Medicare Supplement Plan F Explained
Medicare Supplement (MS) Plans, also known as Medigap, are insurance plans sold by private insurance companies. These plans are designed to help pay for some of the health care costs that Original Medicare (Part A and Part B) doesn’t cover, like copayments, coinsurance, and deductibles.
There are 10 Supplement plan types offered in most states, and each plan includes a certain level of coverage—A, B, C, D, F, G, K, L, M, and N. Plan F is the most comprehensive of these plans, offering the most complete coverage available.
What Plan F Covers
All supplement plans are standardized in most states, meaning that regardless of where you live or which insurance company you buy your policy from, the coverage will be the same. However, even though the benefits are the same, your premiums may vary.
These types of plans in Massachusetts, Minnesota, and Wisconsin are standardized differently than in the rest of the country. If you live in one of these states, contact one of our licensed insurance agents or your local state insurance department to help you understand your options.
Below is a list of basic benefits covered:
- Hospitalization: Part A coinsurance plus coverage for up to 365 additional days after Part A benefits end
- Medical Expenses: Part B coinsurance or copayment for outpatient services, treatments, supplies, and more
- Blood: Coverage for the first three pints of blood
- Hospice Care: Part A coinsurance or copayment
In addition to the basic benefits, Plan F also provides the following:
- Skilled Nursing Facility Care: Part A coinsurance
- Hospitalization: Part A deductible
- Hospital Outpatient Services: Part B deductible
- Part B Excess Charges: Pays for the difference between what a doctor or other provider legally charges and the Medicare-approved amount
- Foreign Travel Emergency Coverage: 80% (up to your plan’s limit)
Because it covers costs in excess of the Medicare-approved amounts, you may not have any out-of-pocket costs for hospital and doctor’s office care with this plan. This plan is a popular choice for those who want more financial assistance with out-of-pocket costs. However, the premiums may be more expensive due to the comprehensive coverage.
Rate comparison to understand how much it costs
The costs vary depending on the county you live in and the insurance companies that offer the plan in your location.
Although it offers the most coverage of all 10 MS Plans, it doesn’t completely cover the costs you may have with Part A and Part B. If you are paying premiums for Part A and/or Part B, for example, you still need to pay those, as Plan F does not cover these costs.
It also has a high-deductible option. The coverage is the same, but the costs are different. If you choose the high-deductible option, you have to pay a deductible ($2,300 in 2019) each year before the plan pays anything.
This amount can go up each year. High-deductible policies have lower premiums, but if you become sick, you’ll have higher out-of-pocket costs. Depending on where you live, you may be eligible for a Medicare SELECT Plan F.
This policy generally requires you to use specific hospitals, and in some cases, specific doctors. If you purchase this type of policy, you may change your mind within 12 months and switch to a standard Supplement plan.
There are other plan options with lower premiums, but if you visit the doctor frequently or require a lot of health care services, Plan F may be a good option for you.
The end of Plan F
Plan F is being phased out of Medicare for new enrollees starting in 2020. That means you won’t be able to enroll in Plan F after 2020.
If you have a Plan F policy on January 1 2020, you won’t be kicked out of the plan. You can stay as long as you like. Since no new members can join the plan but any member can leave, however, fewer people will have P.
When to enroll
To join or switch Supplement Plans, apply with the insurance company directly. To get a quote in your area, click here.
We recommend joining a plan during the Medigap Enrollment Period. This is a six-month period that begins the first day of the month that you are enrolled in Part B and are 65 or older.
During this period, you are protected by federal law that ensures you won’t be charged more—or refused coverage—due to your health history. This is called a guaranteed issue right.
You may lose your guaranteed issue right if you purchase a Supplement plan after your Medigap Open Enrollment period has ended. However, there are exceptions in certain situations. For example, you may still have a guaranteed issue right if you have other health insurance and you lose coverage because that health plan no longer services your area.
Learn more about scenarios in which you have guaranteed issue rights.
What else do I need to know about plan F?
Here are some other things you should keep in mind:
- You must be enrolled in Part A and Part B to purchase Plan F.
- Massachusetts, Minnesota, and Wisconsin standardize their plans differently. If you live in one of these states, please contact us for more information, or contact your local state insurance department.
- Of the 10 different Supplement plans offered, Plans F and C are the most popular plans among the carriers.1
If you want to learn more about your plan options, we can help. See our benefits guide to supplemental insurance plans here, or use our Suggest a Plan tool to understand which may be a good choice for your healthcare needs.
1 Kaiser Family Foundation, “Medigap: Spotlight on Enrollment, Premiums, and Recent Trends”