For those on Medicare, copays and deductibles can really start to add up. Even though you might receive premium-free Part A coverage, there are many other out-of-pocket costs associated with Medicare that you will need to pay. Many might think that services don’t cost you anything when you have Medicare coverage, but that is not the case. Plus, there are many items that Medicare does not cover. Medigap plans help cover these expenses and lower your overall healthcare expenses. If you decide to purchase Medicare supplement insurance, you might have already discovered that there are many plan options available. So, just what is Plan F, and how does it work? Keep reading as we give you all the details on Medicare supplement Plan F.
What Is Medicare Supplement Plan F?
Medicare Supplement Plan F is one of the most comprehensive Medigap plans available, and it can help cover out-of-pocket expenses not covered by Original Medicare. As you likely already know, Medicare supplement insurance plans help you with expenses not covered by Medicare. Those expenses come in various ways, like copayments, coinsurance amounts, deductibles, and even services that Medicare doesn’t cover. There are many different Medigap plans available, and Plan F is one of the most comprehensive. It will help pay for nearly every out-of-pocket cost that you may have with Original Medicare. However, you should know that Plan F policies are no longer available to new Medicare enrollees as of 2020. If you already had Plan F coverage before this date, then you will be allowed to keep it.
Medigap policies are generally standardized according to state law. In fact, they are the same across 47 states in America. Only Massachusetts, Minnesota, and Wisconsin have their own rules when it comes to Medigap. Plan F is generally considered the most comprehensive Medigap plan available because it even covers your Medicare Part B deductible. As of 2020, the law no longer allows coverage of the Part B deductible. Now, Medigap Plan G is usually considered the most comprehensive. It provides essentially the same coverage as Plan F, except for the Part B deductible.
What Medicare Supplement Plan F Covers
Since Medigap plans are managed and administered by private insurance companies, they get to set their own rules regarding coverage and costs. The great thing about Medigap policies is that they are standardized in most states today. So, just what does Plan F cover? Here are some of the most important coverage details.
First, Plan F covers many items associated with your Medicare Part A coverage. Remember that Medicare Part A is your hospital insurance. Part A covers inpatient services and hospital stays, and it requires a deductible and copayments or coinsurance amounts. Plan F will cover your Part A deductible as well as most of your Part A copays and coinsurance amounts. Plan F also covers up to 365 additional days in a hospital stay after your Medicare Part A benefits are used up. Plan F also covers copays associated with care in a skilled nursing facility or hospice care. While Medicare covers blood transfusions after the first three pints, Plan F will pay for the first three pints of blood during a transfusion.
The covered services don’t stop there. Plan F also covers many items associated with your Medicare Part B coverage. Remember that Part B is like regular health insurance. It pays for things like doctor visits, lab work, or preventive care services. However, Part B also has a deductible and copay amounts that must be paid out of your own pocket. Plan F will cover your Part B coinsurance amounts. Remember that Medicare only pays 80% of the cost of services up to the Medicare-approved amount. If your health care provider charges more than this, then you might be stuck paying the difference. Medigap Plan F will pay for these Medicare Part B excess charges, up to a certain amount. Plan F assists with the payment of almost all medical expenses for outpatient services not covered by Medicare — including your Medicare Part B deductible.
Lastly, Medicare does not generally cover medical services that are rendered outside the United States. However, what happens if you are traveling internationally and have a medical emergency? You might be stuck with a big bill if you don’t have the comprehensive coverage provided by Plan F. Plan F will pay up to 80% of the cost of foreign medical services incurred while engaging in foreign travel.
Services Not Covered By Medicare Plan F
Many Medicare beneficiaries might now be wondering what Plan F doesn’t cover. While these plans provide coverage for many items, there are a few things that these standardized plans do not cover. One of the most significant expenses not covered by Plan F is prescription drugs. These Medigap plans will not help you with the cost of your prescription medication. You will need to be enrolled in a Medicare Part D prescription drug plan to get coverage for your prescription drugs.
Plan F also does not pay for stays in assisted living facilities. These charges are not covered by Original Medicare, and they are also not covered by Plan F policies. Similarly, you will not receive help with expenses related to private-duty nursing. If you require either of these services, then you will still need to pay for the expenses on your own.
Another big item that people often wonder about is dental and vision benefits. Plan F does not provide payment for dental or vision services. These items are not covered by Original Medicare, and Plan F does not assist with the cost. Many Medicare Advantage plans provide both dental and vision benefits. However, you should know that you cannot be enrolled in both a Medicare Advantage plan and a Medigap plan. You must select one or the other as the law prohibits you from enrolling in both of these types of plans.
Medicare Plan F Costs For 2022
So, just how much will Plan F cost you in 2022? First, remember that you can no longer purchase a new Plan F policy. However, if you already have a policy, then you will be allowed to keep it in effect. In addition to monthly premiums, there could also be a few other expenses associated with your coverage that we will discuss here. Also, remember that the average cost of Medicare supplement plans varies because private insurance companies are allowed to set their own rates.
