Medicare Supplement Plan A: Coverage, Costs, Pros & Cons

Plan A is the most basic Medigap policy. Medigap policies are private plans that pay part of what Original Medicare leaves unpaid, such as daily hospital co-insurance and outpatient cost sharing. Federal law sets the same Plan A benefits for every licensed insurer, so policies differ mainly in price.

Plan A isn't the cheapest Medigap plan. At 65 on attained-age pricing, it averages $197 a month in MoneyGeek's 2026 data, against $196 for Plan G and $148 for Plan N, and Plans K, L and M average less as well. Plans G and N pay the Part A deductible and skilled nursing co-insurance too, two of Original Medicare's costliest out-of-pocket charges.

For prescription drugs, you'll need a separate Medicare Part D plan, since Plan A doesn't cover them. Your Part B premium ($202.90 a month in 2026, per CMS) comes on top of your Plan A premium. To buy Plan A, you must be enrolled in both Part A and Part B. Insurers must sell it to you during your Medigap Open Enrollment Period at 65, and state law decides whether you can buy it before 65.

In any year with a hospital stay and a 30-day skilled nursing stay, Plan G costs less overall than Plan A. That combination leaves you $3,906 out of pocket under Plan A, more than eight times the largest yearly premium gap between the two plans at 65 in MoneyGeek's data ($476). If you've needed hospital care in the past two years, price Plan G before you choose Plan A.

Every licensed insurer's Plan A pays the same four federally standardized benefits, whatever the price: Part A hospital co-insurance with up to 365 extra hospital days, Part B co-insurance, the first three pints of blood and Part A hospice co-insurance.

Part A hospital co-insurance starts on day 61 of a hospital stay. After day 90, Medicare gives you 60 lifetime reserve days, and each one you use is gone for good. Without Medigap, a reserve day costs you $868 in 2026, per CMS. Plan A pays that charge, along with the $434 daily co-insurance for days 61 through 90.

Once Original Medicare covers its portion of an approved service, Plan A pays the co-insurance you owe. It doesn't pay the Part A deductible or skilled nursing co-insurance. Plan B adds the Part A deductible, and Plans G and N pay both.

Under Plan A, you pay the Part A deductible and skilled nursing facility co-insurance yourself, along with a few other costs.

• Part A deductible: You pay the full $1,736 per benefit period in 2026, per CMS, and you can owe it more than once a year. A benefit period begins when you're admitted as a hospital inpatient and ends once you've gone 60 days in a row without inpatient hospital or skilled nursing care, per Medicare.gov. Two hospital stays in separate benefit periods cost $3,472 in deductibles.
• Skilled nursing co-insurance: From day 21 through day 100, you pay $217 a day. A 30-day skilled nursing stay, common after joint replacement surgery, means 10 days of co-insurance and a $2,170 bill under Plan A. Plan G pays that cost in full.
• Part B excess charges: A doctor who doesn't accept Medicare assignment, meaning Medicare's approved rate as full payment, can bill above that rate. Under Plan A, you pay the difference.
• Foreign travel emergencies: Plan A pays nothing for emergency care outside the U.S.
• Part B deductible: You pay the $283 Part B deductible (2026, per CMS). Since January 1, 2020, no new Medigap enrollees can buy a plan that covers it, per Medicare.gov.

Insurers use three pricing methods, so the same four Plan A benefits cost $197 to $267 a month at 65 in MoneyGeek's 2026 data. Attained-age pricing starts $70 a month below community-rated pricing at that age. Its premiums climb every year as you age, though, and Medicare.gov notes attained-age policies can end up the most expensive of the three methods over time. Someone buying an attained-age policy at 75 pays an average of $257 a month.

*Averages come from MoneyGeek's 2026 Medigap premium quotes at 65 and 75 under attained-age, issue-age and community-rated pricing. Age 75 figures show what a new policy costs someone who buys at 75. A community-rated policy charges every buyer the same premium regardless of age, per Medicare.gov, so the table shows no separate age 75 figure.

Plan A is the starting point for the other three plans. Plan B pays the Part A deductible on top of Plan A's benefits. Plans G and N pay that deductible plus skilled nursing co-insurance and 80% of foreign travel emergency costs, and only Plan G of the four pays Part B excess charges.

With Plan A, ask yourself whether you could pay the $1,736 Part A deductible if you went into the hospital. At 65, Plan B pays that deductible for $22 to $56 a month more than Plan A in MoneyGeek's data.

If you expect a hospital stay, Plan G is the better value. The $1,736 Part A deductible alone is more than the largest yearly premium gap between the two plans at 65 in MoneyGeek's data ($476), and Plan G pays skilled nursing co-insurance as well. Plan A's lower premium pays off only in years without hospital care.

*Plan N pays 100% of Part B co-insurance except copays of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to inpatient admission.

At 65, Plan A undercuts Plan G under two of the three pricing methods, but Plan N beats it under all three. Under Plan A, you pay the Part A deductible and skilled nursing co-insurance yourself.

Plan A's hospital benefit pays the $868 daily co-insurance on lifetime reserve days, plus up to 365 more days once those 60 are used up. Every standardized Medigap plan includes this benefit, so it doesn't set Plan A apart.

Choose Plan A only if Plan N's office copays would cost you more each year than Plan N saves you in premiums, which is $208 to $583 at 65 in MoneyGeek's data. That describes a healthy enrollee who rarely goes into the hospital, can cover the Part A deductible and sees the doctor often. Plan A also costs less than Plan G at 65 on issue-age and community-rated pricing.

Any licensed Medigap carrier in your state sells Plan A. Federal law sets identical benefits across insurers, so compare them on price and financial strength.

Licensed carriers include Aetna, Anthem, Humana, UnitedHealthcare, Cigna, Blue Cross Blue Shield and Transamerica. You apply with the insurer directly.

Whether you can buy Plan A before 65 depends on your state, since federal law doesn't require insurers to sell Medigap to people under 65. As of March 2026, 33 states require insurers to offer at least one kind of Medigap policy to people with Medicare under 65, per Medicare.gov. Some limit that right to people who qualify through a disability or End-Stage Renal Disease (ESRD). Your State Insurance Department can confirm the rules where you live.

At 65, a new six-month Medigap Open Enrollment Period opens. Insurers then must sell you any Medigap policy they offer, and they can't charge you more than other 65-year-olds because of a disability or other health problem.