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Medicare can be a complicated subject—especially when you dive into all its variations. “A lot of people hear ‘Part A,’ ‘Part B,’ ‘Plan F’ and all these different letters flying around, and they definitely get a little confused,” says Sterling Price, a senior research analyst at ValuePenguin who specializes in health and life insurance.
Medicare is the federal health insurance program for older U.S. adults, available starting at age 65. It consists of two main plan options: Medicare Part A covers hospitalization without a premium, and Medicare Part B covers doctor and outpatient care for a monthly premium.
Meanwhile, Medicare Plan F is an example of Medicare Supplement Insurance (Medigap). As its name suggests, Medigap helps fill the gaps that Medicare doesn’t cover.
“When you go to the doctor, Medicare pays 80% of the approved amount,” says Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center. “If you didn’t have a Medigap, you would pay 20%. But if you buy a Medigap plan, it pays that 20%.”
Despite its popularity, Medicare Plan F is no longer available to anyone signing up for Medicare for the first time. Here’s what that means for you.
What Is Medicare Plan F?
Historically, Medicare Plan F provided the most benefits of all the Medicare Supplement plans, says Price. It addresses some of the coverage gaps in Medicare Part A and Part B, which is why many people thought it was worth the extra premium, he notes.
The main benefit of Plan F, which sets it apart from other Medigap plans, is that it covers the
Medicare Part B annual deductible.
“Plan F was the best plan available,” says Price. “That’s why people were so interested in it. It was so popular, it was just automatically like, ‘OK, I’m signing up for Plan F. I’m not going to look at anything else.’”
What Does Medicare Plan F Cover?
Regardless of which insurance provider you choose, Plan F provides the following benefits:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B deductible
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Skilled nursing facility care coinsurance
- Blood transfusion (first three pints)
- Foreign travel emergency coverage (maximum of $50,000, after hitting a $250 deductible)
Plan F was designed to cover most charges that are not covered by Original Medicare. However, Plan F does not cover every medical cost or concern.
What Is Not Covered by Medicare Supplement Plan F?
Plan F’s coverage is robust, but it still has gaps. For instance, Plan F does not cover:
- Prescription drugs
- Hearing health
- Dental care
- Vision care
- Surgeries that are deemed “cosmetic”
If you’re counting on coverage for any of those benefits, you’ll need to purchase additional coverage.
How Much Does Medicare Plan F Cost?
This figure depends on a multitude of factors. Plan F premiums hinge heavily on where you reside, but gender, age and tobacco use all come into play as well as insurance providers determine their rates. Sometimes discounts are available for non-smokers, women or married people who have multiple policies. Meanwhile, companies that use medical underwriting might set higher premium rates depending on your health status.
People who are eligible for Plan F enrollment can expect to pay a monthly premium between $150 and $400 , with the average hovering around $230. Again, that number could vary significantly depending on the provider you pick and the personal factors mentioned above.
If you choose a high-deductible Plan F option, the annual deductible is $2,490.
Who Is Still Eligible for Medicare Plan F?
Those who were eligible for Medicare on or before January 1, 2020 can still sign up for Medicare Plan F. People who already had or were covered by Medicare Plan F before January 1, 2020 are also able to keep their plan.
Eligible people can purchase Medicare Plan F from private health insurance companies, such as Aetna, UnitedHealthcare and Kaiser Permanente, says Price.
Medicare Plan F Alternatives
People newly eligible for Medicare can’t sign up for Plan F, but they still have options when it comes to other Medigap plans. Here’s a look at what some experts say are the two best alternatives to Plan F.
Medicare Plan G
Medicare Supplement Plan G is generally the best option for people who are no longer eligible for Plan F, says Price. “It’s very similar to Plan F,” he notes.
Plan G features almost the exact same benefits of Plan F, with one main difference: It doesn’t cover the Part B deductible. “It’s basically Plan F without the deductible—kind of a modern-day Plan F,” says Price.
The premium for Medicare Part G varies based on the company from which you purchase your plan. You can choose from a normal plan with no deductible or a high-deductible version of the plan.
Some of the things that Medicare Plan G covers include:
- Medicare Part A deductible, coinsurance, hospital costs and hospice coinsurance or copay
- Skilled nursing coinsurance
- The first three pints of blood
- 80% of foreign travel emergencies
“They’re as covered as they can be,” says Price, referring to people who sign up for Plan G. “They won’t see unexpected medical bills or stuff like that, and they’re willing to fork over a little bit more money to have that peace of mind.”
Medicare Plan N
Plan N can be a solid alternative to Plan F, and it’s typically less expensive than Plan G, says Price. Like Plan G, it doesn’t cover the Part B deductible.
One of the main differences between Part G and Part N is Part N doesn’t cover the excess charges related to Part B, which occur when a doctor charges more than a Medicare-approved amount. Plan G does cover those excess charges.
What Is a Medicare Supplement Plan?
Medicare Supplement plans, also known as Medigap plans, help fill coverage gaps left by Medicare Part A and Medicare Part B. To purchase a Medicare Supplement plan, you must first enroll in Original Medicare Part A and Part B.
Medicare Supplement plans can be purchased from private insurance companies. Every Medigap plan is required by the Centers for Medicare & Medicaid Services (CMS) to provide the same set of standardized benefits. However, premiums vary from provider to provider and can vary widely depending on a variety of factors, such as where you live, your gender and tobacco use. All Medicare Supplement plans and policies provide individual coverage.
How to Choose a Medicare Supplement Plan
Now that Medicare Plan F is only available to a certain subset of the population, those who are just signing up may struggle with their coverage decisions. Is a Medigap Supplement plan necessary? And is Plan G the best option?
Price recommends doing online research and speaking with an insurance agent who can guide you through the process. Medicare.gov also has a tool that helps people find and compare supplement plans.
“Really focus on the things that matter to you most—whether that be getting the maximum amount of coverage or saving some money,” says Price, regarding the research process.
And don’t stress too much about the phaseout of Plan F. “We haven’t seen this be a big problem,” says Schwarz. “It’s just not that significant because these other plans are available.”
Frequently Asked Questions (FAQs)
What is the difference between Medicare Plan F and Plan G?
Plan G features almost the exact same benefits as Plan F, with one key difference: It doesn’t cover the Part B annual deductible.
Why is Medicare Plan F being discontinued?
Medigap Plan F is being phased out as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which prohibits the sale of Medicare Supplement plans that cover Medicare Part B’s annual deductible in full. By discontinuing these plans, all Medicare beneficiaries can expect some degree of out-of-pocket spending when using health care services.
What are the benefits of Medicare Plan F?
According to Medicare.gov, Plan F covers:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B deductible
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Skilled nursing facility care coinsurance
- Blood transfusion (first three pints)
- Foreign travel emergency coverage (maximum of $50,000, after hitting a $250 deductible)
Should I switch from Medicare Plan F to Plan G?
Medicare Supplement Plan G is generally the best option for people who aren’t eligible for Plan F, according to Sterling Price, a senior research analyst at ValuePenguin who specializes in health and life insurance.
Medicare Plan G coverage includes:
- Medicare Part A deductible, coinsurance, hospital costs and hospice coinsurance or copay
- Skilled nursing coinsurance
- The first three pints of blood
- 80% of foreign travel emergencies
“They’re as covered as they can be,” says Price, referring to people who sign up for Plan G.
