Plan A and Plan B Are the Most Basic Medigap Options — and That’s Not a Compliment
Most people assume Plan A is the best Medigap plan because it’s first in the alphabet. It’s not. Plan A is actually the most stripped-down Medigap option available, and Plan B isn’t much better. I’m not saying they’re useless — I’m saying you need to understand exactly what you’re getting before you sign up for either one, because a lot of people don’t.
Here’s the thing: the letters in Medigap don’t rank by quality. They just label standardized benefit packages set by the federal government. Every insurance company selling Plan A has to offer the exact same benefits as every other company selling Plan A. So when you’re comparing Plan A vs Plan B, you’re really comparing two specific sets of coverage — not two tiers of quality.
Let’s get into what each one actually covers, where they differ, and whether either of them makes sense for someone buying Medigap in 2026.
What Plan A Covers (and What It Leaves Out)
Plan A is the floor. It covers the absolute minimum that any Medigap plan is required to cover by federal law. That includes:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Medicare Part B coinsurance or copayments (typically 20% of outpatient costs after the deductible)
- The first three pints of blood each year
- Part A hospice care coinsurance or copayments
That’s it. What’s notably not covered under Plan A: the Part A hospital deductible, the Part B deductible, skilled nursing facility coinsurance, or foreign travel emergency care. The 2026 Part A deductible is $1,676 per benefit period. That’s per benefit period, not per year — meaning if you’re hospitalized twice in one year and they’re counted as separate benefit periods, you could owe that deductible twice. Plan A doesn’t touch any of that.
So if you have Plan A and you end up in the hospital for five days, you’re paying $1,676 out of pocket before Plan A picks up anything hospital-related. That’s a real exposure most people aren’t expecting.
What Plan B Adds Over Plan A
Plan B covers everything Plan A covers, plus one thing: the Part A inpatient hospital deductible. That’s the $1,676-per-benefit-period deductible mentioned above. That single addition is the only difference between Plan A and Plan B.
Here’s a side-by-side look:
| Benefit | Plan A | Plan B |
|---|---|---|
| Part A coinsurance and hospital costs (up to 365 additional days) | Yes | Yes |
| Part B coinsurance or copayments | Yes | Yes |
| Blood (first 3 pints) | Yes | Yes |
| Part A hospice care coinsurance | Yes | Yes |
| Part A inpatient hospital deductible ($1,676 in 2026) | No | Yes |
| Skilled nursing facility coinsurance | No | No |
| Part B deductible ($257 in 2026) | No | No |
| Part B excess charges | No | No |
| Foreign travel emergency (up to plan limits) | No | No |
Plan B’s one improvement is genuinely meaningful. The Part A deductible is the most commonly triggered big-ticket exposure for Medicare beneficiaries. A short hospitalization — even just two nights — triggers that full $1,676. If you’re hospitalized more than once in a year, Plan B protects you each time.
That said, both plans leave a lot of gaps open. Skilled nursing facility coinsurance, which runs $209.50 per day for days 21 through 100 in 2026, isn’t covered by either. Neither is foreign travel emergency coverage, which matters more than people realize once they actually retire and start traveling.
The Mistake People Make When They Pick Plan A or Plan B
I’ve seen this happen too many times. Someone turns 65, gets a mailer from an insurance company showing a low premium for Plan A or Plan B, and thinks they’ve found a deal. They haven’t. They’ve bought the cheapest version of a product that already isn’t very expensive to begin with, at the cost of leaving themselves exposed to thousands of dollars in potential out-of-pocket costs.
The misconception is that a lower premium means you’re saving money. For Medigap, that’s often backwards. A plan with a lower premium but worse coverage can cost you far more in a year where you actually use healthcare. A 68-year-old in Ohio paying $85/month for Plan A looks like she’s saving money compared to someone paying $145/month for Plan G. But if she has one hospital stay, she’s immediately out $1,676 that Plan G would have covered. Her “savings” evaporate in a single billing cycle.
The other mistake: people confuse Medicare Supplement Plan A with Medicare Part A. They’re completely different things. Medicare Part A is the original hospital coverage you get through Medicare. Medicare Supplement Plan A is a private insurance product that fills gaps in your Medicare coverage. I know it sounds obvious when you lay it out like that, but the confusion is real and I’ve seen it derail entire purchasing decisions.
Who Should Actually Consider Plan A or Plan B in 2026
I want to be straight with you: most people shopping for Medigap in 2026 should not be stopping at Plan A or Plan B. Plans G and N offer dramatically better coverage, and the premium difference is often smaller than people expect. Plan G, which covers almost everything except the 2026 Part B deductible of $257, typically runs $100 to $200 per month at age 65 depending on your state, insurer, and health status during open enrollment.
That said, there are situations where Plan A or Plan B might make sense:
- You’re on a very tight fixed income and need to minimize monthly premium costs above all else
- You’re in excellent health and are willing to take on more financial risk in exchange for lower premiums
- You have other assets that could absorb a large unexpected medical bill without devastating your finances
- You live in a state like Massachusetts, Minnesota, or Wisconsin, which have their own standardized Medigap systems and these plan labels may not apply the same way
Between Plan A and Plan B specifically, I don’t see a strong argument for Plan A at all. Plan B adds the hospital deductible protection, and the premium difference between the two is usually modest. A 65-year-old in Texas might pay $10 to $20 more per month for Plan B than Plan A. Given that the Part A deductible alone is $1,676, you’d only need to trigger it once every seven to fourteen years to break even on that premium difference. Most people will exceed that easily.
Bottom Line
If you’re choosing between Plan A and Plan B, pick Plan B without much hesitation. The single benefit it adds over Plan A — covering the Part A hospital deductible — is worth more than its premium difference in almost every realistic scenario. But honestly, most people shopping for Medigap should be looking at Plan G or Plan N first, not stopping at Plan A or Plan B. These are entry-level plans, and if you can afford even slightly higher premiums, you’ll almost certainly be better protected by stepping up.
Frequently Asked Questions
Is Medicare Supplement Plan A the same as Medicare Part A?
No, and this mix-up is more common than you’d think. Medicare Part A is the hospital insurance component of original Medicare that you receive through the federal government. Medicare Supplement Plan A is a private insurance policy you buy to help cover what original Medicare doesn’t pay. They share a letter, but they’re completely different programs.
Why would anyone buy Plan A instead of Plan B?
Mainly the lower monthly premium. Plan A will generally cost a bit less per month than Plan B because it covers less. For someone with a very tight budget where every dollar matters, that can be the deciding factor. But if you have any flexibility at all, the extra coverage from Plan B is almost always worth it.
Can I switch from Plan A to Plan G later if I want better coverage?
You can try, but there’s no guarantee you’ll qualify. Outside of your initial Medigap open enrollment period (which starts when you’re 65 and enrolled in Part B), insurers in most states can require medical underwriting. That means they can deny you or charge you more based on your health history. If you have a serious diagnosis after you enroll in Plan A, switching to a better plan could be difficult or impossible.
Do Plan A and Plan B premiums vary by insurance company?
Yes, significantly. The benefits are standardized by federal law, so every Plan A has the same coverage no matter who sells it. But the premiums are set by each insurer individually. A 65-year-old woman in Florida could see Plan B premiums ranging from roughly $80 to $160 per month depending on the insurer. This is why it pays to compare quotes from multiple companies, not just go with the first mailer you receive.
