Medicare Supplement Insurance Plan F vs. Plan G | Comparing Benefits and Costs

Medicare Supplement Insurance Plan F and Plan G offer more benefits than many of the types of Medicare Supplement Insurance plans (Medigap) that are available in most states.

To get help comparing Medicare Supplement Insurance Plan F vs. Plan G and to find plans in your area, visit MedicareSupplement.com today.

It’s understandable why you might consider choosing one of these two Medigap plans. This guide compares and contrasts Medicare Supplement Insurance Plan F vs. Plan G, including what they cover and some of the costs associated with each plan.

Medicare Supplement Insurance Plans 2019
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%
MedicarePart 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.

What do Medigap Plan F and Plan G cover?

Plan F and Plan G both offer coverage for most of the nine Medicare costs that can be covered by a Medicare Supplement Insurance plan. The main difference is that Plan F covers the Medicare Part B deductible, and Plan G does not.

Plan F and Plan G both offer 100 percent coverage for the following 2019 Medicare costs:

  • Medicare Part A (Medicare hospital insurance) deductible
    Before Medicare Part A starts to pay its share of health care costs, beneficiaries must meet a $1,364 deductible for each benefit period in 2019. You could potentially experience multiple benefit periods in one year, and you would need to meet your Part A deductible all over again each benefit period.

    Medigap Plan F and Plan G both cover the Medicare Part A deductible, no matter how many benefit periods you have in one year.

  • Part A coinsurance and hospital costs
    After you meet your Medicare Part A deductible, Part A requires a coinsurance payment of $341 per day (in 2019) for days 61-90 of an inpatient hospital stay. The coinsurance is $682 per day for a hospital stay that lasts longer than 90 days, but only for up to 60 additional lifetime reserve days. After that point, Medicare Part A holds you responsible for all costs.

    Medigap Plan F and Plan G both cover all of these Medicare Part A coinsurance costs.

  • Part B coinsurance and copayments
    After Part B beneficiaries meet the required Medicare Part B annual deductible ($185 in 2019), Medicare requires a 20 percent coinsurance payment for all covered services.

    Medigap Plan F and Plan G both cover all Part B coinsurance or copayment costs.

  • Part A hospice care coinsurance
    Part A beneficiaries in hospice care may face minor copayments for prescription drugs and a 5 percent coinsurance payment for inpatient respite care.

    Medigap Plan F and Plan G both cover any Part A hospice care coinsurance or copayments you might be charged.

  • Skilled nursing facility coinsurance
    Extended stays in a skilled nursing facility require a copayment of $170.50 per day for days 21-100 of a stay in 2019, after you meet your Part A deductible. After day 100 of a stay in a skilled nursing facility, Medicare requires you to pay all costs.

    Medigap Plan F and Plan G both cover these Part A hospice care coinsurance costs.

  • Part B excess charges
    If you visit a health care provider that does not accept Medicare assignment, you may be subject to an excess charge of up to 15 percent of the Medicare-approved amount for any services or products covered by Medicare Part B.

    Medigap Plan F and Plan G both cover Part B excess charges, no matter how high they may be.

  • First three pints of blood
    The first three pints of blood that are needed for a blood transfusion are not covered by Original Medicare. Plan F and Plan G both cover the costs of the first three pints of blood.

Medicare Supplement Insurance Plan F and Plan G both cover 80 percent of the costs for qualified emergency care received outside of the U.S. Original Medicare only covers foreign emergency care under limited circumstances.

What are the differences between Plan F and Plan G?

In 2016, 55 percent of all Medicare Supplement Insurance beneficiaries were enrolled in Medigap Plan F, which was by far the most popular type of Medigap plan.1

Plan G was the second-most popular type of Medigap plan, with 10 percent of all Medigap enrollees.

In addition to the large difference in enrollment rates, there are three differences you might find between Medicare Supplement Plan F and Plan G:

  • Coverage of the Medicare Part B deductible
  • Cost
  • Availability

Medicare Part B deductible

As mentioned above, Medicare Supplement Insurance Plan F offers coverage for the Medicare Part B deductible ($185 per year in 2019), and Medicare Plan G does not. This is the primary difference in coverage between these two types of Medigap plans.

Plan cost

Medicare Supplement Plan F and Plan G are sold by private insurance companies who are free to set their own costs.

Because plans offering more coverage can often cost more than plans with less coverage, Medicare Supplement Plan F may cost more than Plan G in some areas.

Plan availability

Each type of Medicare Supplement Insurance plan may not be available in every location.

Some people may have access to Plan F but not Plan G, while others may be able to purchase Plan G but not Plan F. Just as with plan costs, the availability of these two plans may differ from one area to the next.

As of 2016, 84 percent of insurance companies selling Medicare Supplement Insurance offered Medigap Plan F, while only 57 percent of companies sold Medigap Plan G.1

By law, if an insurance company sells Medicare Supplement Insurance, they must offer at least Plan A. If they choose to offer any additional plans, they must also offer at least either Plan C or Plan F.

Deciding between Medicare Supplement Insurance Plan F and Plan G

How do you decide between Medicare Supplement Plan F vs. Plan G?

First, decide how costly the Medicare Part B deductible is for your health care budget. If you currently have Part B, how often do you use it? Having the Part B deductible covered by a Medicare Supplement Insurance plan may be more important to some people than others.

Next, compare prices. The $185 annual deductible for Part B in 2019 averages out to a little more than $15 per month. If having coverage for the Part B deductible is important to you and you can find Medigap Plan F in your area that is no more than $15 more expensive than Medigap Plan G, the extra monthly premium cost may be worth it.

If it is not critical for you to have coverage for the Part B deductible, or if your only Plan F options are at least $15 more expensive per month than Plan G, you may actually save money by opting for Plan G and paying the Part B deductible yourself.

It’s worth noting that there is also a high-deductible Plan F option. This Medigap option offers a lower monthly premium, but beneficiaries must first meet a $2,300 annual deductible in 2019 before the plan covers any costs.

Enroll in Medigap Plan F or Plan G

One great way to get help on deciding between Medicare Supplement Insurance Plan F vs. Plan G is to visit MedicareSupplement.com.

A licensed agent can help you compare the Plan F and Plan G options that may be available in your area so that you can find the best plan for your needs.

Plan F in 2020

Beginning in 2020, newly eligible Medicare beneficiaries will not be allowed to enroll in Medigap Plan F because of a new federal law that prohibits plans from covering the Medicare Part B deductible.

Those who are already enrolled in Plan F prior to 2020 will be allowed to keep their coverage. If you become eligible for Medicare before Jan. 1, 2020, it may be possible to buy Plan F after the law goes into effect if it's available where you live.

 

Related articles:

 

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.

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