What is Medicare Plan F?
Here’s a quick overview of Medicare Supplement Plan F:
- Works in lock-step with Medicare Part A and B (does not replace it).
- About 56% of seniors with a Medigap policy choose Plan F.
- Covers Medicare Part A Deductible.
- Covers Medicare Part A Coinsurance and an additional 365 days of hospitalization.
- Covers Medicare Part B Deductible.
- Covers Medicare Part B Coinsurance.
- Covers Medicare Part B Excess Charges.
- Covers Skilled Nursing Facility Coinsurance.
- Covers Blood (first 3 pints).
- Provides Foreign Travel Emergency Coverage (up to plan limits).
In other words, a Plan F Medicare Supplement covers all of the gaps in Original Medicare and adds coverage when you travel. It’s the most extensive of all plans offered, but, be warned… it’s going away!
(NOTE: Many people refer to Plan F as Medicare Part F or Medigap Part F. The correct name is plain old Plan F. Only Medicare has Parts; Medicare Supplements do not.)
Medicare Supplement Plan F
Currently, there are ten standardized Medicare Supplements, also known as Medigap plans. Of the ten standardized letter plans (A, B, C, D, F, G, K, L, M, N), Plan F offers the most coverage, but not for long. Medigap Plans F and C are scheduled to be terminated in 2020. The good news is that you can buy an F Plan now and keep it after the year 2020.
RELATED: Is Medigap Plan F Going Away?
The reason Plans F and C are being phased out is due to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, better known as the “doc fix” law. Congress passed this legislation to help ensure that doctors would get the pay they need to provide services to Medicare beneficiaries.
Medicare Plans F and C are affected because they are the only plans that cover Medicare Part B deductible. After January 2020, if you’re not enrolled in a Plan F or Plan C, you will have to pay the Medicare Part B deductible out-of-pocket.
Why Do So Many Seniors Love Medigap Plan F?
The reason Medicare Plan F is liked by so many is because it covers ALL gaps in Original Medicare, including both your hospital (Part A) and medical (Part B) deductibles. It even pays the 20% coinsurance that Medicare Part B does not cover.
This means no out-of-pocket costs when you see your doctor.
It’s easy to see why so many seniors think Plan F is the best Medicare supplemental plan, isn’t it? It offers peace-of-mind.
Medicare Supplement Plan F Coverage
With a Medicare Plan F policy you have first-dollar coverage. After Medicare pays its share, your Medigap Plan F pays the rest, leaving you with zero out-of-pocket costs. That’s the peace-of-mind I mentioned above. Here’s how you’re covered:
- Plan F pays both your Part A inpatient deductible and your Part B outpatient deductible.
- It pays 100% of the Medicare Part B coinsurance that you’d normally pay at your doctor’s office.
- It covers the 15% excess charges that doctors are allowed to charge for Part B services if they do not accept Medicare assignment.
- Unlike Medicare Advantage, you can see any doctor you like that accepts Medicare (over 880,000 physicians do).
- Unlike Medicare Advantage, no referrals are required! See any Medicare specialist whenever you like.
- Can’t be cancelled. That’s right, a Plan F is guaranteed renewable, regardless of your health conditions or the number of claims you file.
- You have guaranteed issue rights. That means you cannot be turned down if you enroll during your individual enrollment period when you turn age 65.
Medigap Plan F Pays Deductibles and Coinsurance
Still trying to wrap your head around the value of a Plan F? Consider this: if you don’t have a comprehensive Medicare Supplement, you will pay a whopping $1,340 deductible if you need to be admitted into the hospital. That’s the 2018 Part A deductible, and it increases almost every year. On top of this, you’ll owe 20% of all medical costs, like surgery or an MRI, because Part B only pays 80% of these costs.
If you had a Medigap Plan F, all of these costs would be paid for by your insurance.
Are all Medicare Plan F the same as an AARP Medicare Supplement?
Yes. No matter which insurance company you choose, the benefits are the same. What’s different is the financial stability of the insurance company, the level of customer service they offer, and how they calculate their rates and rate increases.
When deciding which F Plan to go with, it’s important to ask your agent to show you the rate increase history of the carriers they represent. This will help you understand what you can expect down the road.
You might be surprised to learn that there are many solid insurance companies with good financial ratings that offer rates lower than the big brand-name carriers, such as AARP supplemental insurance (by United Healthcare). In a 47 state study, MedicareWire discovered that a AARP Medicare Supplement Plan F was never the least expensive. However, United Healthcare offers the AARP branded plans as a Medicare SELECT policy, in most states, with highly competitive rates. Unlike a normal Medigap policy, a Medicare SELECT policy requires you to use a selected hospital in your area for hospital services.
How Much Does Medicare Plan F Cost?
Costs for Medicare Plan F vary by area, gender and tobacco use. In most cases, Medicare Plan F premiums for males are slightly higher than those for women. Tobacco use is another factor that warrants a higher rate. In a 2018 national survey, MedicareWire discovered an average rate of $120 to $145 for a 65 year old non-smoking woman.
Should I Switch Carriers if I Find a Lower Plan F Premium?
Many seniors we’re talked with are afraid of switching carriers to get a lower rate. It’s important to remember that your benefits on an F Plan are exactly the same, regardless of the carrier. This means you should be comparing rates between insurance companies annually. Obviously, the cancellation of Plan F will make it impossible to switch after January 2020, because after this date no new policies can be sold. However, we believe that many carriers will try to force seniors out of their Plan F through premium increases. In this case, Medigap Plan G is a great alternative.
Medicare Plan F vs. Plan G
In a national review of Medicare Plan F vs. G costs, MedicareWire discovered an average savings of $254 per year with Medicare Plan G. The interesting thing about the annual costs difference is that it’s more than the $184 Medicare Part B deductible that’s not included in Plan G. In fact, the Part B deductible is the only difference between these two plans, making Plan G a better value.
Here’s the bottom line. With a Plan G you pay the annual Part B deductible out-of-pocket, but you save the rest of the year with lower monthly premiums. In some cases, premiums on a Medicare Plan G policy are quite a bit cheaper.
What Does Medicare Plan F cover?
As a general rule, Plan F covers all of your Medicare Part A and B cost-sharing. That means if a service or procedure is not covered as a Medicare benefit it won’t be included in the coverage benefits of an F Plan.
Does Medicare Plan F cover prescription drugs?
Medigap plans cover medications administered in the hospital or by your doctor in a clinical setting. Medigap plans do not cover outpatient prescriptions or over-the-counter medications. For this coverage you must enroll in a Medicare Part D plan.
Does Medicare Plan F cover dental, vision and hearing aids?
Medigap plans do not include routine dental, vision or hearing benefits, including eye exams and hearing aids. However, there are many great standalone plans that you can enroll in that offer these benefits at a reasonable cost. We have researched all of the best dental plans for seniors to make finding a plan easy.
Does Medicare Plan F cover chiropractic?
Yes. Because Medicare covers 80% of most routing chiropractic adjustments, a Plan F pays will cover the 20% coinsurance. Be aware, however, Medicare doesn’t cover all services provided by chiropractors, including x-rays.