Medigap Plan F, also known as Medicare Supplement Plan F, provides extensive coverage for Medicare deductibles, copays, and coinsurance, ensuring that you won’t have any out-of-pocket expenses for Medicare-approved services. It has been the preferred choice among Medicare beneficiaries for a significant period, with approximately 57% of all Medigap policies in force being Plan F policies, as per a 2016 report by America’s Health Insurance Plans (AHIP). However, eligibility for Plan F is now limited to individuals who became eligible for Medicare before January 1, 2020. If you became eligible on or after this date, Plan F is not an option for you.
In such cases, Plan G emerges as the most comprehensive Medigap plan available. Plan G has gained immense popularity in recent years and offers extensive coverage similar to Plan F.
A Medigap plan, also known as a Medicare Supplement, is designed to assist in covering deductibles, copays, and coinsurance that would otherwise be your responsibility after Medicare pays its portion. It’s important to note that Medigap plans do not replace Medicare Part B. To be eligible for a Medigap Plan F policy, you must first have Medicare Part A and Part B. When you choose to add either Plan F or Plan G to your existing Original Medicare benefits, your coverage becomes quite comprehensive. Medigap Plan F is considered the Medicare Supplement policy with the most extensive range of benefits. While some individuals may refer to it as Medicare Part F or Medigap Part F, it is important to use the correct terminology, which is Plan F. Remember, only Medicare has Parts.
Choosing Plan F
Medicare Plan F is highly favored due to its comprehensive coverage, as it fills in all the loopholes in Original Medicare Part A and Part B. This includes covering your hospital and outpatient deductibles, as well as the 20% that Medicare Part B does not typically cover.
Consequently, you will no longer have to pay anything out-of-pocket for Medicare-approved services during your visits to the doctor’s office.
Medicare Supplement Plan F provides extensive coverage.
Medicare Plan F policies provide comprehensive coverage, ensuring that you have minimal out-of-pocket expenses. Once Medicare has paid its portion of your medical claims, Medigap Plan F steps in to cover the remaining costs, leaving you with zero out-of-pocket expenses.
With Plan F, you can rest assured knowing that both your Part A hospital deductible and your Part B outpatient deductible are covered. Additionally, it takes care of the 20% that Medicare Part B typically requires you to pay.
One of the significant advantages of Medicare Plan F is that it covers all Part B excess charges. This means that you will never have to pay the standard 15% excess charges that doctors under Medicare are allowed to charge for Part B services.
Moreover, you have the freedom to choose any doctor in the United States who accepts Medicare insurance. No referrals are required, allowing you to see any Medicare specialist whenever you need to without having to obtain a referral from your primary care doctor. However, it’s worth noting that some offices may still require a referral.
Lastly, Medicare Plan F offers guaranteed renewable coverage. Regardless of your health conditions or the number of claims you file, your policy cannot be canceled. This ensures that you have continuous coverage and peace of mind.
Medicare Plan F covers both your deductibles and co-insurance expenses.
If you do not have Supplement, you will be responsible for a $1,632 deductible (Part A deductible in 2024) when you visit the hospital. Additionally, you will have to pay 20% for costly procedures such as surgery since Part B only covers 80%.
However, if you have a Medigap F policy, your insurance will cover all of these expenses.
It may come as a surprise to discover that numerous reputable insurance companies with excellent financial ratings offer lower rates than well-known brand-name carriers.
What is the cost of Medicare Plan F?
The cost of Medicare Plan F can vary depending on factors such as location, gender, zip code, and tobacco usage. Generally, the pricing for a female turning 65 ranges from $120 to $140 per month in many areas. However, it is always crucial to obtain quotes specific to your area when considering the cost of Medicare Plan F.
In most cases, the cost of Plan F for males tends to be slightly higher compared to females. Additionally, tobacco users often have a higher cost for Medigap Plan F compared to non-tobacco users. Some insurance companies also offer household discounts for their Medicare Supplement policies.
It is not uncommon to come across individuals who have been enrolled in Plan F for several years. Due to the comprehensive coverage it provides, they may be hesitant to switch carriers. The good news is that the benefits of Plan F remain the same regardless of the Medigap company offering it. Therefore, it is important to compare the cost of Medicare Plan F among insurance companies annually to find the most affordable option in your area.
Most states require underwriting when making changes.
In order to switch to a different Medigap policy, it is typically necessary to answer health questions. Nevertheless, there are specific enrollment periods in some states that enable Medicare beneficiaries to change Medigap policies without undergoing underwriting.
If you currently have Plan F and are considering making a change, it is advisable to check if your state provides any of these guaranteed issue periods.
Since Medigap rates change on a yearly basis, it is beneficial to review your Medigap coverage annually to ensure that you still have a plan that is cost-effective and helps you manage your expenses effectively.
Example of Plan F Expenses
For instance, let’s consider the case of John, a Medicare beneficiary who applies for Medigap Plan F. After his application is approved by the insurance company, John visits an orthopedic specialist to address his knee issues.
Medicare covers 80% of the specialist visit cost, while Plan F takes care of the remaining 20% under Part B.
Consequently, John doesn’t have to pay anything out of pocket.
