below is verbatim from medicare.gov. Every cell is federally frozen by the 1990 NAIC Medicare Supplement Standardization Act.

  • Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)Covered ✓
  • Part B coinsurance or copaymentCovered ✓
  • Blood (first 3 pints)Covered ✓
  • Part A hospice care coinsurance or copaymentCovered ✓
  • Skilled nursing facility care coinsuranceNot covered
  • Part A deductibleNot covered
  • Part B deductibleNot covered
  • Part B excess chargesNot covered
  • Foreign travel emergency (up to plan limits)Not covered
  • Out-of-pocket limit (applies to Plans K and L only)Not covered

State availability

Plan A is part of the federal 10-letter Medigap system. Massachusetts, Minnesota, and Wisconsindo not use the federal letter system — if you live in those states, your Medigap plan structure is different. See your state page:

When can you buy Plan A?

During your federal 6-month Medigap Open Enrollment Period (per 42 U.S.C. § 1395ss), every insurer that offers Plan A in your state must issue you a policy regardless of your health status. Outside that window, in most states, insurers may medically underwrite, deny, or surcharge .

Compare Plan A side-by-side

The full federal benefits matrix with Plan A highlighted:

Federal Medigap plan-letter benefits matrix (Plans A–N, CMS-standardized).
BenefitABCMACRA grandfatheredDFMACRA grandfatheredGKLMN
Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)
Part B coinsurance or copayment50%75%See note
Blood (first 3 pints)50%75%
Part A hospice care coinsurance or copayment50%75%
Skilled nursing facility care coinsurance50%75%
Part A deductible50%75%50%
Part B deductible
Part B excess charges
Foreign travel emergency (up to plan limits)
Out-of-pocket limit (applies to Plans K and L only)

Reading the matrix: ✓ = the plan covers 100% of the federally-defined benefit; 50%/75% = the plan pays that share of the benefit; ✗ = the plan does not cover the benefit. Plans C and F are closed to people newly eligible for Medicare on or after 2020-01-01 per MACRA 2015 grandfathering. Massachusetts, Minnesota, and Wisconsin do not use the federal 10-letter system; see your state page for the state-specific Medigap structure.