Medigap Plan F is the most common and comprehensive Medicare Supplement plan. This plan fills in all the gaps in Medicare so that you don’t have any out of pocket co-pays or deductibles when you go to the doctor or hospital. This plan has emerged as the most popular choice among Medicare recipients, due to its predictability and stability. Many people like the security of not having to pay anything out of pocket when they go to the doctor or hospital.

Why Choose Medigap Plan F

  • It is the most comprehensive plan.
  • It gives you predictable out of pocket expenses. You can budget for health care at the start of the year by simply multiplying the premium by 12.
  • A standardized Medicare supplement Plan F can be used at any doctor/hospital that takes Medicare. There are no networks.
  • Coverage and claim payments are standardized. All companies pay claims through the Medicare “crossover” system.
  • It is easy to compare “like” plans. A Plan F with one company is the exact same coverage as a Plan F with another company.
  • Benefits will never change on Plan F unless you change insurance. Once you sign up for a Plan F, the contracted benefits will stay the same.
  • Plan F is offered on a Federally-mandated “Guaranteed Issue” basis in some situations (i.e. losing employer coverage).

What Does Plan F cover?

Before you start comparing rates and companies that offer Plan F, it is important to understand exactly what this plan covers. Because it is the top level of Medicare Supplement coverage available, it is a good starting point when you are comparing options for supplemental coverage. To help you compare Medigap plans, familiarize yourself with what Medigap Plan F covers:

  • Basic Benefits, including 100% Part B coinsurance. Basic Benefits also encompasses Part A coinsurance (the 20% that Medicare doesn’t cover), plus coverage for an additional 365 days after Medicare benefits end.
  • Blood – Plan F covers the first three pints of blood each calendar year.
  • Hospice – Plan F covers the Medicare Part A coinsurance (20% that Medicare doesn’t pay) for these services.
  • Skilled nursing facility coinsurance. The plan covers the 20% that Medicare doesn’t pay for a skilled nursing facility.
  • The Medicare Part A deductible. For 2017, this deductible is $1,316/benefit period. The Plan F covers this deductible.
  • The Medicare Part B deductible. For 2017, this deductible is $183/year. The plan also covers this deductible.
  • Part B Excess charges. Although these are not a frequent occurrence, they can occur if a doctor doesn’t accept the Medicare-approved amount. The plan picks up those excess charges, so you aren’t subject to paying them.
  • Foreign Travel Emergency. Plan F covers medically necessary emergency care services beginning during the first 60 days of each trip outside the USA. There is a separate $250 deductible on these charges and a $50,000 lifetime limit.

How Does Medigap Plan F Work?

Plan F works just like all Medicare Supplement plans do. Benefits are provided through the private company, in supplemental (or secondary) to Medicare. If you have a Plan F, the plan will automatically pay claims through the Medicare “crossover” system for Medicare-covered services so that you aren’t subject to the Medicare co-pays, deductibles, and coinsurance. Without a supplemental plan, you are subject to the unlimited 20% Medicare coinsurance – there is no “cap” on this 20%. However, with a Plan F, your out of pocket exposure is eliminated.

Where Can I View the Benefits of Plan F?

The standardized plans chart is the Federally-published and mandated chart that all companies must go by. You can view it here: Medigap Coverage chart.
This chart shows you which Medicare Supplement plans cover which things, so that you can easily compare Medigap plans.

Frequently Asked Questions about Plan F

While benefits are Federally-standardized and specifically spelled out in the Medigap coverage chart, some people do still have questions about how the plan works or what it covers. Here are some of the most frequently asked questions about this plan:

  • When can you enroll in a Medigap Plan F?
    You can enroll in any Medicare Supplement plan at any time; however, there are certain times that it is advisable to do so. First and foremost, the “open enrollment” period that everyone is given surrounding their 65th birthday or their enrollment in Medicare Part B is the optimal time to enroll in a Medicare supplement plan. This period lasts for 6 months and begins on the first day of the month that they are both age 65 and enrolled in Medicare Part B. Secondarily, you may have a “Guaranteed Issue” period if you are in a certain situation, such as leaving/losing employer coverage, losing a Medicare Advantage plan coverage, or leaving a plan’s service area. For more specifics and to find out if you are in one of these periods, please contact us using our website – Medicare Supplement.
  • If coverage is the same, why are rates so different?
  • How Can I Compare Rates from Multiple Companies for Plan F?

To get a rate quote comparison from us, simply request the information online using: Medicare Supplement Quotes. We can provide the information you are seeking so you can compare multiple quotes in a centralized place.