Medicare Plan F Important Details
What’s the Difference Between Medigap Plan F and Original Medicare?
Original Medicare is a program managed by the federal government, which offers medical coverage under three main parts:
- Part A — Hospital insurance, including long-term hospital care, skilled nursing facility care, hospice and palliative care, and home health care.
- Part B — Covers many medically necessary and preventative services not covered under Part A.
- Part D — Prescription drug coverage.
You can also find these same coverages, along with extras, under Part C plans (also known as Advantage plans), which, like Medigap plans, are offered by individual insurance carriers.
Comparatively, supplementary Medigap plans — which are lettered A through N — cover the excess charges not covered by Original Medicare, such as out-of-pocket costs for hospital and doctor’s office care.
Compared to other types of health insurance, Medigap plans are standardized, which means each plan offers the same coverage, regardless of the insurance carrier you choose. However, each carrier sets their own prices, so what you pay for Plan F through Company A can vary widely compared to Company B.
How Does Medicare Supplement Plan F Work?
Because it’s the most comprehensive plan available from a coverage standpoint, Medicare Supplement (Medigap) Plan F is the most popular among eligible individuals.
Specifically, Plan F provides the most assistance with Original Medicare costs, which can be especially useful if you visit your physician frequently, require a lot of healthcare services, or already have a lot of out-of-pocket expenses. In fact, Plan F covers most remaining hospital and doctor costs after Original Medicare has paid its share, which means you might have minimal, if any, other hospital and medical expenses. Plan F also covers Original Medicare’s Part B deductible.
While these are some meaningful benefits, though, it’s essential to keep in mind that this means you’ll likely have higher premiums with Plan F compared to other Medigap plans (more soon).
Should You Consider Plan G Instead of Plan F?
It’s crucial to emphasize that as of January 1, 2020, Medigap plans can no longer cover the Part B deductible. As a result, Plan F is in the process of being phased out, so you won’t be able to purchase it if you didn’t qualify for Medicare (i.e., reach 65 years old) until January 1, 2020 or later.
However, if you qualified for Medicare before this date, you may still be able to purchase Plan F. Furthermore, you can typically maintain your Plan F coverage if you already have it in place.
As an alternative, you might consider Plan G, which provides many of the same coverages as Plan F, except for the Part B deductible.
Related: Medicare Supplement Plan F Versus G Explained
Let’s take a closer look at the benefits provided under Plan F and how they compare to other Medigap plans.
How Does Medigap Plan F’s Coverage Compare?
According to the Medicare.gov website, Plan F provides the following coverages:
|Medigap Benefits||Medigap Plans|
|Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Part B coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Blood (first 3 pints)||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A hospice care coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Skilled nursing facility care coinsurance||No||No||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A deductible||No||Yes||Yes||Yes||Yes||Yes||50%||75%||50%||Yes|
|Part B deductible||No||No||Yes||No||Yes||No||No||No||No||No|
|Part B excess charge||No||No||No||No||Yes||Yes||No||No||No||No|
|Foreign travel exchange (up to plan limits)||No||No||80%||80%||80%||80%||No||No||80%||80%|
|Out-of-pocket limit**||N/A||N/A||N/A||N/A||N/A||N/A||$5,880 in 2020 ($6,220 in 2021)||$2,940 in 2020 ($3,110 in 2021)||N/A||N/A|
IHS Pro Tip: Keep in mind that if you live in Massachusetts, Minnesota, or Wisconsin, you’ll find that your state offers their own standardized plans, which means your coverages might differ from those listed above.
What is the Plan F High-Deductible Option?
The high-deductible Plan F option doesn’t vary in basic coverage compared to the standard plan. However, it does require beneficiaries to pay $2,370 (as of 2021) up front before the plan begins to pay for Medicare-covered costs.
In exchange for these upfront costs, the high-deductible Plan F option comes with a lower premium. Let’s take a closer look at this aspect in the following section.
How Much Does Supplement Plan F Cost?
Like any other Medigap plan, how much you’ll pay will vary depending on variety of factors, including the county in which you live, your gender and age, whether or not you’ve used tobacco products, and the insurance company you choose, including whether or not they use medical underwriting and any applicable discounts. Examples include paying via EFT (electronic funds transfer), having more than one policy with the same company, and so forth.
Furthermore, choosing the high-deductible Plan F will deliver lower premiums than the standard version, although your out-of-pocket deductible might offset any cost savings.
With these details in mind, Medicare’s Find a Medigap Policy tool returns Plan F premiums ranging between $213 and $408 per month, based on a 70-year old male that doesn’t use tobacco and lives in the 90210 zip code. Keep in mind that this doesn’t include Part B’s monthly premium, which can range between $148.50 and $504.90 for 2021, depending on your income.
On the other hand, if you choose Plan F’s high-deductible option, your premium will decrease to between $54 and $89 per month.
How Can You Learn More About Medicare Supplement Plan F?
With more than a decade of experience under our belt, the team at IHS Insurance Group has the knowledge to help answer your important questions regarding Medicare and Medigap plans, including Plan F.
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