Medicare Supplement Overview
Understanding Medicare Supplement Plan F
Medicare Supplement Plan F, often called Medigap Plan F, is one of the most comprehensive supplement plans available. For years, it has been a popular choice for Medicare beneficiaries because it covers nearly all the gaps in Original Medicare, including deductibles, copayments, and coinsurance. This means that with Plan F, you could have virtually no out-of-pocket costs for Medicare-approved services, giving you predictable healthcare expenses and significant peace of mind.
Keep reading or jump to our Highlights and Frequently Asked Questions.
What is Medicare Supplement Plan F?
Medicare Supplement plans, also known as Medigap, are sold by private insurance companies to help pay for some of the healthcare costs that Original Medicare (Part A and Part B) doesn’t cover. Plan F is often considered the “Cadillac” of these plans due to its extensive coverage.
What Does Plan F Cover?
Plan F offers the most robust benefits of any Medigap plan. If you have Plan F, it will cover the following out-of-pocket costs:
- Part A Coinsurance and Hospital Costs: Covers the daily coinsurance for hospital stays and provides coverage for an additional 365 days after your Medicare benefits are used up.
- Part B Coinsurance or Copayment: Pays the 20% coinsurance that you would typically owe for most doctor’s services and outpatient care.
- Blood (First 3 Pints): Covers the cost of the first three pints of blood needed for a medical procedure.
- Part A Hospice Care Coinsurance or Copayment: Pays for the out-of-pocket costs associated with hospice care.
- Skilled Nursing Facility Care Coinsurance: Covers the coinsurance for stays in a skilled nursing facility.
- Part A Deductible: Pays the inpatient hospital deductible that you would otherwise be responsible for.
- Part B Deductible: Covers the annual deductible for Medicare Part B.
- Part B Excess Charges: If your doctor charges more than the Medicare-approved amount, Plan F covers these excess charges.
- Foreign Travel Emergency: Provides coverage for medical emergencies when you are traveling outside the United States.
With this level of coverage, you can visit any doctor or hospital that accepts Medicare nationwide without worrying about network restrictions or unexpected bills for covered services. For more official information, you can always visit the official Medicare website at Medicare.gov.
Who is Eligible for Plan F?
An important change occurred regarding Plan F eligibility. Due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigap plans that cover the Part B deductible are no longer available to newly eligible Medicare beneficiaries.
This means:
- If you were eligible for Medicare before January 1, 2020: You can still purchase Plan F if it is available in your area. You can also keep your Plan F if you already have it.
- If you became eligible for Medicare on or after January 1, 2020: You are not able to purchase Plan F. However, similar comprehensive plans, such as Plan G, are available to you.
High-Deductible Plan F
There is also a high-deductible version of Plan F. With this option, you must pay for Medicare-covered costs up to a certain deductible amount before your supplement plan begins to pay for anything. This results in a lower monthly premium. This option is also only available to those who were eligible for Medicare before January 1, 2020.
Medicare Can Be Confusing
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Medicare Supplement Plan F
Frequently Asked Questions
If I have Plan F, do I still need to pay my Part B premium?
Yes. A Medicare Supplement plan is secondary to your Original Medicare coverage. You must continue to pay your monthly Medicare Part B premium to the government, in addition to the premium for your Plan F policy.
Can I be denied coverage for Plan F?
During your Medigap Open Enrollment Period, which is the six-month window that starts the month you are 65 or older and enrolled in Part B, insurance companies cannot deny you coverage or charge you more due to health conditions. Outside of this period, you may have to go through medical underwriting and could be denied.
Why would I choose Plan G over Plan F if I am eligible for both?
Plan G offers nearly identical coverage to Plan F, with one exception: it does not cover the annual Medicare Part B deductible. Often, the premium savings on Plan G compared to Plan F are greater than the Part B deductible amount, making Plan G a more cost-effective choice for many people.
Insurance Connection USA is a division of Garrison Enterprises a licensed Insurance agency and not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the United States government or the federal Medicare program.
Important Highlights
Medicare Supplement Plan F offers the most comprehensive coverage available, paying for nearly all of your out-of-pocket costs under Original Medicare.
If you are new to Medicare, you cannot buy Plan F, but other comprehensive options like Plan G are available.
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