Of the 10 different Medigap policies, Medicare Plan F offers the best financial assistance with out-of-pocket costs for your health insurance.
However, enrollment in Medicare Supplement Plan F is limited to those who became eligible for Medicare before Jan. 1, 2020.
Private insurance companies sell Medigap policies. Because of the variety of insurance policies and covered services, we recommend you speak to a licensed agent, like one of us at Policy Guide, to help get you on the right track whether you will be Medicare-eligible soon or a few years down the road.
What is Medicare Supplement Plan F?
Medicare Plan F pays for health insurance fees not covered by Medicare Plan A and Plan B.
Medicare Parts A (hospital insurance) and B (outpatient insurance) are the building blocks of Original Medicare provided by the federal government.
Basic Medicare coverage includes:
- Hospital costs
- Outpatient care
- Medical appointments
- Preventative care and lab work
- Skilled nursing facility care
- Home health care
- Emergency service
While the federal government covers most fees associated with these services, beneficiaries share some costs after Medicare pays its approved amount. Medigap plans, such as Plan F, decrease costs by covering various copays, deductibles and coinsurance fees.
What does Medicare Plan F cover?
Medicare Plan F covers:
- Medicare Part A coinsurance (what you owe after the Medicare program pays its share) and hospital costs (up to an additional 365 days after Medicare benefits pay)
- Medicare Part B coinsurance or copayments
- First three pints of blood if you are injured or sick
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible of $1,556 in 2022. This is what beneficiaries pay when admitted to the hospital.
- Part B deductible ($233 in 2022)
- Part B excess charge
- Urgent and emergency inpatient care in the event of a foreign travel emergency (up to 80%)
How much does Medicare Plan F cost?
Monthly premiums vary from state to state and among zip codes in the same state for Plan F coverage.
For example, for a 65-year-old female, nonsmoker Plan F monthly deductibles average:
- $176.63 in the 77450 zip code in Houston with a range of $146.69 to $243.91 per month
- $335.91 in the 33311 zip code in Fort Lauderdale with a range of $297.63 to $391.35 per month
When can I enroll in a Medicare Supplement Plan F plan?
First, you will have to sign up for Original Medicare, Parts A and B. Then, you can enroll in Medicare Supplement Insurance Plan F.
The best time to buy a Medigap policy is during your six-month Medigap open enrollment period. This automatically starts the first month you have Medicare Part B and you’re 65 or older.
This timeframe is the only chance to purchase a Medigap policy regardless of preexisting health problems. This means insurers cannot take your health conditions into account when pricing out the policy.
However, after the open enrollment period, if you’re able to buy a Medigap policy, it may cost more because of past or present health problems.
Sometimes you may qualify for a special enrollment period if:
- You retire
- Your insurance company goes out of business
- You move to another zip code
What is the difference between Medicare Plan F and Plan G?
Medicare Supplement Insurance Plan F and Plan G are similar. However, Medicare Supplement Plan F is limited to those who became eligible for Medicare before Jan. 1, 2020. Therefore, Plan G is the closest policy to Plan F for those eligible for Medicare on Jan. 1, 2020, or later.
Both of these plans offer high deductible versions for medical expenses. Monthly premiums for both plans are lower than the premiums for the standard plans. However, enrollees pay a higher deductible before coverage kicks in at 100%.
Medigap Plan F FAQ's:
Is Plan F available in 2021?
Plan F is still available for those who purchased it when they were eligible for a Medigap policy. However, it is unavailable for beneficiaries who became Medicare eligible on Jan. 1, 2020, or later.
Who qualifies for Plan F?
Those who became eligible for Medicare on or before Dec. 31, 2019, can purchase Medicare Supplement Insurance Plan F.
Does Medicare Plan F Have Provider Networks?
- You can seek treatment from any doctor in the United States that accepts standard Medicare
- You won’t be required to get a referral for your doctor visits
- You’ll have the freedom of a no provider network
- You can change doctors at anytime
- You have access to any hospital or healthcare facility that accepts standard Medicare
Ready to learn more?
If you need help sorting through your options or understanding which path might be best for your situation, give us a call. One of our licensed Medicare Specialist would be glad to assist with the education process and can also help you apply for the plan of choice right over the phone.