Medicare Plan F (Medigap) Supplemental Coverage, Cost and Alternatives
Key Takeaways
- Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). covers a host of essential inpatient and outpatient health expenses, but you will incur some out-of-pocket costs. Medicare Supplement Insurance, also known as Medigap, helps fill in the cost gaps.
- MedigapMedicare Supplement Insurance (Medigap) is designed to provide coverage that Original Medicare (Parts A and B) does not. Medigap policies are purchased in addition to Original Medicare and have their own monthly premiums you’ll need to pay. plans are private insurance plans you can buy to offset your share of Original Medicare costs. Plan F is one of several options in this program.
- Plan F is the most comprehensive Medigap plan, but you can only purchase it if you first became eligible for Medicare before January 1, 2020.
- You cannot have both a Medigap plan and a Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plan.
Original Medicare covers a lot of basic healthcare services, but you will still have to pay copayments, coinsurance and deductibles. Medicare Supplement Insurance, or Medigap, can help with these costs. Plan F is the most comprehensive option, but this Medigap plan can only be purchased by people who were eligible for Medicare before January 1, 2020.
What is Plan F, and how does it work? And what if you want a level of coverage similar to what Plan F offers but you don’t qualify to purchase it?
Here’s what you need to know.
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What Does Medicare Supplement Plan F Cover?
Plan F is a private insurance plan that helps cover the out-of-pocket costs you would normally pay with Original Medicare. It is a Medigap plan, and these plans generally cover what Original Medicare doesn’t, including:
- Copayments
- Coinsurance
- Deductibles
Some Medigap plans may also cover some additional services or costs like medical care in foreign countries. However, there are also certain services that Medicare Plan F coverage does not cover, including:
- Long-term care
- Vision care
- Dental care
- Hearing aids
- Eyeglasses
- Private nursing services
- Part A coinsurance and hospital costs
- Part B coinsurance and copayment
- The first three pints of blood if your require a transfusion
- Hospice care coinsurance and copayment
- Coinsurance for skilled nursing care
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel care (80%)
Is it a Plan or a Part?
You may have heard it referred to as Medicare Part F, but this is incorrect. “Parts” refer to the main portions of Medicare only. Original Medicare is made up of Parts A and B, while Medicare prescription drug coverage is referred to as Part D. Medicare Advantage, sold through private insurers, is called Part C.
Medigap is broken up into different plans, and this is the term used officially by Medicare and reputable insurance companies. If an insurance company is offering to sell you a Medicare “Part” F plan, you’ll want to verify with an expert that the offer — and plan — is legitimate.
How Much Does Medicare Supplement Plan F Cost?
The cost of a Medigap plan depends on the prices set by the private insurance company that is offering the plan, where you live, and what is included.
The costs associated with your Medigap plan includes your monthly premium, which you will pay in addition to your monthly premiums for Medicare Part B and Medicare Part A. If you worked and paid Medicare taxes for at least 10 years, you don’t have to pay a Part A monthly premium.
Generally there are three pricing methods, called ratings, that insurance companies use to set prices for Medigap plans. Be sure to ask which type of rating is used before signing up for a plan. The three ratings for Medigap plans are:
- Community rated: The premium costs for these plans are the same for everyone who buys them, regardless of age.
- Issue-age related: These plans are priced based on the age you are when you first purchase your plan. People who sign up at younger ages pay less for their premiums.
- Attained-age related: Monthly premiums are set based on your current age, meaning your premium cost will increase as you get older.
- Gender
- If you smoke
- If you are married or single
- Multiple policy discounts
- Discounts for electronic (paperless) payments
- If you sign up outside an open enrollment period
- If you sign up for a plan that restricts you to seeing certain providers
- High-deductible plan options
- If you have an older plan that still covers things like Part B deductibles and prescription medications
For example, Plan F policies offered in Omaha and Los Angeles will provide the same benefits. However, beneficiaries in Omaha may pay less per month for their plan than their West Coast counterparts. This difference is largely because of their location.
You can research all the Medigap plans in your area and look up their prices through the Medicare website, or you can contact a GoHealth licensed insurance agent that will offer impartial guidance on the Medigap plans in your area.
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Is Medicare Supplement Plan F Being Discontinued?
If you’re shopping for Medigap plans, you may have asked the question, “Is Medicare Plan F going away?” No, Medicare Supplement Plan F has not been discontinued, but the eligibility rules have changed.
Eligibility for Plan F is based on when you were first eligible for Medicare, not when you try to purchase a plan. If you were eligible for Medicare on or before January 1, 2020, you can still purchase Plan F. Before doing so, it’s important that you know when to enroll in Medigap plans, and what could happen if you don’t.
Medicare Plan F alternatives
The 2020 changes only apply to Plans F and C — just two of 10 standard Medicare Supplement Insurance options available in most areas. You should review plan options, prices, and availability in your area to find the plan that best fits your needs.
If you’re interested in comprehensive coverage but aren’t eligible to purchase Plan F, you might want to take a look at Plan G.
Medicare Supplement Plan F
- Offers 100% coverage for most Original Medicare services.
- Covers 80% of foreign travel emergency care.
- Covers 100% of the Medicare Part B deductible.
- Has a higher cost.
Medicare Supplement Plan G
- Offers 100% coverage for most Original Medicare services.
- Covers 80% of foreign travel emergency care.
- Does not cover the Medicare Part B deductible.
- Has a lower cost.
The main difference between Plan F and Plan G is that Plan F covers the Part B deductible while Plan G does not. Plan F costs more than Plan G because of that difference.
Medicare Plan F vs. Medicare Advantage
Plan F is a private insurance policy that can be added on to Original Medicare, which includes just Medicare Part A and Part B.
Medicare Advantage (Part C) replaces Original Medicare (Part A and B) but offers the same Part A and B benefits and coverage as Original Medicare. Along with receiving Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.
Medicare Supplement Insurance plans — including Plan F — can only be purchased with Original Medicare. They cannot be purchased with Medicare Advantage plans.
Both Medigap and Medicare Advantage plans charge a monthly premium but could save you out-of-pocket costs for Medicare services in other ways. Carefully compare your healthcare costs with Original Medicare and a Medigap plan to the cost of a Medicare Advantage plan in order to see which option works for your needs and budget.
Sources
- Cost of Medigap policies. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
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.