What is Medicare Part F? What Does it Cost and Cover?

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What Is Medicare Part F?

Medicare Part F, officially known as Medigap Plan F, is a Medicare Supplement insurance policy. Medigap policies like Plan F are designed to help seniors with health care costs not covered by Medicare Part A and Part B, which is called Original Medicare when combined.

There are 10 different Medigap policies, all designated with letters—A, B, C, D, F, G, K, L, M, and N. Plan F is the most complete and most popular Medigap plan. In 2014, 56% of Medicare beneficiaries were enrolled in Medgap Plan F.1 Plan F covers nearly all the costs someone enrolled in Original Medicare might be responsible for, including Medicare Part B excess charges. Plan F also tends to be the most expensive because of the amount of coverage it provides.

You can learn more about Medigap and Medicare Supplement insurance by reading our Medigap FAQ page.

What benefits does Medicare Plan F cover?

Plan F is the most comprehensive of all the Medigap plans. It covers a variety of costs that Medicare beneficiaries might have to pay when they receive health care:2

  • Deductibles for both Medicare Part A and Part B
  • Coinsurance and copayments for Part B
  • Hospital costs for an additional 365 days after Medicare benefits are maxed
  • Coinsurance and copayments for Part A hospice care
  • Coinsurance for skilled nursing facilities
  • Foreign travel emergency costs
  • Excess charges for Part B

Medigap Plan F essentially takes care of all out-of-pocket costs you might encounter with Original Medicare, but you will still be expected to pay for Part B premiums.

What does it not cover?

Even though it’s the most comprehensive Medigap plan available, there are still a few things that Plan F doesn’t cover:

  • Hearing aids and related services
  • Eyeglasses and related services
  • Dental care
  • Private nursing
  • Long-term custodial care

These health care services are not covered by any Medigap plan because they are not covered by Original Medicare. If you need coverage for one or more of these, you can purchase additional private insurance or switch to a Medicare Advantage plan that offers coverage for them. Medicare Advantage plans are offered by only private insurance companies, and they combine Medicare Part A and Part B with additional benefits and coverage, such as dental or vision coverage.

How much does Plan F cost?

The national average for Plan F monthly premiums was between $159 and $236 in 2016.3 The exact costs for Medigap policies, including Plan F, vary depending on a variety of factors. These include where you live, your age, your gender, and whether you smoke.

What is Plan F Select?

Plan F Select is an option offered by some insurers. Plan F Select differs from traditional Plan F in that it only provides coverage for a select network of doctors and hospitals, whereas standard Plan F covers services by any provider that accepts Original Medicare. The advantage of Plan F Select is that it has lower monthly premiums than traditional Plan F. If you already have health care providers that you like and they are in the covered network, Plan F Select can be a good way to save a little money.

What is High-Deductible Plan F?

High-deductible Plan F offers the same network of doctors and hospitals as traditional Plan F, but there is a higher deductible that you’ll need to meet before the plan will start paying for your Medicare costs. But, like with Plan F Select, you’ll pay a lower monthly premium. The deductible for high-deductible Plan F is $2,200.4 Note that this deductible only applies to the Medigap coverage—your normal Medicare coverage is still in effect and will still pay its portion of costs regardless of whether you’ve met your Medigap deductible.

High-deductible Plan F can be a good option for people who don’t go to the doctor often or have chronic health issues.

Who can get coverage?

Plan F is available for anyone who is enrolled in Medicare Part A and Part B. You must be enrolled in both parts of Original Medicare to purchase Plan F.

In order to enroll in Medicare, you must be a US citizen and meet one or more of the following criteria:

  • You are age 65 or older.
  • You have a disability.
  • You have been diagnosed with End-Stage Renal Disease (ESRD).

You cannot be enrolled in both a Medigap policy and a Medicare Advantage plan. If you’re currently enrolled in Medicare Advantage and want to switch to Original Medicare and a Medigap plan, you’ll have to make sure to cancel your Medicare Advantage plan before the new coverage begins.

How do I enroll?

Medigap plans like Plan F are provided by private insurers. Providers, plans offered, and the cost of Medigap plans can vary from state to state. Medigap coverage is standardized across the different letter plans, so for Plan F, the benefits will be the same regardless of which provider you choose and where you live. The only thing that may differ is cost. You can find Medigap plans in your area through our website.

Once you find a plan and provider you like, you can enroll directly with that provider. Generally, this can be done online, or you can call if you prefer. The best time to enroll in any Medigap plan is during the Open Enrollment Period, which is a six-month period beginning when you turn 65 and enroll in Medicare Part B. After this period ends, you can still enroll, but you may be subject to higher rates based on your age and health history.


Sources:

1America’s Health Insurance Plans, “Trends in Medigap Enrollment and Coverage Options, 2014
2Medicare.gov, “How to Compare Medigap Policies
3Bankrate, “Medigap Plan F the Most Costly, yet Popular
4Medicare.gov, “Costs of Medigap Policies

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