Medigap Plan F – Medigap Plan F is the Medicare supplement that provides the most comprehensive coverage. It covers both the Medicare Part A and B deductibles, all copayments, and all coinsurance. If you enroll in Plan F, you have no out-of-pocket medical expenses.
But what does that mean exactly? Are there any services that Plan F doesn’t cover? Who can enroll in this plan? How much does Plan F cost? We’re going to answer all of those questions and a few more.
What is a Medigap plan?
Let’s start by discussing what a Medigap plan is. Medigap plans are also called Medicare supplement plans, and they provide secondary insurance to your coverage from Medicare Part A and Part B. You may know by now that Parts A and B do not cover 100% of your healthcare costs. In Part A alone, you have a $1556 (in 2022) deductible, and coinsurance costs over $700 per day if you find yourself in the hospital for an extended stay. In addition, neither Part A nor Part B has out-of-pocket limits on what you could pay in any given year. That’s why so many people choose to enroll in the Plan F Medicare supplement.
Plan F is not the only Medigap plan available to beneficiaries. There are about nine other options, plus a high-deductible Plan F and Plan G. The nice thing about Medicare supplements is that their coverage is standardized. That means that no matter where you purchase a plan, it will always be the same. You can purchase Plan F in Mississippi from Company A or Plan F in California from Company B, and you’ll have the exact same benefits.
What does Medicare Supplement Plan F cover?
Medigap Plan F is the most comprehensive Medigap plan out of all Medicare supplement policies.
Plan F covers:
- Part A deductible
- Part A coinsurance and hospital costs with an additional 365 days after Original Medicare’s benefits are exhausted
- Part A hospice care coinsurance
- Skilled nursing facility care coinsurance
- Part B deductible
- Part B excess charges
- Part B coinsurance and copayments
- First three pints of blood used in an approved medical procedure
- 80% of a foreign travel emergency (up to plan limits)
As you can see, there’s a reason Medicare supplemental Plan F has been called the Cadillac of Medicare supplements. It picks up every remaining cost after Original Medicare has paid its share. That’s right – that means there are no out-of-pocket costs for Medicare-approved services.
What doesn’t Plan F cover?
Before you run to sign up for Plan F, there are a few more things you need to know. First, let’s discuss some of the things not covered by Plan F or any of the other Medicare supplement plans. To put it simply, if it’s not covered by Original Medicare, it won’t be covered by your Medicare supplement.
No Medigap plan covers prescription drugs. There are a few select prescriptions that are covered under Medicare Part B. Those would also be covered by Plan F. However, if we’re talking about prescriptions that you take at home and pick up from your local pharmacy, they’re generally not covered. To get prescription drug coverage, you’ll need to enroll in a stand-alone Part D plan. Medicare Part D includes all prescription drug plans – that’s the only thing you’ll find in Part D. It’s important that if you enroll in a Medigap plan, you also enroll in Part D. If you don’t, you will be penalized and pay a monthly fee when you do decide to enroll. You’ll pay that penalty for life.
Original Medicare and Medigap plans also do not cover routine dental, vision, or hearing services. You won’t find coverage for dentures or a new pair of eyeglasses. (There are very select vision and hearing services included in Part B, but only when they pertain to a condition like glaucoma, for example.) If you’d like coverage for these services, there are other options. DVH (dental, vision, hearing) plans are a popular way to get insurance for those services Medicare doesn’t cover.
Is Plan F the best Medicare supplement plan?
Plan F was certainly the most popular Medicare supplement until recent years. We’ve already discussed why it was so popular. However, its popularity started to decline in 2020 due to MACRA.
MACRA is the Medicare Access and CHIP Reauthorization Act. It was put in place in 2015, though we didn’t see changes to Plan F until 2020. MACRA ruled that no Medicare supplement plan could offer 100% cost-sharing payments. Plan F and Plan C both did just that, so plans were made to phase them out of the Medigap lineup.
To be eligible for Plan F, you must have turned 65 before January 1, 2020. Anyone already enrolled in Plan F was allowed to keep their policy, and anyone who had delayed Medicare enrollment could also still get Plan F, as long as they met the birthday cutoff.
But is Plan F the best Medicare supplement plan? If you’re simply looking at coverage, yes, it is the best plan. However, that doesn’t mean it’s the right choice for everyone. There are other things to consider when it comes to your Medicare options, so you should speak to a licensed insurance agent to find out if Plan F is the best supplement for you.
