Table of contents
Table of contents
Medicare recipients in the United States spend an average of $6,663 in out-of-pocket costs per year, according to the AARP.[1] That’s a lot for anyone to pay, let alone if you’re on a fixed income. A good way to lower those costs is by buying a Medicare Supplement Plan, also known as “Medigap.”
Medigap Plan F is one of the best options, covering most, if not all, of your regular healthcare costs. But there’s one catch: Not everyone can buy it. Learn who can purchase this popular plan, how it works, and what else is available if you don’t meet eligibility requirements.
Understanding the coverage of Medicare Plan F
Medicare Plan F is only available to people who opt for Original Medicare (Medicare Part A and Medicare Part B) rather than a Medicare Advantage plan. It helps pay for healthcare costs Original Medicare passes onto Medicare beneficiaries.
Medigap Plan F covers 100% of the following Medicare-eligible expenses:
Part A deductible
Part B deductible
Part A co-insurance and copays
Part B co-insurance and copays
Up to three pints of blood[2]
In addition, Plan F expands some of your existing Medicare coverage. For example, you’ll get an additional 365 days of hospital coverage, and it covers 80% of your healthcare costs if you run into a travel emergency while out of the country. You’ll also get coverage for any billing discrepancies if your doctor bills for more than Medicare will pay.
Plan F is also available with a high-deductible option. Rather than covering eligible expenses right off the bat, a high-deductible version of Plan F will only kick in after you’ve spent $2,800 of your own money first.[3]
Good to Know
It’s important to note that Medicare Supplement Insurance plans may work differently in select states. For example, if you live in Massachusetts, Minnesota, or Wisconsin, you won’t have access to Plan F. Residents of Minnesota, for example, can only choose between a basic plan or an extended basic plan.
Understanding the costs associated with Medicare Plan F
Most people pay the same amount for Original Medicare, but that’s not the case with Medigap policies since private insurance companies offer them rather than the federal government. Your rates for a Plan F policy vary with each insurance company depending on several factors, including your:
Age
Gender
ZIP code
Health status
Eligible discounts
High-deductible option
The best time to sign up for a Medigap plan is during the first six months that you’re eligible for Medicare, if you can. During this Medigap Open Enrollment Period, you can pick any Medigap plan in your state and you won’t have to worry about getting denied or paying extra for having pre-existing conditions. When that window closes, insurers can charge you more or even deny you a policy.
The difference between Medicare Plan F and Plan G
Plan F policies are no longer available as of Jan. 1, 2020. If you already have one, you can keep it for as long as you want. If you’re a new Medicare Supplement policyholder, you’ll need to purchase something else, and Plan G is the next-closest option.
The only difference between Plan F and Plan G is that Plan F covers the Medicare Part B deductible.
This means in 2024 you’ll have to pay $240 out of pocket before your Part B coverage kicks in.
The future of Medicare Plan F
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 ended the ability to buy Plan F and Plan C after 2020. This was done to curb government expenses the program caused.
If you were lucky enough to qualify for Medicare before 2020 and purchased a Plan F policy, you don’t need to worry. You can renew your coverage every year for as long as you wish, provided your insurer doesn’t go out of business.
But people qualifying for Medicare after 2020 must choose another plan type. Medigap Plan G is the most popular alternative since it offers the exact same coverages as Plan F, but it doesn’t cover the Medicare Part B deductible.
In 2023, 53% of new Medicare patients buying a Medicare Supplement plan opted for Plan G.[4]
Factors to consider when choosing another Medicare plan
If you already have Plan F Medigap coverage, keep in mind that you may never be able to buy it again if you voluntarily cancel it now.
For everyone else, here are some things to consider when going through the different types of Medigap plans:
Check your state laws for Medigap coverage options and your rights when switching plans, since some states offer additional protections.
Insurance companies aren’t required to sell you a Medigap plan unless you’re within your Medigap Open Enrollment Period or have “guaranteed issue rights” in certain situations, such as if your insurer is dropping your coverage.
If you switch Medigap plans outside of a Medigap Open Enrollment Period and aren’t covered by guaranteed issue rights, insurers can charge you higher premiums based on your health condition. They can also deny coverage for some health problems or deny you a policy entirely.
You’ll have a 30-day “free-look” period after you buy a new Medigap plan to decide if you want to continue coverage (although you’ll still pay the monthly premium).
You’ll need to cancel your old Medigap policy if you switch to a new plan, but you can schedule coverage to end after your 30-day free look period in case you want to keep your original plan.
Make sure to consider your unique needs for healthcare both now and in the future when selecting a plan since you may not be able to change your coverage again.
High-deductible Plan F is no longer available to new enrollees, but a high-deductible option is still available with Plan G, depending on which state you live in.
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