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Medigap - Plan F
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Important Points
Medigap Plan F is the most comprehensive plan on the market - it covers ALL gaps in Original Medicare.
Medigap Plan F was phased out to beneficiaries who became eligible for Medicare on or after January 1, 2020.
The cost of Medigap Plan F will depend on your age, gender, tobacco use, and where you live.
Mohring Insurance Services LLC | Talk to a Medicare Expert at (866) 440-1885
Overview
Medigap Plan F is the most comprehensive of all the Medigap plans available. It covers deductibles, copays, and coinsurance, leaving you with nothing out-of-pocket for your Medicare-approved services.
Plan F was very popular among Medicare beneficiaries for many years. However, there was a change in 2020. Plan F is now only available to beneficiaries who became eligible for Medicare BEFORE January 1, 2020. Anyone who became eligible on or after January 1, 2020, is no longer eligible to sign up for Medigap Plan F.
If that is you, you will find that Medigap Plan G is the most comprehensive plan available to you. Plan G has become one of the most popular Medigap options in recent years.
Medigap Benefits - Plan F
Medicare Part A Coinsurance & Hospital Costs
(Up to an additional 365 days after Medicare benefits are used)
Medicare Part B Coinsurance or Copayment
Blood (First 3 Pints)
Part A Hospice Care Coinsurance or Copayment
Skilled Nursing Facility Coinsurance
Medicare Part A Deductible
Medicare Part B Deductible
Medicare Part B Excess Charges
Foreign Travel Emergency (up to plan limits)
A Medigap plan pays after Medicare to help cover your deductibles, copays, and coinsurance that you would be obligated to pay with Original Medicare. Medigap plans do not replace your Medicare Part B. You must have Medicare Part A and Part B first - then you can enroll in a Medigap Plan F policy.
When you add Medigap Plan F or Plan G to your Original Medicare coverage, it will be very comprehensive. Plan F is the Medigap plan with the most benefits, while Plan G is a close second, only leaving you responsible for your Part B deductible.
What Are the Benefits of Plan F?
Never Pay a Doctor Copay Again!
Medigap Plan F is so popular because it pays for ALL of the gaps in Original Medicare, including both your hospital and outpatient deductible. It even pays the 20% that Medicare Part B does not cover.
This means ZERO out-of-pocket for you at the doctor's office for Medicare-approved services.
Medigap Plan F is Comprehensive
Medigap Plan F policies are the Cadillac of Medicare Supplement Plans. After Medicare pays its share of your claims, Medigap Plan F pays what is left, leaving you with $0 out of pocket.
Medigap Plan F covers both of your Part A hospital and Part B outpatient deductibles.
Plan F covers all of the 20% coinsurance that Medicare Part B normally leaves you to pay.
Plan F covers all Part B excess charges. You will never have to pay the 15% excess charges that doctors under Medicare are allowed to charge for Part B services.
No referrals are required. In most cases, Medigap plans allow you to see any Medicare specialist whenever you want without a referral from your primary care physician.
You can choose any doctor in the U.S. that accepts Medicare insurance.
Your coverage is guaranteed renewable. Your policy cannot be canceled due to health conditions or the number of claims that you file.
Plan F Pays your Deductibles AND Coinsurance
As an example, if you have no Medigap plan in place, you would owe a $1,632 deductible (for Part A) if you go to the hospital. You would also have to pay 20% for expensive procedures such as surgery because Part B only pays 80%.
When you have a Medigap Plan F policy, all of this would be paid for by your insurance.
There are many good insurance companies with good financial ratings that offer Medigap Plan F. Be sure to shop around when you apply. If you would like help looking at your options, feel free to call us at (866) 440-1885.
Cost
What Does Medigap Plan F Cost?
The cost for Medigap Plan F can vary by gender, zip code, and tobacco use. In many areas, we find that pricing starts around $140-$150/month, but getting quotes for Plan F in your area is always important.
At most insurance companies, the Plan F cost for males will be slightly higher than for females. Also, tobacco users will often have a higher cost than non-tobacco users.
Several companies offer household discounts for their Medigap plans, lowering the cost if you and your spouse are with the same company.
A common occurrence is that people will stay on the same Plan F for many years. Since the coverage is so good, they fear changing insurance companies. The great news is that benefits for Plan F with one company will be exactly the same as the benefits of Plan F at another company. This really means that you should compare the Plan F cost between insurance companies each year and look for the cheapest Medigap Plan F in your area.
Doing an annual review of your area's Medigap Plan F rates can save you a bunch over the years!
Changing Plans Requires Underwriting in Most States
Switching to a different Medigap policy typically requires that you answer health questions. But, some states have certain enrollment periods that allow Medicare beneficiaries to switch Medigap plans without underwriting.
If you have a Medigap Plan F and want to make a change, see if your state offers one of these guaranteed issue periods.
Medigap rates change each year, so it can be useful to review your Medigap coverage annually to ensure you still have a cost-effective plan and keep your costs low.
Cost Example - Medigap Plan F
Let's look at a hypothetical example:
Jacob applies for a Medigap Plan F, and the insurance company approves his application. A couple of years later, Jacob sees an orthopedic specialist about problems with his shoulder. Medicare pays 80% of the cost of this visit to his specialist. Plan F covers the other 20% owed under Part B. This means that Jacob pays nothing.
During the appointment, the specialist sends Jacob to an imaging facility to have a CT scan done on his shoulder. Medicare pays 80% of the cost of the CT scan. Medigap Plan F pays the other 20%. Again, Jacob pays nothing.
