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Medicare Supplement Insurance Plan F

Medigap Plan F is one of the 10 standardized Medicare Supplement Insurance plan options.

Plan F covers the most standardized Medigap benefits and is the most popular4 option available today. More than half of Medigap policyholders have Plan F. It may also be one of the most expensive options, according to the Kaiser Family Foundation.¹ Learn more about how Plan F could supplement your Medicare coverage.

High-Deductible Plan F

There is a regular Plan F and a high-deductible Plan F. If you choose the high-deductible Plan F, you must meet a yearly deductible of $2,300 (in 2019) before it covers anything. The high-deductible version of Plan F may have lower premiums than the regular Plan F, but it also comes with much higher out-of-pocket costs. More info: Learn how a high-deductible Medigap Plan F works.

Plan F Benefits

Medigap Plan F covers all 9 of the available Medicare Supplement Insurance benefits.

Standard Medicare Supplement Insurance benefits Plan F
Medicare Part A co-insurance and hospital costs
Medicare Part B co-insurance or co-payment
First 3 pints of blood
Part A hospice care co-insurance or co-payment
Co-insurance for skilled nursing facility
Medicare Part A deductible
Medicare Part B deductible
Medicare Part B excess charges
Foreign travel emergency 80%

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days.  Medigap Plan F pays for all of these co-insurance fees.

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a co-insurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% coinsurance in most cases. Plan F pays the 20% coinsurance or copayment costs.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond. If you need blood while in the hospital, Medigap plans cover the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care. Plan F covers these costs completely.

Co-insurance for skilled nursing facility: Co-insurance for medical care provided at skilled nursing care facilities is fully covered by Plan F.

Medicare Part A deductible: Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019.² Medigap Plan B will cover your deductible in full for each benefit period you require.

Medicare Part B deductible: Plan F is one of two Medigap plans to fully cover the Medicare Part B deductible, which is $185 in 2019.³

Medicare Part B excess charges: Doctors can bill a procedure for up to 15% higher than what Medicare pays for it. The extra expenses are called “excess charges.” If there are any excess charges for an approved visit, a person insured under Plan F would be covered.

Foreign travel emergency: This benefit provides coverage for medical care provided outside of the United States. This insurance benefit pays for 80% of the billed charges. Coverage is provided after a $250 deductible has been met for the year.

For more detailed information, read our page about Medicare Supplement Insurance benefits.

Plan Comparison

Plan F covers the most benefits out of any of the standardized plan options.

This popular plan may be suitable for you if you may need extensive medical coverage and don’t want to worry about co-pays and deductibles. Although Plan F’s premiums tend to be some of the highest, it offers coverage for all 9 standardized benefits.

Plan F vs. Other Medigap Plans

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility 50% 75%
Medicare Part A deductible 50% 75% 50%
MedicarePart B deductible
Medicare Part B excess charges
Foreign travel emergency 80% 80% 80% 80% 80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything. 2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

 

Plan F Enrollment Statistics

Plan F is the most popular Medicare Supplement insurance plan, according to America’s Health Insurance Plans’ (AHIP) 2014 “Trends in Medigap Enrollment and Coverage Options” report. About 56% of Medigap policyholder chose Plan F in 2014.

It’s also growing in popularity. Enrollment increased 9% in one year, climbing from 5.5 million in 2013 to 6 million in 2014, according to AHIP.

The popularity of Plan F varies greatly based on location, according to the U.S. Department of Health & Human Services (HHS).4 In 2010, only 2.6% of Vermont residents chose this plan, while 91.3% of residents in North Dakota did. Popularity is not the only factor that changes considerably based on location. Average monthly premiums varied nearly $100 depending on the coverage state. The average monthly premium for Plan F was a low $79 in Vermont but jumps in New York to an average monthly premium of $220, according to HHS.

Despite the higher average costs associated with Plan F, it is not the most expensive plan offered. According to a 2010 study by the Kaiser Family Foundation, Plan D the was most expensive Medigap plan option.¹


¹ https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8412-2.pdf

² https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

https://aspe.hhs.gov/report/variation-and-trends-medigap-premiums

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