What Is Medicare Plan F?Learn more about Medicare’s most popular supplement plan with PolicyScout’s guide to Medicare Plan F.
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A Brief Overview of Medicare
Medicare is a federal health insurance program for people aged 65 or older, individuals with disabilities and people of any age with End-Stage Renal Disease.
To help cover various medical services, the federal Medicare program is made up of different parts:
Part A (Inpatient care) covers the care and treatment of patients in hospitals and other medical facilities. For example, hospice care and skilled nursing facility care.
Part B (Outpatient care) covers outpatient care and services. This includes bills for specialist consultations, screenings, vaccines, and durable medical equipment such as wheelchairs and walkers.
Part D covers the cost of prescription drugs. Instead of being run by the government, these plans are run by private insurance companies.
If you’d like to find out more, be sure to read our 2022 guide to Medicare to learn about the different parts, what your coverage options are and how you can make the most out of it.
Terms You Need to Know:
Deductible: This refers to the set amount you pay for health care services before your insurance begins to pay. For example, if you have a $1,350 deductible you have to pay $1,350 before your insurance kicks in.
Coinsurance: The percentage of costs you pay after your deductible has been met.
Copayment: A set rate you must pay for doctor visits, hospital stays and prescriptions.
Out-of-pocket costs: This term refers to expenses that are not covered by Medicare and that you must pay for yourself. For example, a fee for a visit to the dentist.
A Summary of Medicare Supplement Insurance Plans
The cost of medical care can be overwhelming. This is why many Americans buy Medicare Supplement Insurance Plans to help them cover some of these expenses.
Also known as Medigap plans, a Medicare Supplement Plan is health insurance that you can buy from private companies.
Medicare Supplement Insurance Plans have been designed to help pay for the remaining out-of-pocket costs that Medicare Parts A and B don’t cover.
These expenses include:
Eye tests and glasses
Hearing aids and appointments for fitting them
There are ten standardized Medicare Supplement Plans that you can choose from.
Each plan can be identified by a letter: A, B, C, D, F, G, K, L, M and N. These plans should not be mistaken for Medicare parts that cover basic medical services.
If you live in Wisconsin, Massachusetts or Minnesota, it’s important to note that the policies work differently.
Learn About Medigap Plans in Your State
Depending on which Medicare Supplement Plan you choose, it could cover:
Part of the expense that Original Medicare doesn’t cover, known as the deductible.
20% of the amount you’re responsible for paying, this is called coinsurance.
Any other additional medical costs.
If you already have Medicaid or a Medicare Advantage Plan, private health insurance companies cannot sell you a Medicare Supplement Plan.
To learn more about Medicare Supplement Plans and how they can help lower your out-of-pocket costs, be sure to read this article.
Important Points to Remember:
Medicare Supplement Insurance pays for the expenses that Medicare Part A and B don’t cover.
To be able to buy a Medicare Supplement Plan, you must first be enrolled in Parts A and B.
If you already have Medicaid or a Medicare Advantage Plan, an insurance company cannot sell you a Medicare Supplement Plan.
The 10 different Medicare Supplement Plans you can choose from can be identified by a letter: A, B, C, D, F, G, K, L, M and N.
Who Qualifies for Medicare Supplement Plan F?
Plan F (also known as Medigap Plan F) is one of the most popular choices because it's the most comprehensive Medicare Supplement Plan on the market.
In order to buy a Medicare Supplement Plan you must either be 65 or older, disabled, or suffering from ESRD and enrolled in Medicare Parts A and B.
If you are signing up for Medicare for the first time, Plan F will no longer be available to you.
This is because of the Medicare Access and CHIP Reauthorization Act (MACRA) which was signed into law in 2015.
What Does MACRA Mean for Me?
If you were eligible for Medicare before 1 January 2020 (i.e. you were 65 before this date or qualified for Medicare because of a disability or ESRD) then you will be able to apply for Plan F.
However, if you only became eligible for Medicare after 1 January 2020 (i.e. you turned 65 after this date or did not have a disability or ESRD) then you will not be able to apply for Plan F.
If you already have Medicare Supplement Plan F, you will be able to keep this policy.
Top tip: The best way to see when you were first enrolled is to check your Medicare ID card. The start date should be in a large bold font near the bottom of the card.
What Does Medicare Plan F Cover?
As we mentioned before, Plan F is often the most popular supplement plan because it covers almost all of the benefits that Medicare Part A and B don’t pay for.
As the table below shows, if you have Medicare Supplement Plan F there will be very few medical expenses that you will have to pay for yourself.
How to read the table:
Where you see a percentage, Plan F will cover that percentage of the benefit and you will have to pay the rest.
|Medicare Part A: Coinsurance and hospital costs up to an additional 365 days after Medicare Benefits are used||100%|
|Medicare Part B: Coinsurance or copayment||100%|
|Blood (the first 3 pints)||100%|
|Part A Hospice Car: Coinsurance or copayment||100%|
|Skilled Nursing Facility Care||100%|
|Part A Deductible||100%|
|Part B Deductible||100%|
|Part B Excess Charges||100%|
|Foreign Travel Emergency (up to plan limits)||80%|
Compared to other Medicare Supplement policies, one of the main benefits of Plan F is that it covers the Medicare Part B annual deductible.
A Recap of Deductibles:
A deductible is a set amount you cover for health care before your insurance begins to pay.