— Plan F Premiums
Your monthly premium is typically going to be the largest cost associated with your Plan F coverage. Since it provides the most comprehensive Medigap coverage out there, you can expect that it will generally be the most expensive as well. Since the private insurance companies who administer these plans get to set their own rates, you will find that the premiums vary according to several factors. Your age and location have a large effect on the price of the premium, and other items like your gender, health history, and lifestyle can also affect the cost. In 2023, the average monthly premium for Plan F coverage is around $186 per month. Low-risk individuals can sometimes find coverage as low as $100 per month, while high-risk individuals might pay nearly $500 per month for coverage.
One way to lower your monthly premium is by enrolling in a high-deductible Plan F policy if it is available. Remember that not all Plan F policies are available everywhere, so you would need to check your local area for options. However, the high-deductible Plan F option would lower your monthly premium, although it means that you would be required to meet a deductible before Plan F starts to pay for expenses. Opting for this type of plan could lower your premium to around $55 per month.
— Plan F Deductibles
The standard Plan F has no annual deductible. This means that your coverage will start to pay for covered items right away. However, the high-deductible Plan F does have a deductible that must be met prior to the plan starting to cover your health care costs. For 2023, this amount is $2,700. This means that you will need to pay $2,700 worth of expenses out of your pocket before your Plan F begins to pay for these items. The advantage to enrolling in the high deductible plan is the fact that you will get lower premiums.
— Plan F Copayments
Plan F has no copayment amounts. One of the big reasons for enrollment in Plan F coverage is because it will cover your copay expenses associated with Original Medicare. For instance, imagine you visit the doctor and are required to pay a $20 copay. Instead of paying that amount out of your pocket, your Plan F would pay the copay amount for you. This is one of the reasons why Plan F coverage can be such a good idea and why it is one of the most comprehensive Medigap plans available.
Eligibility & Enrollment For Medicare Plan F
Many people wonder who is eligible for these plans and how you can get enrolled. First, you must be enrolled in Original Medicare to be eligible for Plan F coverage. This means that you must be at least 65 years old and have been a U.S. citizen or permanent resident for at least five years. You can also qualify for Medicare if you have received Social Security disability benefits for at least 24 months or if you are diagnosed with ALS or ESRD. You should be enrolled in Original Medicare and not a Medicare Advantage plan. If you enroll in a Medicare Advantage plan, this will disqualify you from eligibility for Medigap. You may choose to enroll in Part D prescription drug coverage without any effect on your Medigap eligibility.
Enrollment in Plan F is fairly straightforward. Simply navigate to Medicare.gov to find a Medigap plan in your area. You can also talk to a licensed insurance agent in your area to discuss plan options and availability. The best option is to enroll in Plan F coverage during the general enrollment period. This period begins when you first enroll in Medicare Part B after your 65th birthday and runs for six months. Enrolling during this time will allow you to pay the same premium regardless of your medical history. If you decide to enroll after this period expires, you might pay more for your premium. In some cases, your coverage could be denied completely.
Once you find the health insurance plan that you wish to enroll in, you simply need to contact that insurance company to get signed up. Although it is usually best to enroll in Medigap during the general enrollment period, you can also sign up at other times. You may choose to enroll during the open enrollment period each year from January 1 to March 31. Many people who are already enrolled in a Medicare Advantage plan wonder if they can switch to a Medigap plan. The answer is yes. You can switch plans during the annual Advantage plan selection period.
The Bottom Line
If you need a Medigap insurance policy, there are many options out there. Plan A, Plan B, Plan C, Plan D, Plan G, Plan F, Plan K, Plan L, Plan M, and Plan N are the options available. Medicare Supplement Plan G and Plan F are the two best plans on the market; however, Plan F is no longer available to new Medicare enrollees. Plan F includes coverage for nearly all items not covered by Original Medicare — and that even includes your Part B deductible! If you need help lowering your out-of-pocket costs associated with the Medicare program, then a Medigap plan can be a great option!
Frequently Asked Questions
What are the benefits of Medicare Plan F?
The biggest benefit of a Plan F Medigap policy is the fact that it helps reduce your overall out-of-pocket health care expenses. Plan F covers items like copays and deductibles that are not covered by Original Medicare. Instead of paying for these items each time you visit the doctor, you pay a monthly premium for your Plan F coverage. This coverage then covers those items that you would otherwise pay for on your own.
Does Medicare Plan F cover dental?
No, Plan F does not cover any dental expenses. Original Medicare does not provide any dental coverage, and neither does Plan F. If you wish to receive dental coverage, then you would need to find a Medicare Advantage plan that provides this coverage. However, remember that you cannot be enrolled in both Medigap and a Medicare Advantage plan. You must choose one or the other.
What is the difference between Medicare Plan F and Medicare Plan G?
The biggest difference between Plan F and Plan G is the fact that Plan G does not cover your Medicare Part B deductible while Plan F does cover it. The other coverage details for these two types of policies are basically identical. The law no longer allows Medigap to cover your Part B deductible, so remember that Plan F is no longer available to new Medicare enrollees.