Which healthcare providers accept the Plan F Medicare supplement?
Provider acceptance is another thing that makes Plan F – and other Medigap plans – so popular. As long as a provider accepts Medicare, they’ll also accept your Medicare supplement insurance. It does not matter which plan you have or which insurance company carries it. There are no “networks” when it comes to Medigap policies. Approximately 96% of all healthcare providers accept Medicare, so you’ll have no problem finding a doctor who accepts Medicare supplements.
How much does Plan F cost?
The cost of Plan F depends on a variety of factors. Your age, gender, tobacco use, and zip code all play a part in setting your premiums. In addition, private insurance companies use different rating methods and can choose their own premiums. (This is why it’s important to shop at different carriers. Why pay more for a plan that’s the same everywhere?)
A Medicare beneficiary in their late-60s should expect to pay a minimum of $150 per month for Plan F. Of course, that’s just an average. In states where the cost of living is higher, a person of the same age could pay more than $300.
Also, keep in mind that Medigap premiums tend to increase as we age since we can assume that our healthcare needs will as well. Plan F is increasing at a faster rate than some of the other medicare supplement plans because the average age of Plan F enrollees is getting higher each year.
Alternatives to Plan F
If you aren’t eligible for Plan F or can’t afford those higher monthly premiums, you have plenty of other great options. Both Plans G and N still have minimal out-of-pocket costs and are an excellent alternative to Plan F.
In fact, many people who are eligible for Plan F still choose one of these other options simply for the lower premiums. In many cases, the lower premiums offer enough cost savings to pay for the out-of-pocket expenses you’ll have.
Plan F versus Medicare Advantage
If you’ve turned your TV on at all in the last year, you’ve probably seen a ton of commercials for Medicare Advantage (Part C) plans. They are becoming accessible to more parts of the U.S. and do have some excellent benefits. But how do Medicare Advantage plans compare to Plan F?
It’s difficult to make a simple comparison between these two types of Medicare plans. But, you’ll need to choose one or the other if you want more coverage than just Original Medicare. (You can’t have both.) You’ll need to spend more time learning about Medicare Advantage plans if you decide to consider one, but we’ll review some of the basic differences between the two plans.
Cost: Premiums for Plan F will be higher than with a Medicare Advantage plan. (Some Advantage plans have a $0 monthly premium.) However, you’ll have more out-of-pocket expenses if you enroll in Medicare Advantage.
Accessibility: Medigap plans are available all over the country. Medicare Advantage plan availability varies from one county to the next. Some counties have many options, while others may have just one.
Networks: We said that you could use your Medigap Plan F nearly anywhere. That is not true with Advantage plans. You’ll need to utilize your plan’s specific network of doctors and facilities to have coverage.
Benefits: Medicare Advantage plans typically include extra benefits not found in Medigap plans. You might have prescription drug coverage, dental and vision care, gym memberships, meal delivery, and more. Benefits vary by plan.
So, which option is better? It really depends on your unique needs and budget. Individuals who know they require a lot of medical attention should probably consider a Medicare supplement plan instead of an Advantage plan because their costs are much more predictable. But if you’re healthy or don’t mind paying for services as you need them, an Advantage plan can be a great option.
How do I enroll in Plan F?
If you are ready to enroll in Plan F, give Bobby Brock Insurance a call today. Our licensed insurance agents can answer any Medicare questions you have and shop from many different insurance companies to find you a competitive rate. The best part? Our services come at no additional cost to you, and your premiums won’t go up just because you used our services.
Our expert Medicare advisors are waiting for you!
Frequently Asked Questions
How much does Plan F cost?
The cost for Plan F averages between $150 – $300. Your age, gender, and zip code will greatly affect your monthly premium.
Is Plan F better than Plan G?
Plan F offers more coverage than Plan G, but it is more expensive, and not everyone is eligible. The best plan for you is the one that fits your medical needs and budget.
Who can enroll in Plan F?
Medicare beneficiaries who turned 65 before January 2020 can enroll in Plan F. You must be enrolled in Part A and Part B to enroll in any Medicare supplement plan.
Does Plan F cover dental?
No, Plan F does not include routine dental care.
What is Medicare Plan F?
Medicare Plan F is the same this is Medigap Plan F and Medicare supplement Plan F.