Of the 10 Medicare Supplement Insurance plans (Medigap) that are available in most states, Plan F is the most popular plan and offers the most benefits.
In fact, 55 percent of all Medigap beneficiaries in 2016 were enrolled in Medicare Supplement Insurance Plan F.1
Let’s take a closer look at the benefits offered by Medigap Plan F, how it compares to other Medicare Supplement Insurance plans and how you can apply for Plan F.
Medicare Supplement Insurance plans can offer coverage for varying combinations of up to nine defined areas.
Medigap Plan F is the only Medigap plan to offer coverage for each potential Medigap benefit.
Here is a look at how Plan F compares to other Medigap plans, as well as a detailed description of each benefit Plan F can offer.
If you are admitted to the hospital for inpatient care, you will first need to satisfy your Medicare Part A deductible in each benefit period before your Medicare coverage kicks in. Part A helps cover inpatient care costs.
Once you meet the Part A deductible in 2019, you will be responsible for a Part A coinsurance payment of $341 per day for days 61-90 of a hospital stay in each benefit period, and $682 per day beyond that.
Every Medicare Supplement Insurance plan, including Plan F, covers the Part A coinsurance in full.
After you meet your annual Part B deductible (Part B covers costs of doctor’s appointments, medical equipment, supplies and some other costs), your Part B coverage will typically require you to pay a 20 percent coinsurance for the remainder of your costs until the end of the year.
Every Medicare Supplement Insurance plan offers at least some coverage for the Medicare Part B coinsurance.
Medigap Plan F covers the Part B coinsurance in full.
While in hospice care, you may be charged copayments for administered drugs and respite care.
Every Medicare Supplement Insurance plan offers at least some coverage for Part A hospice care coinsurance and copayments.
Medigap Plan F covers the Part A hospice care coinsurance or copayments in full.
While staying at a skilled nursing facility, you will be required to make coinsurance payments of $170.50 per day in 2019 for days 21-100 of your stay, and you will be responsible for all costs thereafter.
Eight Medicare Supplement Insurance plans offer at least some coverage for skilled nursing facility coinsurance.
Medigap Plan F offers full coverage of skilled nursing facility coinsurance.
Part A of Medicare requires a deductible of $1,364 for each benefit period in 2019. You can potentially face more than one benefit period in a calendar year.
Nine Medicare Supplement Insurance plans provide some coverage for the Part A deductible.
Medicare Supplement Insurance Plan F covers the Part A deductible in full.
Part B of Medicare requires beneficiaries to meet an annual deductible of $185 in 2019.
Only two Medicare Supplement Insurance plans provide any coverage for the Part B deductible.
Medigap Plan F covers the Part B deductible in full.
If a health care provider does not accept Medicare assignment, they are allowed to charge up to 15 percent more than the Medicare-approved amount for their products or services.
Only two Medigap plans offer any coverage for Part B excess charges.
Medigap Plan F covers Part B excess charges in full.
During a blood transfusion, Medicare does not cover the cost of the first three pints of blood.
All 10 Medicare Supplement Insurance plans provide at least some coverage for the first three pints of blood.
Medigap Plan F offers full coverage for the first three pints of blood.
Medicare only provides coverage for emergency care received outside of the U.S. under limited circumstances.
Six Medicare Supplement Insurance plans offer some coverage for qualified care received outside of the U.S.
Medigap Plan F covers 80 percent of the costs of qualified foreign travel emergency care.
|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.
Plan F also offers a high-deductible version, which requires members to meet a $2,300 annual deductible in 2019 before the plan’s coverage may begin.
By paying a higher deductible, beneficiaries of the plan may pay a lower monthly premium.
While Plan F offers the most comprehensive benefits of any Medigap plan, Medigap Plan G offers almost an identical level of coverage as Plan F.
Plan F covers the Medicare Part B deductible, and Medigap Plan G does not offer any coverage for the Part B deductible. Other than that, Plan F and Plan G offer the same coverage.
The Medicare Part B deductible is $185 per year in 2019, which equates to around $15 per month.
If you enrolled in a Plan G that costs at least $15 less than Plan F per month, Plan G could potentially offer the better value over the course of the year.
Here’s an example:
If Joe and Mary had identical out-of-pocket Medicare costs otherwise, Mary would have saved paid less for her Plan G premiums and her Part B deductible than Joe paid for his Plan F premiums alone.
Plan G isn’t the only Medigap plan that offers comparable coverage to Plan F.
The average premium for Medicare Supplement Plan F was $169.14 per month in 2018.1
Several factors can affect the cost of a Medicare Supplement Insurance plan in 2019, such as gender, age, smoking status and where you live.
It’s important to note when comparing premiums that Plan F beneficiaries typically have little if any out-of-pocket Medicare expenses.
The chart below illustrates the average monthly Plan F premiums in each state in 2018.
from least expensive (1) to most expensive (45)
|District of Columbia||No data available||N/A|
|Massachusetts||No data available||N/A|
|Rhode Island||No data available||N/A|
|Vermont||No data available||N/A|
|Wisconsin||No data available||N/A|
Plan F and Plan C won’t be available for new Medicare beneficiaries who become eligible for Medicare on or after January 1, 2020.
If you already have Plan F or Plan C before 2020, you can keep your plan. If you become eligible for Medicare before 2020, you may still be able to buy either Plan C or Plan F after January 1, 2020, if either is available where you live.
A good time to buy Medicare Supplement Insurance is during your Medigap Open Enrollment Period (OEP).
Your Medigap Open Enrollment Period begins as soon as you are at least 65 years old AND enrolled in Medicare Part B.
During your Medigap OEP, Medicare Supplement Insurance companies can’t use your health to determine your eligibility for a Medigap plan or to charge you higher plan premiums.
A licensed insurance agent can help you learn more about Medicare Supplement Insurance companies and the Medigap plans that may be available where you live. Plan F may be available in your area.
Find a Medigap plan that works for you.
Learn about Medigap plans in your areaVisit MedicareSupplement.com
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1 AHIP. State of Medigap 2018 Trends in Enrollment and Demographics. (June 2018). Retrieved from https://www.ahip.org/wp-content/uploads/2018/06/State_of_Medigap18_FINAL.pdf.
2 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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