What is Medigap Plan F?
Medigap Plan F (Medicare Supplement Insurance Plan F) helps fill the gaps in Original Medicare. This might include co-payments, co-insurance, and deductibles. It can also pay for emergency medical care while traveling outside the USA. (But has a $50,000-lifetime cap, so I usually recommend buying travel insurance).
Most Medigap Plans are standardized so a Plan F with one company will cover the EXACT same benefits as a Plan F with another company. However, recently some insurance companies have brought out new plans that are NOT standardized. These plans include Innovative Plan F and Plan F Extra. If you'd like to see why we don't recommend these non-standardized plans, read the article on the Downside of Innovative Plan F.
- Monthly Premium Cost
- How often the company increases your rate
- What the average rate increases have been over time (so you can get a feel for what your rate increases might be
- The financial strength of the company
- Customer Service that clients and brokers experience with the company
Medigap Plan F Benefits
Medicare Part A coinsurance and hospital costs (up to an extra 365 days)
Medicare Part B copayment or coinsurance
First 3 pints of blood
Part A hospice care copayment or coinsurance
Skilled Nursing Facility (SNF) care coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel emergency (up to plan limits)
- Plan F covers Part A coinsurance for hospital stays, hospice care, and SNF
- After you've used up the first 3 pints of blood, that's covered by Plan F (for example, if you've ever need a blood transfusion), Part A will cover the rest.
- Covers the Part A deductible which could reset the next time that you're admitted in a hospital. The Part A deductible is NOT an annual deductible. You can pay multiple Part A deductibles in the same calendar year.
- Plan F also covers Part B costs such as copayments, deductibles, and excess charges.
- Meaning $0 out-of-pocket for your doctor's visits.
- It also covers up to 80% of Medical Emergencies overseas, after a deductible and up to a lifetime maximum of $50,000.
Standardized Medigap plans don't cover vision care, dental care, long-term care, eyeglasses, hearing aids, and nursing services. Medigap plans also do not cover prescription drugs (except for some old plans that new enrollees cannot get).
So what IS covered by Medigap Plan F?
Even though Medigap Plan F doesn't cover ancillary benefits, it fills all the gaps in Original Medicare. This plan lets you see any doctor in the USA who accepts Medicare and covers all the co-pays, co-insurance, and deductibles of original Medicare. That means that when you go to the doctor or hospital, you won't have to worry about what it costs unless you're opting for something that Medicare doesn't cover. You can also find out if Medicare covers it by searching under Does Medicare Cover….
My husband didn't pay a dime when he underwent chemotherapy in 2017.
And, besides the gaps that Medicare Supplement Insurance covers, it also gives you an EXTRA 365 days in the hospital. Hopefully, you won't ever need to use that part of the coverage, but it's nice to know it's there.
You have other benefits like foreign travel emergency coverage, which has a coverage of up to 80% of your emergency bills after a deductible of $250. The lifetime limit of the travel portion is $50,000 so I usually recommend travel insurance, anyway.
Medigap Plan F also covers 100% of the skilled nursing facility coinsurance.
As of this writing, Plan F is the most popular Medigap policy available because of its full coverage and relatively low price at age 65. (My husband saved $700 per month when we transitioned to Medicare!)
And as far as the cost of Plan F: it is the most expensive of all the Medigap Plans because it offers the most coverage. The next most comprehensive is Plan G.
How do I know it will cover my bills?
Unlike your other insurance plan that you got before Medicare kicked in, there is no going back and forth with the insurance company when you have a medical bill. If Medicare covers it, your Medigap plan MUST cover it.
So even if your doctor has never heard of YOUR Medigap Plan F's company name, you don't have to worry. The doctor must accept your Supplement Plan F if he or she accepts Medicare. It doesn't matter which company you get it from.
This site shows you how to find out if your doctor accepts Medicare.
Cost of Medigap Plan F
The cost of Medigap Plan F will depend on the location (some areas have high costs) on where you enroll Plan F and the insurance company you use.
You can find out how much it costs in your area by using our Free Medigap Quote Tool.
Difference between Plan F vs Plan G
The difference between these two plans is minimal. You can tell what the benefit is, based on the plan letter. Plan G doesn't cover Part B deductible, but Plan F does.
The Part B deductible was $185 in 2019. This is an annual deductible, not a per-occurrence deductible. What that means is that if you can save more than $185 a year by purchasing a Plan G instead of a Plan F, you'll save money.
Medicare Part F and Medigap Plan F are not technically the same thing. The correct term for it should be Plan F but those who are new to Medicare sometimes call it Part F. In order for you try to clear things up, let's just say that Medicare has PARTS (A, B, C, D) and Medigap has PLANS.
Plans F and G cover Chiropractic but not Acupuncture (which is an alternative medicine, and Medigap plans don't cover alternative medicines). Medicare covers 80% of the treatment and both Plans F & G cover 20%. (But with Plan G, you have to pay the annual deductible).
Remember that you must continue to pay your Medicare Part B premiums on top of your Medigap Premium. If you lose your Medicare benefits, your Medigap plan is worthless.
And make sure you pay your Medigap premium. The insurance company can't cancel you because of your health (once you get the plan), but they CAN cancel you because you missed a payment.
Medicare Plan F will be closed to people who begin their Medicare benefits in the year 2020 or later. But you could still enroll if you're eligible for Medicare prior to 2020. And if you already have a plan, don't worry. Anyone who already has a Plan F at that time will be able to keep it.
For those of us who won't qualify for a Plan F, Plan G is almost as good, and likely a lot less expensive.