Before we go into detail about Medicare Plan F, the government has enacted a major change to this plan.
As of Jan. 1, 2020, new Medicare enrollees will not be able to purchase Medicare Plan F. If you already have Plan F, you will be grandfathered in. You may keep the plan.
Because Plan F was such a popular plan, we understand the disappointment. However, we will give you a few comparable options in this article.
In This Article:
- What is Medicare Plan F?
- Benefits of Medicare Plan F?
- What Medicare Plan F Pays
- How Much Does Medicare Plan F Cost?
- Medicare Plan F vs. Plan G
- Plan F Commonly Asked Questions
- Is Plan F Being Phased Out?
- Why You Need A Medicare Supplement Plan
What is Medicare Plan F?
Medicare Plan F has, up until 2020, been the most sought after Medicare Supplement Plan.
Due to its extensive coverage, many seniors added this plan. Last year, Congress passed a bill stating after Jan. 1, 2020, any new enrollees would not be able to purchase Plan F.
Alternatives To Medicare Plan F
If you were enrolled in Medicare BEFORE Jan. 1, 2020, you still have the option to purchase Plan F.
Benefits of Medicare Plan F
Plan F was known as the “buy it and forget it” plan because it covers so much. This plan can cut out any unexpected expenses left from Medicare gaps.
If you’re looking for a plan that offers extra coverage at an affordable price, Plan F has been the best option.
Check out this list of benefits the Medigap Plan F offers to those who enrolled on time:
- Covers Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits used).
- Covers Medicare Part B coinsurance copayments.
- Covers skilled nursing facility coinsurance.
- Covers Part A Hospice Care coinsurance or copayments.
- Offers foreign travel emergency (up to plan limits)
- Covers Medicare Part A deductible.
- Covers Medicare Part B deductible.
- Blood (first 3 pints)
- Covers Medicare Part B extra charges.
Plan F Means No More Copays
Plan F pays for all copays Medicare Part A and B don’t cover including hospital and outpatient deductibles — even the remaining 20 percent left behind by Part B. This means you never have to pay a dime at the hospital or doctor’s office.
Plan F Means Full Coverage
Adding Plan F means 100 percent protection of your wallet, paying for any and all gaps of coverage.
Here are few bulleted points explaining the comprehensive coverage:
- Choose any doctor: There is no coverage net you need to stay under.
- Covers all extra Part B expenses: You won’t have to deal with the 15 percent doctor’s can charge under Medicare.
- No Doctor Referral Needed: You can see a Medicare agent without a doctor’s referral.
- Deductible Coverage: Completely covers both Part A hospital deductibles and Part B outpatient deductibles.
- Guaranteed renewal: Don’t worry about the number of claims or any new health conditions you may be diagnosed with each year.
- Fills The Gap: Fills in the 20 percent gap Part B leaves behind.
Is your Plan F the same Plan F as your friends or coworkers even if they come through different providers?
Yes! The benefits are standardized across the board. Each company may charge different rates, have different customer service reputations, and even offer unique discounts.
Be sure to compare companies to find one that aligns best with your budget.
Plan F Pays Deductibles and Coinsurance
To better understand Plan F’s coverage, let’s run a scenario using a 70 year old male, Cecil.
Cecil found a Medicare agent and with the agent’s help, researched several companies that offered the coverage he wanted at the prices he needed. Deciding Plan F fits best, he applied and was accepted.
Cecil began to notice hip pain while on his morning walks with his wife, Clara. At Clara’s urging, Cecil reluctantly went to his physician. His doctor recommended Cecil see a specialist and have extensive testing.
In the checkout line, Cecil imagined that brand new camper fading away, being replaced with doctors and hospital bills. He was pleasantly surprised when he realized he had Plan F which could pay all his expenses.
Even though Cecil did, in fact, need a full hip replacement, in-home care for a few weeks, and extensive physical therapy, he didn’t pay a dime out of pocket to his health care providers. He spent out-of-pocket money only on his medications.
Medicare Supplemental Insurance Plan F, just like all the Medicare supplement plans, is billed through the Medicare billing system. So you don’t have to pay anything out of pocket.
Medical Service: What Medicare Plan F Pays
Overall you should experience the least hassle with this type of coverage. But to make it clearer, this chart will show how Plan F should work if you were to be hospitalized:
|Medical Service||What Medicare Pays||What Plan F Pays||Your Cost|
|Hospitalization First 60 Days||Everything Except $1,184||$1,184||$0|
|Hospitalization Days 61-90||Everything Except $269 per day||$269 per day||$0|
|Hospitalization Days 91-150||Everything Except $592 per day||$592 per day||$0|
|Hospitalization Next 365 Days||$0||All Medicare Eligible Expenses||$0|
|Hospitalization Additional 365 Days||$0||$0||All Costs|
As you can see Medigap Plan F picks up all the charges and you are given an additional 365 days of hospitalization coverage by the plan. Having a Plan F policy will keep you from being saddled with a dozen of different medical bills after you leave the hospital.
This goes for all nine gaps left by Medicare. In fact, the only charges you could incur when you have one of these plans are the hospitalization past 515 days, skilled nursing care past 100 days, and the first $250 and a 20 percent coinsurance if you were to have a foreign travel emergency.
Compared to all the other out-of-pocket expenses left by other Medigap policy, Plan F could save you thousands of dollars in an emergency situation. Plan F costs more each month, but you are completely covered from all expenses be those doctors or hospital bills.