Medicare Part B covers outpatient services like specialist consultations and vaccines. This benefit has a standard annual deductible of $233.
Due to the fact that Medicare Plan F covers the Part B deductible, you will not have to pay this amount.
If Medicare Plan F did not cover the Medicare Part B deductible, you would have to pay for outpatient care until you have paid or reached the $233 amount.
Benefits of Medicare Plan F’s Coverage:
For many seniors, saving money on the Part B annual deductible is very beneficial.
The other benefit of Medicare Plan F is that it covers 80% of Medicare-approved costs for foreign travel emergencies.
This is great for seniors who want peace of mind that their healthcare expenses would be partially covered when traveling outside of the United States.
There is also a high-deductible version of Medicare Supplement Plan F. As of 2021, this amount was set at $2,370.
Like the Part B annual deductible example above, you would have to pay or reach the amount of $2,370 before the plan begins to cover your medical expenses.
For many people, the high-deductible plan is an expensive choice. This is why it’s important to consider whether you would be able to pay $2,370 before your medical insurance kicks in.
How Much Can I Expect to Pay for Medicare Supplement Plan F?
To give you a better idea of how much Medicare Supplement Plan F could cost you, take a look at this breakdown:
The Medicare Plan F monthly premium is set by the insurance company you buy the policy from, or
$2,370 if you choose Plan F’s high-deductible option
Standard Plan F vs High-Deductible Plan F:
It’s important to note that because Plan F offers such comprehensive coverage, the monthly premiums are generally more expensive than other plans.
Research shows that the average monthly premium for the standard version of Plan F ranges from $271.00 to $800.98.
However, the advantage is that you will have almost no out-of-pocket expenses when you need medical care.
Remember, your premium will depend on the insurance provider, state, and your unique health circumstances.
If you choose Plan F’s high-deductible option, you will likely have lower premiums compared to the standard version.
The average cost of Plan F’s high-deductible premiums ranges from $47.50 to $88.68.
Although this may sound like a good choice, you will have to reach or pay $2,370 before your insurance begins to cover your medical expenses.
This is why it’s important that you weigh up all the costs and carefully consider your healthcare needs before choosing which version of Plan F will work best for you.
How Do Insurance Companies Set Premiums for Medicare Plan F?
Although Medicare Plan F benefits are standardized, health insurance providers can charge different rates for the same coverage.
This can depend on their location, plan options, and pricing structure.
There are three ways that insurance businesses set their premiums for Medicare Plans:
Community-rated: This premium is not based on your age. This means that the same monthly premium is charged to everyone. However, the price will vary according to inflation.
Issue-age rated: This premium will be based on the age you are when you buy the policy. Therefore, the premium is lower for people who buy it at a younger age and won’t change as you get older.
Attained-age rated: This premium is based on your current age and will go up as you get older. Although these premiums might be the least expensive at first, they will eventually become the most expensive and are also affected by inflation.
Insurance companies will also consider where you live and what your lifestyle habits are when they set your monthly premium.
You should compare the price of Medicare Supplement Plan F from a few different insurance businesses.
This is an effective way to make sure you find a premium that works for your budget.
When Do I Enroll in Medicare Supplement Plan F?
One of the best times for new members to enroll into a plan is during the Medicare Supplement Open Enrollment Period. Here’s why:
Companies cannot reject you based on your medical history or pre-existing health conditions
You will most likely get better prices
There will be more options for you to choose from
Enrolling outside of this period could put you at risk of paying higher premiums and you might be denied healthcare coverage due to pre-existing conditions.
When Does the Open Enrollment Period Begin?
You must be 65 or older for the Open Enrollment Period to begin.
Generally, this window only happens once in your life (unless you collect Social Security Disability Income) and will last for six months.
The six-month window starts on the first day of the month that your Medicare Part B (Medical Insurance) is effective.
Do not confuse the Open Enrollment Period with the other Medicare enrollment periods:
|Fall Medicare Open Enrollment Period||This window runs every year from October 15th to December 7th. During this window, you can change your Medicare Supplement Insurance Plan without losing any medical coverage.|
|Initial Enrollment Period (IEP)||This is your first chance to sign up for Medicare once you are eligible. This window begins 3 months before your 65th birthday. During the IEP you can sign up for Medicare Parts A and B, a Medicare Advantage Plan or a Part D Prescription Drug Plan.|
|General Enrollment Period||From January 1st to March 31st, you can sign up for Medicare Parts A and B, as well as a Medicare Advantage Plan if you missed the deadline.|
|Special Enrollment Period||This period refers to certain situations where you can enroll outside the regular enrollment periods. For example, if your Medicare coverage is discontinued, you move states or if your healthcare coverage under an employer ends. The dates for the Special Enrollment Period differ from person to person and depend on the circumstances.|
For more information, take a look at our guide to Medicare Open Enrollment Period 2022.
Where Can I Learn More about Medicare and Supplement Insurance?
Supplement Insurance is really helpful for people who want to lower their out-of-pocket Medicare expenses.
With all the different plans, providers and rules, finding a policy that’s right for your healthcare needs and budget can be tricky.
Visit our Medicare Hub to learn more about Medicare, health cover for people over 65, and the different Supplement Insurance plans available.
If you have any specific questions or concerns, reach out to one of PolicyScout’s friendly Medicare consultants.
You can contact us by phone at 1-888-912-2132 or email us at Help@PolicyScout.com