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.
To get help finding a Medicare Supplement Insurance Plan F that may be offered in your area, you can compare your options today at MedicareSupplement.com.
An agent can help you compare plans and find the plan that’s a good fit for your unique health care needs.
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 meeting 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, and Medigap Plan F is one of eight plans to offer full coverage.
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, and Medigap Plan F is one of eight plans to offer full coverage.
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, and Medigap Plan F is one of only six plans to offer full coverage.
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 coverage for the Part A deductible, and Medicare Supplement Insurance Plan F is one of six plans to cover it 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 it 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.
Plan F offers full coverage for these Part B excess charges and is one of just two plans to offer any such coverage at all.
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, and Medigap Plan F is one of eight plans to offer full coverage.
Medicare only provides coverage for emergency care received outside of the U.S. under limited circumstances.
Six Medicare Supplement Insurance plans, including Plan F, offer 80 percent coverage 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.
Medicare Supplement Insurance Plan F is the only Medigap plan to offer coverage in all nine benefit areas, and it’s the only plan to offer full coverage in eight areas.
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.
If you become eligible for Medicare after January 1, 2020, you will not be able to enroll in the high-deductible Plan F. However, if you already have Medicare, you can still enroll in Plan F if it’s available in your area.
Medicare Supplement Insurance is sold by private insurance companies, so the cost and availability of Plan F may differ from one area to the next. However, the basic benefits of Medigap Plan F remain the same, no matter where you live.
To learn more and to get started enrolling in Medicare Supplement Insurance Plan F, compare your plan options at MedicareSupplement.com today!
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.