by Russell Noga | Updated May 8th, 2023
Are you currently on Medicare Supplement Plan F? It’s one of the most comprehensive Medigap plans available. However, it’s expensive, and you get most of the same benefits using Plan G, but Plan G comes with a more affordable monthly premium.
So, you might wonder if you can switch from Plan F to Plan G and save on your annual healthcare expenses with this option.
53% of all Medicare members utilize a supplemental “Medigap” plan to support the additional medical expenses not covered by Original Medicare. Private insurance companies issue these plans, and they come in several options.
Medigap is a gap cover for out-of-pocket medical costs that Original Medicare Part A and Part B don’t cover. Plan F was the go-to choice for the most comprehensive medical coverage for the longest time.
However, new Medicare members can no longer access Medicare Supplement Plan F, as it’s only available for legacy members. Instead, Plan G offers an attractive alternative with nearly all the same benefits and a lower monthly premium.
Changing Plans - Medical Underwriting
As a short answer, yes. You can switch, but you’ll need to pass the underwriting process to qualify. Underwriting involves looking at your medical history to review your eligibility for joining Plan G. Plan G might not cover you for certain pre-existing medical conditions.
For professional advice on making the switch from Plan F to Plan G, call our team at 1-888-891-0229.
Why Did Medicare Discontinue Medigap Plan F?
Congress passed the “Medicare Access and CHIP Reauthorization Act” in April 2015, aiming to reduce Medicare expenses for members. The Act stipulated that insurers couldn’t sell policies covering the annual Medicare Part B deductible to new Medicare members as of January 1, 2020.
This legislation effectively prevents insurers from offering Medigap Plan F or C to new beneficiaries after January 1, 2020, because these plans cover the Part B deductible. Plan F or Plan C members enrolled before January 1, 2020, can stay on Plan F or C.
Americans eligible for Medicare before January 1, 2020, can still apply for Plan C or F if it’s available in their state.
What are the Benefits of Medicare Supplement Plan G & F?
Plans G and F provide beneficiaries with 100% coverage for the following.
- Medicare Part A deductible.
- Medicare Part A hospital costs and coinsurance.
- The first three pints of blood in transfusions.
- Coinsurance for skilled nursing facilities.
- Medicare Part A hospice care copays or coinsurance.
- Medicare Part B excess charges.
- Medicare Part B coinsurance or copays.
- Coverage for 80% of emergency care costs when traveling abroad.
- Plan F covers the Medicare Part B deductible, but Plan G doesn’t offer this.
Medicare Plan G vs Plan F – Out-of-Pocket limits
Plans F and G have no limitations on the amount of qualifying out-of-pocket costs. So, in the case of severe injury or illness, members can incur high hospital fees and not have to pay a dime extra for the care they receive.
Policy Premium Costs
Plans G and F require the member to pay a monthly premium. The premium cost depends on your policy, and premiums vary depending on your location in the United States. The insurer offering your plan formulates the premium structure. So, the premium can vary, depending on who you choose as your insurer and other factors like your age, smoking status, and gender.
High-Deductible Medigap Plans
Both Medicare Plan G and F have high-deductible options in certain states. The high-deductible option means you pay a higher deductible (the threshold amount before benefits kick in), but they have a lower monthly premium.
The High-deductible option is ideal for healthy seniors who don’t require many healthcare services during the year. Plan premium costs and availability vary by state and provider. So, compare the options for Medigap Plan G & F where you live.
Plan G vs Plan F – Availability
Plan F is available from 85% of insurers, and Plan G policies are available from 73% of insurers. Plan F policies are no longer available to new Medicare members, but those with existing policies receive ongoing coverage in many states.
Medicare members can purchase Plan G policies, except for Minnesota, Massachusetts, and Wisconsin residents. These states standardize Medigap plans.
Which Is Better – Is Medigap Plan or Plan G?
There are plenty of similarities between Medigap Plan F and G. You’ll need to consider several points when choosing to switch from Plan F to Plan G. Plan F covers the Medicare Plan B deductible, offering a more comprehensive level of cover compared to Plan G, but with a more expensive monthly premium.
Your annual savings on taking Plan G over Plan F may be enough to cover your Part B deductible. If Plan F premiums cost more annually than the $226 required for the Medicare B deductible and the Plan G premium, you’ll save money by enrolling in Plan G.
Tips for Switching from Medicare Supplement Plan F to Plan G
- For members enrolled in Plan F before 2020, you can stick with Plan F or switch to Plan G, provided you pass underwriting.
- Making the change from Plan F to G could significantly reduce the costs of your supplemental Medicare premiums. However, every state has different rules to consider before switching.