Later on, the orthopedic specialist refers John to an imaging facility for an MRI of his knee. Medicare covers 80% of the MRI cost, while Medicare F covers the remaining 20%. Once again, John is not required to make any payments.
The MRI results reveal significant problems, leading the orthopedic specialist to recommend a total knee replacement for John. He undergoes the surgery at his local hospital and stays there for a couple of days. Additionally, John receives home health care from a nurse who visits him several times in the weeks following the surgery.
John’s surgery, hospital stay, and follow-up care amount to a total cost of $70,000. After Medicare covers its portion of the expenses, the remaining $14,000 is sent to John’s Supplemental insurance carrier. The carrier takes care of the entire bill, leaving John with no financial obligation for any of the Part A and Part B services mentioned. The only expenses she would need to cover out-of-pocket are for medications.
This implies that the cost of Medicare Supplement Plan F is solely the premium paid for the plan itself. The rates for Medicare Supplement Plan F may vary depending on the insurance company, but you can be confident that there are no additional expenses for services approved by Medicare.
Frequently Asked Questions
What is Medicare Plan F?
Medicare Plan F, also known as Medigap Plan F, stands as the most extensive Medicare supplement plan available. With this plan, you can rest assured knowing that it covers all Medicare deductibles, copays, and coinsurance, leaving you with no out-of-pocket expenses for the entire year.
Can I still Enroll in Plan F?
Individuals who met the eligibility criteria for Medicare before 2020 will still have the opportunity to purchase Plan F. This applies whether you enrolled in Medicare at the age of 65 or postponed it due to having creditable coverage. As long as you were eligible for Medicare prior to January 1, 2020, you remain eligible for Plan F.
What is the cost for Medicare Plan F?
The cost of Medicare Plan F can differ based on various factors. These factors include the location, gender, zip code, and tobacco usage. While the average pricing for a female turning 65 in numerous areas ranges from $130 to $140 per month, it is crucial to obtain personalized quotes for the cost of Medicare Plan F in your specific area.
What is Medicare Plan F Coverage?
The cost of Medicare Plan F can differ based on various factors. These factors include the location, gender, zip code, and tobacco usage. While the average pricing for a female turning 65 in numerous areas ranges from $130 to $140 per month, it is crucial to obtain personalized quotes for the cost of Medicare Plan F in your specific area.
Does Plan F Cover Prescription Drugs?
All Medigap plans provide coverage for medications administered in a hospital or clinical setting. Nevertheless, it’s important to note that Medigap plans do not include coverage for retail prescriptions. To ensure coverage for your retail prescription drugs, it is advisable to enroll in Part D.
Does Plan F Cover Dental, Vision and hearing?
No Medigap plan provides coverage for routine dental, vision, or hearing services. Nevertheless, there are numerous excellent standalone plans available for enrollment that offer these benefits at an affordable price. Our agency provides one such plan that allows you to utilize your preferred providers, and the benefits increase gradually over time.
Does Plan F cover Chiropractic?
Medicare provides coverage for 80% of adjustments, while the remaining 20% is covered by Plan F. However, it’s important to note that Medicare does not extend coverage to additional services offered by chiropractors, including x-rays.
What are the most popular Medigaps?
The top Medigap plans for 2024 remain Plan F and Plan G. Although Plan F has traditionally been the preferred choice, Plan G is rapidly gaining momentum due to the unavailability of Plan F for new enrollees. Obtain a quote for both plans and determine which one provides the most advantageous annual savings for you.
What are the Top Insurance companies?
The variation in Medicare Supplement insurance plans is dependent on the region. The standardized nature of these plans ensures that the benefits remain consistent, eliminating any concerns about differences. Therefore, it is essential to explore the Medicare gap plans available in your specific area to find the ones with the most affordable rates. It is important to note that the best rates for Supplemental insurance will differ from state to state, and factors such as age, gender, tobacco usage, and eligibility for household discount will also impact your rate.
Should I switch from Plan F to Plan G?
The determination of whether Plan G is a better value than Plan F depends on the premium of your Plan F and your location, which may require you to answer health-related inquiries. Nevertheless, opting for Plan G often results in lower premiums, making it a more cost-effective choice. It is crucial to carefully compare the figures before making a decision. In my perspective, the ideal Medicare plan is the one that minimizes your annual out-of-pocket expenses and exhibits the lowest rate hikes in recent times.
Is Plan F going away?
Many individuals inquire about the discontinuation of Medicare Plan F. Indeed, starting from 2020, Plan F is being gradually eliminated. It will no longer be an option for new enrollees. However, those who are already enrolled in Medicare Plan F will be able to retain their coverage. Congress has passed a legislation that prohibits Medicare Supplement policies from covering the Part B deductible for newly eligible Medicare beneficiaries as of January 1, 2020.
Takeaways
By enrolling in Medicare Supplement Plan F, you can enjoy the benefit of having no out-of-pocket expenses for Medicare-approved services. However, it’s worth considering that Plan G might be a more cost-effective option due to its lower premium. It’s important to note that eligibility for Plan F varies among beneficiaries and depends on their Medicare eligibility period.
Mario Arce
I have been working with Medicare clients since 2016. I serve California members in San Bernardino & Riverside county.
