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Medicare Supplement Insurance Plan F

Medigap Plan F is one of the 10 standardized Medicare Supplement Insurance plan options sold in most states.

Plan F covers the most standardized Medigap benefits and is the most popular Medigap plan.

In fact, 55% of Medigap beneficiaries in 2016 were enrolled in Plan F.1

Learn more about the benefits, costs and coverage of Medicare Supplement Insurance Plan F.

 

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What Does Medigap Plan F Cover?

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 CoInsurance

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 Coinsurance and Copayment

Medicare Part B usually charges a coinsurance 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 all of the 20% coinsurance or copayment costs.

First 3 Pints of Blood

Original Medicare only covers the fourth pint of blood and beyond when you need a blood transfusion.

If you need blood while in the hospital, Medigap Plan F covers the cost of the first 3 pints.

Part A Hospice Care Coinsurance or Copayment

Hospice care provides medical treatment and care during a terminal illness.

Medicare covers these services, but it requires copayments. These copayments 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.

Coinsurance for Skilled Nursing Facility Care

If you receive care at a skilled nursing care facility, you are required to pay coinsurance after you are admitted as an inpatient for more than 20 days.

In 2019, the coinsurance charge is $170.50 per day for days 21-100 of an inpatient skilled nursing facility stay. After day 100, you are responsible for all costs.

Plan F fully covers your skilled nursing facility coinsurance.

Medicare Part A Deductible

Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019. This means that you must pay $1,364 out of pocket before your Medicare Part A coverage kicks in.

The Part A deductible is not annual. You could potentially be required to pay this deductible multiple times in a calendar year.

Medigap Plan F will cover your Part A deductible in full for each benefit period you require.

Medicare Part B Deductible

The Medicare Part B deductible is $185 per year in 2019.

Medigap Plan F covers the Part B deductible in full.

Medicare Part B Excess Charges

If a doctor doesn’t accept Medicare assignment, it means that they don’t accept Medicare reimbursement as payment in full for their services.

These providers reserve the right to charge you up to 15% more than the Medicare-approved amount for their services. The extra expenses are called “excess charges.”

If you face any excess charges for an approved visit, Medigap Plan F would cover these excess charges in full.

Foreign Travel Emergency Care

This benefit provides coverage for medical care provided outside of the United States, which is not typically covered by Original Medicare (Part A and Part B).

Medigap Plan F pays for 80% of your foreign travel emergency care costs. Coverage is provided after a $250 deductible has been met for the year in 2019.

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

 

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What Is 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 the plan 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.

Learn more about how a high-deductible Medigap Plan F works.

Medigap Plan Comparison Chart

Plan F covers the most benefits out of any of the standardized Medicare Supplement Insurance 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.

You can use the Medigap plans comparison chart below to see how Plan F compares to other Medigap plans.

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.

Is Medigap Plan F the Best Plan?

There are a few other types of Medigap plans that cover almost as many benefits as Plan F.

  • Medigap Plan G provides coverage for all of the same benefits that Plan F covers except for the Medicare Part B deductible.

    The Part B deductible is $185 per year in 2019, which equates to just over $15 per month.

    Therefore, if you were to find Plan G for a monthly premium that is at least $15 less expensive than Plan F premiums, your annual Medicare spending could actually be less with Plan G if you meet the Part B deductible.

  • Medigap Plan C covers the same benefits as Plan F except for Medicare Part B excess charges.

    You can avoid facing Medicare excess charges by only seeking health care from providers who accepts Medicare assignment. This means that they accept Medicare reimbursement as payment in full.

    Medicare excess charges aren’t extremely common, so you may be able to save some money if you find a Plan C option with lower premiums than Plan F (as long as you only seek care from providers who accept Medicare assignment).

  • Plan N also covers similar Medicare costs as Plan F except for the Medicare Part B deductible and Medicare Part B excess charges.

    As noted above, the cost of the 2019 Part B deductible can be offset by having a Medigap premium that is at least $15 cheaper than that of Plan F. And Medicare excess charges can be avoided by visiting providers who accept Medicare assignment.

Plan F does cover more out-of-pocket Medicare costs than any other Medigap plan. As you can see, however, some of these out-of-pocket costs may not be as much of a concern for you.

Picking a Medicare Supplement Insurance plan comes down to finding a plan that fits your unique needs.

How Much Does Medigap Plan F Cost?

The average monthly premium for Medigap Plan F in 2018 was $169.14 per month.2

For high-deductible Plan F, the average premium in 2018 was just $57.16 per month.2

It’s important to note that each type of Medigap plan offers a different combination of standardized benefits. Plans with fewer benefits may offer lower premiums.

Other factors such as age, gender, smoking status, health and where you live can also affect Medigap plan rates.

One thing to note when comparing premiums is that Plan F members have little to no out-of-pocket Medicare costs throughout the year. This can give you better cost predictability.

 

Compare Medigap Plan F costs in your area.

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What Is Happening to Medigap Plan F in 2020?

Medigap Plan F and Plan C (the only two plans that cover the Part B deductible) will not be available for sale to Medicare beneficiaries who become eligible for Medicare after January 1, 2020.

Anyone who is already eligible for Medicare or who will be eligible before January 1, 2020, will still be able to apply for Plan F or Plan C in 2020 and beyond, if either is available where you live.

Anyone currently enrolled in Plan F and Plan C will be allowed to keep their plan after 2020.

When Is the Best Time to Sign Up for Plan F?

A great time to enroll in Medigap is during your Medigap Open Enrollment Period (OEP).

Your Medigap Open Enrollment Period lasts for 6 months, and it starts as soon as you are at least 65 years old AND enrolled in Medicare Part B.

If you sign up for a Medigap plan during your Medigap Open Enrollment Period, Medicare Supplement Insurance companies can’t use your health status to determine your eligibility for a plan. They also can’t charge you more for a Medigap plan based on your health.

You may be able to enroll in a Medigap plan anytime outside of your Medigap Open Enrollment Period. You may face medical underwriting if you do so, unless you qualify for a guaranteed issue right.

If you have a guaranteed issue right, Medigap insurance companies can’t use your health to determine your eligibility or plan rates.

A licensed insurance agent can help you determine whether or not you qualify for a guaranteed issue right. Not all plan types may be available for purchase if you have a guaranteed issue right.

How Do I Sign up for Plan F?

You may have Plan F options available in your area. A licensed insurance agent can help you compare Medigap plans available near you and help you find a plan that fits your coverage and budget needs.

 

Find Medigap Plan F in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 


¹ AHIP. The State of Medigap 2018. (June, 2018). Retrieved from www.ahip.org/wp-content/uploads/2018/06/State_of_Medigap18_FINAL.pdf.

² TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

 

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