What is Medigap Plan F & What Does It Cover?

Medigap Plan F – Plan F has long been known as the “best” Medicare supplement plan on the market. While that might be true, you should still learn more about it before you enroll because, believe it or not, it’s not for everyone!

What is Plan F?

Plan F is one of the Medigap plans available to Medicare beneficiaries who want to reduce their out-of-pocket medical expenses. All Medicare supplements act as a secondary form of insurance and pay on claims after they’ve been sent through Original Medicare (Parts A and B).

What does Plan F cover?

The coverage it provides is what makes Plan F so well known. Coverage includes:

• Part A deductible
• Part A coinsurance with an extra 365 days of coverage after Original Medicare stops paying
• Part A hospice coinsurance
• Skilled nursing facility coinsurance
• Part B deductible
• Part B excess charges
• Part B coinsurance and copays
• First three pints of blood
• Foreign travel emergencies (up to plan limits)

That long list of benefits includes every single out-of-pocket cost that would otherwise be yours to pay. That’s right; if you enroll in Plan F, you won’t have any financial responsibility for Medicare-approved services.

Who can enroll in Plan F?

The downside of Plan F is that not everyone is eligible for this plan. Only those who turned 65 before 2020 are eligible. Beginning in 2020, no newly-eligible Medicare beneficiary could enroll in a plan that offered first-dollar coverage, meaning that it paid all of your deductibles. Since Plan F did just that, it’s not available to new beneficiaries. Only those who turned 65 before 2020 are eligible. If you do meet the age threshold, you can enroll in Plan F as long as you are enrolled in Medicare Part A and Medicare Part B. Enrollment is open year-round, although you may have to pass medical underwriting if you don’t have guaranteed issue rights.

How much does Medicare supplement Plan F cost?

To enjoy the benefits of Plan F, you’ll have to pay a higher monthly premium. Not all premiums are the same. Individuals who live in zip codes associated with higher costs of living will pay more, as will older individuals. Men pay more than women, and tobacco users pay more than non-users.

Outside of those factors, your insurance carrier sets rates according to their pricing method. While the plans themselves are standardized, the rates are not. (Standardization means that Plan F is Plan F, no matter where you buy it.) Some insurance companies are known for charging more and for increasing their rates faster than others. This is why it’s so important to work with an independent agent – they can shop around at different carriers to find you competitive rates, and they know a carrier’s rate increase history. All of that to say, the average premium for Plan F ranges from $150 – $300 per month. Other Considerations If You Enroll in Plan F There are a few things to consider if you do choose to enroll in Plan F or any other Medicare supplement plan. First, you’ll need to enroll in Medicare Part D to get prescription drug coverage. Many beneficiaries mistakingly assume that if they aren’t taking medications, they don’t need a Part D plan. It’s easy to see why so many make this assumption, but we urge you to enroll regardless of your current medication needs. If you don’t enroll, you’ll pay a late enrollment penalty later. And, that penalty stays with you for life! In addition, Part D enrollment is not open year-round. If your doctor prescribes something outside of one of those enrollment windows, you won’t be able to get coverage until the next enrollment opens. Another thing to consider is other health-related needs. Medicare supplements do not help with preventive and restorative dental treatment, hearing exams or hearing aids, or vision exams or eyeglasses. (In some situations, vision and hearing exams are covered, but not usually.) If you don’t want to pay for these services yourself, you should consider enrolling in a DVH (dental, vision, hearing) plan to help with these medical costs. If you have more questions about Medigap Plan F or you’d like to discuss your other Medicare options, contact one of our Medicare advisors. Our priority is making sure you understand how your plan works and how to get the most out of your benefits. Give us a call today to speak with our licensed insurance agents.