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Everything You Should Know About Medigap Plan F

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Medigap Plan F Plan F is the most comprehensive Medicare supplement. It offers first-dollar coverage, which means it leaves the beneficiary with virtually no out-of-pocket expenses. If you’re looking for the most comprehensive Medigap plan, look no further than Plan F.

However, there are a few more things you should know before you decide to enroll. Let’s take a deeper look into Medigap Plan F.

What is covered under Medigap Plan F?

Medicare Plan F provides benefits for all the costs that Original Medicare leaves behind. If you enroll in Plan F, you’ll have no cost-sharing responsibility. Your only expense will be the monthly premium itself.

As long as your service is covered by Original Medicare and your doctor accepts Medicare, Plan F will pay the rest. There are no provider networks associated with Medicare supplements, so your plan can be used anywhere.

Here are the expenses that will be left by Original Medicare but covered under Plan F:

  • Part A deductible ($1556 per benefit period in 2022)
  • Part A coinsurance costs with an additional 365 days of coverage
  • Skilled nursing facility coinsurance costs
  • First 3 pints of blood
  • Part B deductible ($233 in 2022)
  • Part B copayments and coinsurance costs
  • Part B excess charges
  • Foreign travel emergency, up to plan limits

How much does Plan F cost?

As you might expect, this type of comprehensive coverage does come with a higher price tag.

Medicare beneficiaries in their late-60s can expect to pay at least $175 per month, but there are various factors that impact your rate. Your monthly premium is based on your gender, age, tobacco use, and where you live. The premium will also vary from one insurance company to the next.

Medicare supplements typically increase as you age. Some plans increase their rates faster than others, as do some insurance companies. Plan F has seen a higher rate of increase than some of the other Medicare supplements. The reason for the larger increases is that the pool of individuals enrolled in Plan F is aging. (New beneficiaries can’t enroll in Plan F, which we’ll discuss later.) An older population means more healthcare costs, which is a major contributing factor to Plan F premium increases.

If you decide that Plan F is the best choice for you, you should also ask your licensed insurance agent about which companies are known for lower rate increases. While we can’t predict their future movements, we can at least look at their history of rate increases to make educated choices.

Happy retired senior couple enjoying tea as they discuss medigap plan F.
Plan F has seen a higher rate of increase than some of the other Medicare supplements.

Who can enroll in Medicare Supplement Plan F?

Plan F eligibility is now limited to individuals who turned 65 before January 2020. Medicare supplements never change their benefits, but there are very occasional changes to their eligibility requirements. The most recent one occurred as a result of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

One of the goals of MACRA was to increase provider reimbursements to encourage them to continue participating in the Medicare program. While this was great for providers and patients alike, it did mean that the program had to find ways to increase income. An easy way to do that was to remove Medigap plans that offered first-dollar coverage. Plan F was put on the chopping block.

Anyone who already had Plan F was allowed to keep their plan. Also, anyone who delayed Medicare enrollment can still enroll in Plan F today, as long as they turned 65 before January 1, 2020.

The other basic Medigap eligibility requirements are also still in place. You must be enrolled in both Medicare Part A and Part B to enroll in any Medicare supplement plan.

What’s the best alternative to Plan F?

If you’d like to consider an alternative to Plan F, there are plenty of good options. You have nine other Medicare supplements to choose from, plus a high-deductible version of Plans F and G.

The plan that is closest in benefits to Plan F is Medigap Plan G. It has nearly identical benefits, save for one. It does not cover the Part B deductible. However, since it doesn’t offer first-dollar coverage, anyone who is enrolled in both parts of Medicare can enroll in Plan G.

Even if you are eligible for Plan F, you may want to consider choosing Plan G instead. It offers lower premiums, which usually more than makeup for the $233 difference in coverage. That being said, you should be aware that rate increases for Plan G will likely mirror Plan F overtime.

High-deductible Plan F is another great option. The benefits are the same as Plan F, but you must first pay the deductible before your coverage begins. In 2022, the deductible is $2,490. The same birthday rule applies to this version. However, beneficiaries will see much lower premiums than with the standard plan. You can expect to pay around $35 a month for high-deductible Plan F.

We hope this deeper look into Plan F has been helpful. If you’re still not sure which plan to choose, you’re not alone! Almost everyone seeks the help of a licensed insurance agent when they need to choose a Medicare supplement plan. Our Medicare advisors will educate you on your options and help you find the plan that’s right for you. Our services come at no additional cost to you, so call us today and speak with one of our trusted agents!

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