When the results of the imaging comes back, the specialist informs Jacob that he will need surgery on his shoulder. He undergoes surgery at his local hospital and is released after a couple of days. He also has a home health care nurse come out to his house a few times in the weeks following the surgery.
The total cost for Jacob's surgery, hospital stay, and follow up nursing care is $100,000. Medicare pays its share of the bills and sends the remaining $20,000 to Jacob's Medigap Plan F insurance company. The insurance company pays the entire bill, and Jacob owes nothing for any of the Part A and Part B services that he received. His only out of pocket spending will be for prescription drugs.
The only cost Jacob had to pay was the monthly premium for his Medigap Plan F policy. Although rates for Medigap Plan F vary, there is no back-end spending for services approved by Medicare.
This is exactly why Plan F has been so popular for many years. It can provide the ultimate peace of mind when you go through healthcare treatments.
However, there are other Medigap Plans that provide great value also, like Plan G and Plan N.
Plan F vs. Plan G
Some people do not qualify for Plan F depending on when they first became eligible for Medicare. Many of those people opt for Plan G.
You can often save $200-$300 a year by looking at Plan G options. With that being said, what is the difference between Medigap Plan F and Medigap Plan G? Which plan is better?
The coverage from Medigap Plan G is very similar to Plan F, with one exception: the Part B deductible. Under a Medigap Plan G policy, you will pay the once per year Part B deductible yourself. In exchange, the premiums can be much cheaper and you get to pocket the savings.
Plan G can typically help you keep more of your own money instead of giving it to an insurance company. It is helpful to work with a licensed agent that specializes in Medicare products like Mohring Insurance Services LLC to compare different Medigap plans, such as Plan F, G, and N. We are here to show you which insurance companies offer you the most significant long-term savings and benefits.
FAQs
What is Medigap Plan F?
Medigap Plan F (aka Medicare Supplement Plan F) is the most comprehensive and complete plan. It covers Medicare deductibles and all copays and coinsurance, leaving you to pay nothing out of pocket throughout the year.
What is Medigap Plan F Coverage?
Plan F covers all of your cost-share for Medicare Part A and Part B services. Medicare must approve and pay for the services before your Medigap Plan F policy will cover the rest. If Medicare denies the claim, your Plan F policy will also.
What is the cost for Plan F?
The cost can vary according to several factors. Plan F premiums vary by gender, area, zip code, and tobacco use. In many areas you can find pricing that starts around $140-$150 a month, but it's always important to get quotes for Medigap Plan F policies in your area.
Can I still get Plan F?
If you were first eligible for Medicare prior to 2020, you will continue to have the option to buy Medigap Plan F. This deadline is regardless of whether you enrolled at 65 or delayed enrollment due to having creditable coverage. So long as you were eligible for Medicare before 2020, you are eligible for Medigap Plan F.
Does Medigap Plan F cover prescription drugs?
No! All Medigap plans will cover medications that are administered to you in the hospital or in a clinical setting. However, Medigap plans do not cover retail prescriptions that you would pick up at a pharmacy. For that, you will want to enroll in a stand-alone Part D plan to get your retail prescription drugs covered.
Does Plan F cover dental, vision, & hearing benefits?
No. None of the Medigap plans cover routine dental, vision or hearing services. However, there are many great standalone plans that you can enroll in to get these benefits at a reasonable cost. Mohring Insurance Services LLC offers these plans. They let you use your own providers and the benefits grow over time with no increase in premium.
Does Plan F cover chiropractic services?
Yes! Medicare covers 80% of adjustments, and Plan F will pay the other 20%. However, Medicare does not cover other services offered by chiropractors, such as x-rays.
What's the most popular Medigap plan?
The most popular Medigap plans are Plan F and Plan G. While Plan F has been the most popular for a long time, Plan G is gaining popularity since Plan F is no longer available to new enrollees. We can offer you a quote for both and see which one offers you the best annual savings.
What are the top Medigap insurance companies?
This varies by region, but since Medigap insurance plans are uniform, you never have to worry about benefits being different from one insurance company to another. This means you should look for the Medigap plans in your area with the lowest rates. The best rates will be different depending on the state you live in, your age, your gender, tobacco use, and eligibility for household discounts.
Should I switch from Plan F to Plan G?
That depends on what your Plan F premium is and where you live (you may have to answer health questions). Typically, you get lower premiums for Plan G and sometimes that makes it a better value. It is important to compare the numbers. We are of the opinion that the best Medigap plan is the one that will cost you the least annual out-of-pocket spending and has the lowest rate increases in recent years.
Is Medigap Plan F going away?
Yes, but only for new enrollees. Medicare beneficiaries who are already enrolled in it, though, will be able to keep it. Congress passed legislation that will no longer allow Medigap policies to cover the Part B deductible for newly eligible Medicare beneficiaries after January 1, 2020.
Medigap Plan F Summary
The fact that Medigap Plan F covers all Medicare cost-sharing means it is the most comprehensive coverage available for eligible people. Although, it may not be as cost-effective as other Medigap plans such as Plan G or Plan N.
If you need assistance looking at your options, we can help!
Remember, if you enroll in your Plan F policy through Mohring Insurance Services LLC, you get free support from our Client Service Team for the life of that policy. If Medicare denies a claim, your doctor mis-codes a bill, or any other incident happens, you can call us and we will resolve it - at no charge. We strive to make help with your Medicare plan as easy as possible.
Key Points
Not all beneficiaries qualify for Plan F. It depends on when you are eligible for Medicare.
With Medigap Plan F, you will have zero out-of-pocket costs for Medicare-approved services.
Even though it is the most comprehensive plan, Plan G may be more cost-effective due to the lower monthly premium.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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