by Russell Noga | Updated August 2nd, 2023
Are you looking for the most comprehensive Medigap plan available? Plan F offers the best coverage for the inpatient and outpatient costs associated with your medical care and treatment.
You don’t have to worry about your medical expenses with Plan F; this supplemental policy takes care of everything.
However, there’s a catch. Medigap Plan F is only available to people eligible for Medicare Part A & B before January 1, 2020. If you turn 65 after this date, you must look at Plan G for your supplemental Medicare insurance.
If you’re eligible for Original Medicare before January 1, 2020, you can still apply for Plan F. Anyone currently enrolled in Plan F may stay on the plan for as long as they want.
So, what does Medicare supplement Plan F cover? This article unpacks all the benefits and coverage you receive with this policy.
How Does Medigap Plan F Work?
Medigap Plan F is the most comprehensive supplemental insurance policy available to Original Medicare members. We’ve discussed the eligibility criteria for Plan F since its discontinuance in January 2020, but call us if you have any questions regarding your eligibility for this plan.
Medicare Parts A & B cover up to 80% of the inpatient and outpatient medical costs you incur during the year. However, that means you’ll have to pay for an additional 20% of costs, and that’s where Medigap plans come into play.
These supplemental insurance policies cover the remaining 20%, with Plan F offering the most comprehensive level of coverage available.
What Does Medicare Supplement Plan F Cover?
Here’s the coverage Plan F offers you.
- Part A hospital costs and coinsurance up to an additional 365 days after using up your Original Medicare benefits.
- The Part A deductible.
- Part A hospice care coinsurance or copayment.
- Part B copayment or coinsurance.
- Part B deductible. (Plan F is the only Medigap plan offering cover for this deductible).
- Part B excess charges associated with doctors charging more than Medicare-approved amounts.
- Coinsurance for care at skilled nursing facilities.
- Blood transfusion (first three pints).
- Emergency health care services outside of the US when traveling.
Some insurers offer Plan F as a high-deductible policy in some states. A high-deductible approach means the Part A deductible increases from $1,600 to $2,700 in 2023.
You’ll have to pay 20% of your healthcare expenses until meeting this deductible threshold, where Plan F activates and takes care of the rest.
High-deductible plans come with the benefit of a lower premium but a higher deductible. They’re a better choice for healthy seniors who want the optimal coverage level for medical emergencies but don’t see the doctor much during the year.
What Isn’t Covered by Medigap Plan F
The only thing Plan F doesn’t cover is the costs involved with preventative care, such as acupuncture and physical therapy.
It also doesn’t cover healthcare expenses involved with vision, hearing, and dental services. Plan F also doesn’t cover the costs of private-duty nursing or prescriptions.
However, some insurers offer additional addendum plans covering these healthcare services for an additional fee. Or, if you need coverage for your prescriptions, you can also take Plan D.
How Much Does Plan F Cost?
Plan F is the most expensive Medigap policy. Since it’s discontinuance, it’s not available in all states. However, if you live in a state where you can get Plan F, you will pay a hefty premium.
Insurers set different premiums for their Medigap policies and can charge whatever they like for Plan F.
So, you might find that Plan F in your state costs X from one insurer, and it’s more expensive or cheaper from another provider. Likewise, Plan F might be more costly in some states than others.
The coverage will be the same, but the premium rates can differ vastly. That’s why you need an experienced, licensed Medigap broker assisting you with finding the best rate for Plan F in your state.
Insurers will also use factors like your age, gender, and smoking status when assessing how much to charge you for Plan F. Your premiums usually increase as you age, and smokers and men will pay higher premium rates than women and nonsmokers.
What are the Alternatives for Medigap Plan F?
If you’re not eligible for Plan F because you turned 65, you can always go with Plan G for your supplemental healthcare insurance policy. Plan G offers you all the same benefits as Plan F, except that it doesn’t cover the Part B deductible in Original Medicare.
However, you’ll get a much lower premium for Plan G than Plan F, and the savings you make on premiums during the year will likely cover this amount, and you’ll come out ahead with extra savings. Plan G is also available in high-deductible options from select providers in certain states.
Call us for more information.
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How Do I Enroll in Medigap Plan F?
Medigap policies are not offered by the Federal government; they’re available from private healthcare insurers like Blue Cross Blue Shield and Aetna. Not all healthcare insurance companies offer Plan F, and those that do may charge different rates for monthly premiums.
That’s why you need a professional, licensed broker to assist you with finding the best deal on Plan F in your state.
You’re eligible for Plan F if you turn 65 before January 1, 2020. However, since you’re enrolling after six months from for 65th birthday, you’ll have to undergo medical underwriting by the insurer before they accept you into their Medigap plan.
The underwriting process will assess your health. If you have pre-existing health conditions, the insurer will likely deny your application for Plan F. However, the insurer will usually offer you the plan if you’re in good health.
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Frequently Asked Questions
What is Medicare Supplement Plan F, and what type of coverage does it provide?
Medicare Supplement Plan F is a popular insurance plan that offers extensive coverage to fill the gaps left by Original Medicare. It covers various out-of-pocket expenses such as deductibles, coinsurance, and copayments.
Does Medicare Supplement Plan F cover Medicare Part A coinsurance and hospital costs?
Yes, Plan F covers the Part A coinsurance and hospital costs, ensuring you have financial assistance during hospital stays.
What about coverage for skilled nursing facility care under Medicare Supplement Plan F?
Plan F covers the Part A coinsurance for skilled nursing facility care, providing support for extended stays and rehabilitation.
Is Medicare Part B excess charge coverage included in Plan F?
Yes, Plan F covers Medicare Part B excess charges, which can occur if a healthcare provider charges more than the Medicare-approved amount.
Does Medicare Supplement Plan F provide coverage for Medicare Part A deductible?
Yes, Plan F covers the Medicare Part A deductible, helping you manage the initial costs of inpatient hospital care.
What does Plan F offer in terms of coverage for Medicare Part B deductible?
Plan F covers the Medicare Part B deductible, which is the annual amount you need to pay before Medicare starts covering your outpatient services.
Are outpatient services and doctor visits covered under Medicare Supplement Plan F?
Yes, Plan F covers the Part B coinsurance or copayments for outpatient services and doctor visits, reducing your out-of-pocket expenses.
Does Medicare Supplement Plan F include foreign travel emergency medical benefits?
Yes, Plan F provides coverage for foreign travel emergency care up to 80% of the billed charges, with a lifetime limit of $50,000.
What prescription drug coverage is available under Medicare Supplement Plan F?
Plan F does not include prescription drug coverage. To address prescription medication needs, you may need to enroll in a separate Medicare Part D plan.
How can I determine if Medicare Supplement Plan F is the right choice for me?
Evaluating your healthcare needs, budget, and preferences is crucial in deciding if Plan F suits you. Consulting an insurance expert or visiting the official Medicare website can provide personalized guidance.
Consult with Experts on Medigap Plan F
If you’re eligible for Plan F under the abovementioned criteria, call us at 1-888-891-0229.
We can assist you in enrolling into Plan F with the right provider in your state. Our team will source you the most affordable premium for Plan F from the best provider in your state.
If you can’t call right now, fill out the contact form on this site, and we’ll have a licensed, professional broker call you back for a free consultation. Alternatively, you can use the calculator on our site to get an automated quote.
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.