Plan A (PLH-5372MSA-19)

Plan A covers the four Basic Benefits, which include hospitalization, medical expenses, blood and hospice care. EmblemHealth pays Part B coinsurance* (20 percent of Medicare-approved expenses), Medicare pays 80 percent. There is no referral required. See any doctor who accepts Medicare patients.

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  • Hospitalization: EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare stops paying.
  • Medical Expenses: EmblemHealth pays Part B coinsurance* (20 percent of Medicare-approved expenses), Medicare pays 80 percent.
  • Blood: First three pints of blood each year.
  • Hospice care: EmblemHealth pays Part A coinsurance.*

*Coinsurance is the portion or percentage of the cost of a Medicare covered service that you are responsible to pay.


  • 2019 Medicare Supplement Benefit Chart

  • 2019 Medicare Supplement Brochure

  • Medicare Supplement Application Form

Last Updated 10/29/18

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