There are currently 10 standardized Medicare Supplement Insurance (Medigap) plans available in most states. But in 2020, that selection of plans is going to change.
That’s because beginning on January 1, 2020, Plan F and Plan C will no longer be available to new Medicare beneficiaries.
Any new Medicare beneficiary who first becomes eligible for Medicare on or after January 1, 2020 will not be able to sign up for Medigap Plan F or Plan C.
If you already have Plan F or Plan C before 2020, you will be able to keep your plan. If you become eligible for Medicare before Jan. 1, 2020, you may still be able to enroll in Plan F or Plan C after 2020, but only if it is available where you live.
The upcoming changes to the Medigap Plan F is the result of recent legislation. The Medicare Access and CHIP Reauthorization Act of 2015 prohibits Medigap plans from fully covering the Medicare Part B deductible, starting in 2020.
Medigap beneficiaries who have to meet their Part B deductible before their Part B medical insurance coverage kicks in will have more “financial skin in the game,” according to the lawmakers who supported the legislation.
Legislators believe that beneficiaries may think twice about seeing a doctor for every ache and cold if they are required to pay for at least some part of their coverage.
Medigap Plan C and Plan F members currently enjoy first-dollar coverage in 2019, meaning their Part B coverage kicks in immediately without having to meet their Part B deductible for covered services.
This created concern among legislators that beneficiaries of these plans are over-using health care services, which can contribute to increased wait times, drained resources and increased costs of medical care.
The Part B deductible in 2019 is $185 per year.
The chart below details the benefits that are offered by each of the 10 standardized Medigap plans that are available in most states.
|Medicare Supplement Benefits||A||B||C||D||F1||G||K2||L3||M||N4|
|Part A co-insurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
By looking at the chart, you may notice a few things:
Anyone who is already enrolled in Plan F or Plan C prior to Jan. 1, 2020, will be allowed to keep their Plan C or Plan F coverage (including coverage of the Part B deductible) going forward. They will not lose their plan unless they fail to continue paying their plan premiums.
Anyone who is eligible for Medicare prior to Jan. 1, 2020, may be allowed to enroll in Plan C or Plan F after that date, but only if the plan is available where they live.
But anyone who becomes eligible for Medicare after Jan. 1, 2020, will not be allowed to purchase Plan C or Plan F.
In other words, Medigap Plan F is not actually going away. Plan F and Plan C are simply closing to new Medicare beneficiaries after Jan. 1, 2020.
In 2017, 85 percent of insurance companies that sold Medicare Supplement Insurance offered Plan F, which was the most of any plan. 75 percent of Medigap insurance companies sold Plan C in 2017.1
55 percent of Medigap beneficiaries in 2017 were enrolled in Plan F, which was by far the highest of any standardized Medigap plan.1
One possible reason for Plan F’s popularity is that it is the only plan to provide coverage for each of the nine Medigap benefit areas, which include:
A licensed insurance agent can help you learn more about Medigap plans that are available where you live, which may include Plan F and Plan C, as well as other popular Medigap plans like Plan G and Plan N.
Find Medigap plans in your areaVisit MedicareSupplement.com
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1 AHIP. State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.
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