- Medicare members can switch their Medigap plan anytime in states like New York City.
- California’s “birthday rule” allows members to switch their Medigap plan around their birthday.
- Both CA and NY typically automatically approve applications to switch Medigap plans, even if the member has pre-existing health conditions.
- Some states require members to apply for a Plan G Medigap policy if they want to make the switch.
- Those members applying without guaranteed issue rights may find private insurers require medical underwriting to determine premium costs, and underwriting results may cause them to deny coverage.
What are the Benefits of Medicare Advantage?
The following are some of the most notable benefits that Medicare Part C provides:
- Rather than having to deal with Part and Part B of Original Medicare as two different entities, the coverage that both of these parts of Original Medicare provides are bundled under a single plan. Additionally, you may also be able to add Medicare Part D (prescription drugs) into a Medicare Advantage plan.
- Usually, additional benefits are available and can be grouped under Part C; vision, dental, hearing, mental health, and even food delivery after an inpatient hospital stay.
- The cost of your out-of-pocket expenses may be lower than they would be if Part A and Part B were kept separate.
- You will be granted all of the protections and rights that are provided under Medicare.
Disadvantages of Medicare Advantage
There are some downsides associated with Medicare Part C, as well; the following, in particular:
- The list of in-network doctors and specialists that Part C will cover will be smaller than the list of in-network doctors and specialists under Original Medicare.
- For some services, you might be required to get a referral or authorization, depending on the specific type of plan you have.
- You may not be eligible for a Medicare Supplement Insurance plan (also known as Medigap) if you end up reverting to Original Medicare, or the cost of Medigap Policies could go up.
Frequently Asked Questions
Can I switch from Medicare Plan F to Plan G?
Yes, you can switch from Medicare Plan F to Plan G. However, it’s important to understand the underwriting rules and guidelines associated with this transition.
What are the underwriting rules when switching from Plan F to Plan G?
Medicare supplement plans and companies require medical underwriting if you wish to apply for a different plan. This means you may need to answer health-related questions and undergo a medical evaluation before the switch is approved. Each insurance company has their own medical underwriting guidelines, so be sure to call us today and we’ll compare your situation with what each company offers to see if there is a good solution.
Are there any guaranteed issue rights when switching from Plan F to Plan G?
In most situations, there are not guaranteed issue rights when switching from Plan F to Plan G. Some states have a guaranteed issue period for everyone, and others have a Birthday rule where you may switch within 30 days of your birthday to the same or lesser coverage. Call us today to see if you qualify.
What are the pros of switching from Plan F to Plan G?
Some benefits of switching to Plan G include lower premiums compared to Plan F while still getting comprehensive coverage (except for the Medicare Part B deductible). Medicare Plan G often has lower rate increases each year than Plan F.
Are there any cons of switching from Plan F to Plan G?
One potential drawback of switching to Plan G is the requirement to pay the Medicare Part B deductible out-of-pocket. In most cases, paying this yourself with Plan G will actually save you more money over Plan F.
Can I switch from Plan F to Plan G at any time?
Generally, you can apply to switch from Plan F to Plan G at any time throughout the year. You do not need to wait until the Medicare Annual Enrollment Period (AEP) in October if you already have a Medigap plan.
Will my current insurance company automatically switch me from Plan F to Plan G?
No, your current insurance company will not automatically switch you from Plan F to Plan G. We can help you apply for the new coverage, and then we’ll monitor the insurance company’s decision as to if you are approved or not. Only at that time would you cancel your old policy.
How do the coverage benefits of Plan F and Plan G compare?
Both Plan F and Plan G provide similar coverage, with the exception of the Medicare Part B deductible. Medigap Plan F covers this deductible, while Plan G does not. However, Plan G generally has lower premiums, making it a cost-effective option for many beneficiaries.
Is it possible to switch back to Plan F after switching to Plan G?
If you switch from Plan F to Plan G, there is no guarantee that you will be able to switch back to Plan F in the future. It will depend on the underwriting rules of your insurance company and your health status at the time of the switch
Should I consult with a Medicare expert before switching from Plan F to Plan G?
It is highly recommended to consult with one of our Medicare experts before making any changes to your Medicare coverage. We can provide personalized advice based on your specific needs and circumstances to help you make an informed decision about switching from Plan F to Plan G.
Find the Right Medicare Plan for You
Finding the right Medicare plan is now easier than ever. If you have questions about a Medigap plan, Medicare Advantage, or Medicare Part D, we can help.
Call us today at 1-888-891-0229 and one of our licensed insurance insurance agents will be happy to help.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.