How Much Does Medicare Plan F Cost?
The only real way to know how much any Medicare supplement will cost will be to run a set of quotes.
Because each person is different, there’s not really a way to give you a ballpark figure. If you are 75 and have some health issues you will typically pay more than someone who is 69 and in perfect health. The costs will also vary depending on what state you live in, and each state has drastically different premium averages.
Your health rating also directly affects your premium costs. There are three ways to rate Medicare supplement insurance:
- Attained-Age Rating: Premiums are based on your current age and will likely increase as you age.
- Community Rating: This type of rating means that everyone in a community gets the same rates. Whether you are 65 or 71, you will still pay the same rates.
- Issue-Age Rating: Premiums are based on the age you are when the policy is issued. So as you age the premiums stay the same. This type of rating tends to be slightly higher than attained-age if you get the policy right at 65, but over time could save you money.
Each of these pricing methods has different advantages and disadvantages depending on your age and current health.
For example, with a community-rated plan, you may pay more in monthly premiums when you first enroll, but you’ll save money as you age.
With the various ratings, it is very important to enroll in your Medigap plan within six months of starting your Medicare Part B Coverage. This period is known as the open enrollment period.
During this time, the insurance companies are not legally allowed to take your health into consideration when they issue your policy. They take only your age and other demographic factors into account.
So if you have any health conditions, open enrollment will be the absolute best time to get the lowest rates. To see what your rates will look like just use the form on this page to get started.
When looking for a Medigap plan, you should be aware of a “pre-existing condition waiting period” clause which could impact your supplemental insurance.
The pre-existing condition waiting period means the insurance company could refuse payment for health care expenses related to a health complication you had before you purchased the policy.
While they are legally allowed to have one of these waiting periods, they can deny your coverage for the pre-existing condition only for six months after you sign the policy.
Plan F vs. Plan G
Medicare Plan G is very similar to Plan F, and with the new restrictions, Plan G can save you several hundred dollars a month.
So, What are the differences?
Medicare supplemental plan G has the same coverage as Medicare plan F except it does not cover the $183 annual deductible that comes with Medicare Part B.
At this point we have to do some math. If the premiums for Plan G are $20 less per month, then you would spend $240 less per year (12 months x $20 = $240).
Even after paying the deductible, it is a savings of $93 annually for plan G over Medicare supplement insurance plan F. Now if the monthly savings for Plan G had been less, then F would have been a better choice.
If your budget isn’t as tight, you might like the idea of not having to think about any additional charges. Keep in mind these two plans frequently get closer in price as a person ages. You may decide to pay the slightly higher amount now to avoid the future hassle of a deductible.
Common Questions for Plan F
We’ve put together nine frequently asked questions concerning Plan F:
What does Plan F cover?
Plan F covers all costs left behind by Part A and B.
What is the difference between Medicare Plan F and Medicare Part F?
Medicare has four parts:
Medigap has plans. So Medicare Part F is the wrong term.
Will it cover prescription drug costs?
You will pay for retail prescriptions. If you enroll in Medicare Part D to have drug costs covered. All Medigap plans cover medicines administered in a clinical setting or hospital.
Can I still get Plan F?
If you were eligible for Medicare BEFORE Jan. 1, 2020, yes. Anyone enrolling past this date will need to find a comparable plan.
Which Medigap Plan is the most popular?
As of 2020, Plans F and G are the most popular. Plan G is rapidly growing in popularity due to the limited availability of Plan F.
Does Plan F cover Dental, Hearing, and Vision visits?
No, Medigap plans cover routine dental, vision, and hearing visits. Your best option is to buy a standalone policy that works best for your situation.
Does Plan F cover chiropractic care?
Medicare pays 80 percent and Plan F covers the other 20 percent. The only service you are responsible for paying is X-rays.
What are the top 10 companies to purchase Plan F?
Medigap benefits stay the same across the board thanks to government regulation. Check out our post detailing the top Medicare Supplement Companies to help find the right company and plan for you.
Should I choose Plan G or Plan F?
Plan G covers less (does not cover Part B’s 20 percent deductible) but has lower monthly premiums.
Is Plan F Being Phased Out?
Eventually, Plan F will be phased out completely. Due to the new Medicare regulations effective Jan. 1, 2020, new Medicare enrollees will not be able to choose Plan F.
If you have enrolled in Medicare before Jan. 1, 2020, and currently have Plan F, don’t panic. There is no pressure to switch unless it makes the most sense for your budget. You can keep Plan F for as long as you want or need.
This seems like a lot of information. Transitioning into Medicare does not have to be a stressful experience. We are here to help you find the right plan that best fits your budget!
Why Do You Need A Medicare Supplement Plan?
Every year, we hear stories of thousands of seniors draining their savings accounts. Health care expenses can take huge bites out of your hard-earned nest egg.
We know navigating the Medicare waters can be frustrating. We’re here to help. Our goal is to help you find the best Medicare supplement plan for you.
You could choose from up to 10 Medicare supplemental insurance plans to cover leftover expenses Medicare will not cover. These plans fill the gap in your coverage so you don’t have to spend as much out of pocket.
While each supplemental plan covers a different number or combination of the gaps, Plan F (now Plan G) has been the most comprehensive and popular plan.
If you already understand Medicare and its supplemental options, you can get quotes for any of the Medicare supplements by filling out the form on the side of this page.