Medigap Plan F is one of the most popular Medicare supplemental insurance plans available to Medicare beneficiaries. It’s designed to fill in the gaps left by Original Medicare, covering deductibles, coinsurance, and copayments that would otherwise fall on the patient. However, with so many different options available to Medicare beneficiaries, it can be challenging to understand the differences between each plan and determine which one is right for you. In this blog post, we’ll provide a comprehensive breakdown of Medigap Plan F, so you can make an informed decision about your Medicare coverage.
Medigap Plan F Coverage
Medigap Plan F is a popular supplemental insurance plan for Medicare beneficiaries that provides comprehensive coverage for out-of-pocket healthcare costs that are not covered by Original Medicare. Plan F covers all of the following benefits:
- Medicare Part A coinsurance and hospital costs, up to an additional 365 days after Medicare benefits are exhausted
- Medicare Part B coinsurance or copayment
- The first three pints of blood used in a medical procedure
- Part A hospice care coinsurance or copayment
- Skilled Nursing Facility (SNF) care coinsurance
- Part A deductible
- Part B deductible
- Part B excess charges
- Emergency medical care while traveling outside the United States
Plan F offers the most comprehensive coverage of any Medigap plan, meaning that you will have very few out-of-pocket costs when you use your Medicare benefits. This can provide peace of mind and help you budget for your healthcare expenses, knowing that you will be protected from unexpected costs.
Medigap Plan F Costs
The cost of Medigap Plan F will vary depending on where you live, the insurance company you choose, and your age and health status. Typically, the monthly premium for Plan F is higher than for other Medigap plans, because it provides the most comprehensive coverage. However, it’s important to shop around and compare plans from different insurance companies to find the best price for your needs.
When considering the cost of Medigap Plan F, it’s important to remember that you will still need to pay your monthly Medicare Part B premium in addition to your Medigap premium. Additionally, while Medigap plans help cover out-of-pocket costs, they do not cover services that are not covered by Original Medicare, such as dental, vision, or hearing care.
Overall, Medigap Plan F is, price-wise, considered to be a good option for those who want comprehensive coverage and are willing to pay a higher monthly premium.
Is Medigap Plan F still Available?
Medigap Plan F is no longer available for individuals who become eligible for Medicare on or after January 1, 2020. The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 made changes to Medicare Supplement plans, including the elimination of Plan F for newly eligible Medicare beneficiaries.
However, if you were eligible for Medicare before January 1, 2020, you may still be able to enroll in Plan F or switch to Plan F from another Medigap plan. If you are eligible for Medicare due to disability, you may also still be able to enroll in Plan F.
If you are already enrolled in Plan F, you can keep your coverage as long as you continue to pay your premiums. However, you should be aware that Plan F premiums may increase over time, and there may be other Medigap plans available that could provide similar benefits at a lower cost.
Medigap Plan F Enrollment and Eligibility
To be eligible for a Medigap Plan F, you must be enrolled in Original Medicare – Parts A and B. You can typically enroll in a Medigap plan during your Initial Enrollment Period, which is the 7-month period that begins 3 months before your 65th birthday month, includes the month of your 65th birthday, and ends 3 months after your birthday month.
If you miss your Initial Enrollment Period, you may still be able to enroll in a Medigap plan during a Special Enrollment Period, which can be triggered by certain life events, such as losing other health coverage, moving to a new area, or losing access to a Medicare Advantage plan.
As we have already mentioned, if you became eligible for Medicare on or after January 1, 2020, you are not eligible to enroll in a Medigap Plan F. This is because the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 eliminated the sale of Medigap Plan F and Plan C to newly eligible Medicare beneficiaries.
If you are already enrolled in a Medigap Plan F, you can keep your coverage as long as you continue to pay your premiums. However, you should be aware that Medigap Plan F premiums may increase over time, and there may be other Medigap plans available that could provide similar benefits at a lower cost.
Medigap Plan F Substitutes
If you are not eligible to enroll in Medigap Plan F or are already enrolled in Plan F and looking for other options, there are several other Medigap plans that could be good substitutes. This is also relevant because of the fact that this plan is no longer available for new beneficiaries.
One popular option is Medigap Plan G, which is very similar to Plan F but does not cover the Medicare Part B deductible. Plan G covers all of the other out-of-pocket costs that Plan F covers, including coinsurance, copayments, and excess charges. In many cases, the premiums for Plan G are lower than the premiums for Plan F, which can make it a mAnother option is Medigap Plan N, which provides coverage for many of the same out-of-pocket costs as Plan F and Plan G, but with some cost-sharing requirements. With Plan N, you may be responsible for a copayment of up to $20 for some office visits, and up to $50 for emergency room visits that do not result in an inpatient admission. Additionally, Plan N does not coore cost-effective option.
ver excess charges, which are additional charges that some providers may bill above the Medicare-approved amount.
Ultimately, the best substitute for Medigap Plan F will depend on your individual health needs and budget. It’s a good idea to compare the coverage and costs of different Medigap plans before making a decision and to consider working with a licensed insurance agent who can help you understand your options and choose the plan that is right for you.