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

Medicare Supplement Plan A is the most basic Medigap policy available. Medigap policies are private plans that cover what Original Medicare leaves unpaid and daily hospital co-insurance and outpatient cost-sharing. Because federal law standardizes Plan A's benefits across every licensed insurer, the only real difference between policies is price.

In my analysis of 2026 Medigap premiums, Plan A consistently returned the lowest entry price of any Medigap policy. About 1% of Medigap enrollees choose Plan A, per CMS enrollment data, because Plan A's lower premium comes without coverage for the Part A deductible and skilled nursing co-insurance, two of Medicare's most costly gaps.

Plan A doesn't cover prescription drugs. Add a separate Medicare Part D plan for drug costs. You'll also pay your Part B premium ($202.90 per month in 2026, per CMS) on top of your Plan A premium. Plan A is available to anyone who qualifies for Medicare and is enrolled in both Part A and Part B.   

For enrollees who've needed hospital care in the past two years, Plan G will likely cost less overall. One hospitalization plus 10 days of skilled nursing care costs $3,906 out of pocket under Plan A. That amount often exceeds a full year of Plan G's premium difference.

Medicare Supplement Plan A pays four federally standardized benefits, and every licensed insurer must offer the same four regardless of price. The supplement covers the co-insurance charges that apply from day 61 of a hospital stay, additional days beyond Medicare's lifetime reserve, hospice care cost-sharing and Part B outpatient costs.

Medicare Supplement Plan A also pays the 20% Part B co-insurance on outpatient visits and doctor services.

Plan A's four covered benefits all target co-insurance, which is what you owe after Original Medicare pays its portion of an approved service. The Part A deductible and skilled nursing co-insurance fall outside of Plan A's coverage. Plans B, G and N include both at a higher monthly premium, which is why those plans cost more.

Plan A doesn't cover the Part A deductible or skilled nursing facility co-insurance.   

• The Part A deductible ($1,736 per benefit period in 2026, per CMS) stays entirely out of pocket, as does skilled nursing facility co-insurance at $217 per day for days 21 to 100. 
• The Part A deductible applies per benefit period, not per calendar year. A benefit period begins when you're admitted to a hospital and ends 60 days after you're discharged. A second hospitalization after that 60-day gap resets the deductible, so two qualifying stays in one year cost $3,472 out of pocket.
• The skilled nursing co-insurance applies from day 21 through day 100. A 30-day skilled nursing stay, common after joint replacement surgery, means 10 days of co-insurance at $217 each, a $2,170 bill Plan A doesn't cover. Plan G covers that cost in full.
• Part B excess charges are also out of pocket with Plan A. These apply when a doctor doesn't accept Medicare assignment. A doctor who doesn't accept Medicare's approved rate as full payment can bill above it, and that difference is your responsibility with Plan A. 
• Foreign travel emergency care gets no coverage either. The Part B deductible ($283 in 2026, per CMS) isn't covered, and since January 1, 2020, no new Medigap enrollees can buy any plan that covers it, per Medicare.gov.

Plan A premiums range from $197 to $289 per month for the same four covered benefits because insurers use three different pricing structures. Our 2026 data shows attained-age pricing costs $70 per month below community-rated at age 65. This difference narrows to $32 by age 75. This compression further continues past 75 and can reverse the advantage for long-term policyholders who keep their coverage into their late 70s or beyond.

Medicare Supplement Plan A is the baseline Medigap policy. Plan B adds one feature Plan A doesn't include, the Part A deductible. Plan G and Plan N both add skilled nursing co-insurance and 80% foreign travel emergency coverage at a higher premium.

The practical question Plan A raises is whether you can absorb the $1,736 Part A deductible when you need hospital care. Plan B removes that risk at a higher monthly premium. Plan G also covers skilled nursing co-insurance and Part B excess charges, which Plan N doesn't include.

In my analysis, Plan G gives most enrollees the best value among the four plans once they account for the deductible and skilled nursing risks. Plan A's lower premium only holds its advantage through years when you don't need hospital care.   

Plans C and F are no longer available to new enrollees since January 1, 2020, per CMS. Review all Medigap plans to compare Plan A against the full market.

*Plan N pays 100% of Part B costs except copayments for some office visits (up to $20) and some emergency room visits (up to $50 when not admitted as an inpatient).

Plan A has the lowest Medigap premium. The Part A deductible and skilled nursing co-insurance stay entirely out of pocket.  

Plan A's most under-appreciated benefit is the unlimited additional hospital days coverage. Medicare's lifetime reserve covers only 60 days beyond the standard hospital window, and once those days are exhausted, the daily cost without any Medigap coverage is $868. Plan A eliminates that exposure.

Medicare Supplement Plan A is the right choice for healthy enrollees who don't expect frequent hospitalizations and can cover the Part A deductible out of pocket. It's the most budget-friendly Medigap entry point for those who want basic gap coverage without paying for benefits they're unlikely to use.

Medicare Supplement Plan A is available from any licensed Medigap carrier in your state. Benefits are identical across all insurers by federal law, so price and financial strength are the main differentiators. 

Some of the licensed carriers include Aetna, Anthem, Humana, UnitedHealthcare, Cigna, Blue Cross Blue Shield and Transamerica. You apply directly with the insurer and the coverage starts on your policy's effective date.

Medicare Supplement Plan A is available in most states to enrollees under 65 who qualify for Medicare through a disability. Your Medigap open enrollment window begins when you enroll in Medicare Part B. Insurers can't deny your application or charge more based on health history.

When you turn 65, a new six-month open enrollment window opens. At 65, your premiums reset to the age-65 rate, often lower than what you paid as a younger disabled enrollee.