Medigap Plan F

Medigap Plan F: A Detailed Look At The Most Comprehensive Plan Option On The Market

Medicare Supplement Plan F is one of 10 standardized Medigap plans available to people enrolled in both Medicare Parts A and B.

Standardized means that plans are designed to offer the same benefits regardless of where you buy, except in Massachusetts, Minnesota, and Wisconsin where plans are set up differently.  Medicare supplement Plan F is the most popular Medigap plan because it provides the most comprehensive coverage to fill the gaps in Original Medicare.

“According to the Association for Medicare Supplement Insurance, 66 percent of Medicare beneficiaries choose Plan F.”

Medigap Plan F is the only plan that covers ALL the gaps in Original Medicare. The following are the benefits available with Medicare Supplement plans.

URGENT:  On January 1, 2020, Plan F will no longer be an option when it comes to your Medigap purchase.  Those who purchase the Plan F before this date will be able to keep it, but new enrollees to Medicare or those wanting to switch from another plan to the Plan F will no longer be able to do so.

Whats Not Covered by Plan F

No Prescription Drug Coverage: You can only get Part D prescription benefits if you enroll in a Medicare Part D prescription drug plan.

Doesn’t Cover “The Extras”: Like other Medigap plans, Medicare Supplement Plan F doesn’t include coverage for things like hearing aids, vision and dental care, long-term care, and private-duty nursing.  While other types of policies such as Medicare Advantage plans may offer these benefits, you are paying more out of pocket for your basic medical services and may be restricted to certain hospitals and doctors.

How to Enroll in Medigap Plan F

During the Medigap open enrollment period: The open enrollment period begins the month of your 65th birthday when you’re enrolled in Medicare Part B and lasts for 6 months. This is the BEST time to buy a Medigap policy because you can qualify for any plan that’s sold in your state even if you have health problems.

Outside the open enrollment period: After open enrollment, you have to go through medical underwriting to buy a Medigap policy. You usually can’t enroll in any policy, including Medigap Plan F, if you don’t meet the insurance company’s underwriting requirements.

Plan F vs. The Other Plans

To see how Medigap Plan F fits your needs, it helps to do a side-by-side comparison with the other plan options. The chart above shows the which benefits are covered under each plan. Sections left blank means the plan does not cover that benefit. By doing a Medicare Supplement Plan F comparison, you will notice that Plan C and Plan G are the most similar in terms of the level of coverage available. The only differences are:  Plan C does not cover Part B excess charge while Plan F covers at 100%.  Plan G does not cover part B deductible while Plan F covers at 100%.

Is Medicare Supplement Plan F For You?

There are pros and cons to any Medigap insurance plan. The main advantage of having Medicare Supplement Plan F is you get coverage for ALL the gaps in Original Medicare.  For instance, Medigap Plan F is the only Medicare Supplement plan that covers both your Part B deductible and Part B excess charge. You can pay an excess charge of up to 20% more than the Medicare-approved amount to a provider who doesn’t accept Medicare assignment. An assignment is when a provider accepts the Medicare-approved amount as full payment. While most providers accept assignment, there are some who don’t accept assignment for all services covered under Medicare.

Having the most comprehensive coverage often means paying a higher monthly premium than you would with other plans. So deciding if Medigap Plan F is right for you may be budget dependent. One way to look at it is like this: Would you rather pay a specific monthly premium to get the most coverage, or accept some out-of-pocket responsibility for certain expenses like excess charges and deductibles.

There are other ways to decide if Medigap Plan F is the best fit. And the good news is that you don’t have to figure things out on your own. A knowledgeable licensed insurance advisor here at Senior Market Solutions can help you decide if Medicare Supplement Plan F is the best Medigap plan to meet your needs.

Additional Medigap Plan Information

Premium: The premium you pay for Medigap Plan is completely separate from the monthly premium you pay for Medicare Part B.

Guaranteed renewable: Medicare Supplement policies, including Plan F, are guaranteed renewable as long as you pay your premiums on time, you cannot be canceled.

Covers Individuals: You can only buy a Medicare Supplement policy for yourself. Your spouse would have to buy his or her own policy

No networks: You can use your Plan F or any other Medigap plan nationwide at any provider that accepts Medicare.

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