Medicare Supplement Plan F: Can I still get it?
Can you still get Medicare Supplement Plan F?
Yes and no. It depends. Kind of a cryptic answer. Right?
Here’s the deal…
- Yes. You CAN get Medicare Supplement Plan F if you enrolled before January 1, 2020, were eligible to enroll, or currently have Plan F.1
- No. You CAN’T get Medicare Supplement Plan F if you’re new to Medicare. Why? New enrollment for Medicare Supplement Plan F ended on December 31, 2019.1
If you’re eligible for Medicare Supplement Plan F, we’ll help you understand your two options in this article:
- Keep your current Medicare Supplement Plan F, or…
- Switch to another available option
Understanding the Medicare Supplement Plan F change
Medicare Supplement Plan F was one of 10 standardized plans created to help with the out-of-pocket costs not covered by Medicare Parts A and B.1
- Standardized means that the plans were designed to offer the same benefits regardless of where you buy, with the exceptions of Massachusetts, Minnesota, and Wisconsin, where plans were set up differently.
Is Medicare Plan F being discontinued?
No. If you’re new to Medicare, it’s no longer an option.
- The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) prevented Medicare Supplement plans (F and C, specifically) from providing coverage for Part B deductibles.2
- As a result of this legislation, Medicare beneficiaries who become eligible after December 31, 2019, will not have access to Medicare Supplement Plan F coverage, unless they have a Medicare Part A effective date prior to 2020.
- Who is eligible for Plan F? Beneficiaries who became eligible for Medicare before January 1, 2020, are able to keep Plan F coverage or enroll in a new Plan F policy.
What does Medicare Supplement Plan F pay for?
Medicare Supplement Plan F is the only plan that covers all Medicare Supplement insurance benefits. The following are the benefits available with Medicare Supplement plans. “Yes” means that Plan F covers 100% of this benefit.
Click to view expanded chart
|Covered Under Plan F||Purpose of Coverage|
|Part A coinsurance and hospital costs up to an extra 365 days after Medicare benefits are used up||Yes||If you’re admitted to the hospital for more than 90 days and up to 150 days, you pay $816 in coinsurance for each “lifetime reserve” coverage day you have.3 Your Medicare benefits are used up when you run out of lifetime reserve days, at which time your Medicare Plan F benefits kick in.|
|Part B coinsurance or copayment||Yes||This benefit helps pay your share of the cost for covered medical services, which is usually 20% of the Medicare-approved amount.|
|Blood: first 3 pints||Yes||Unless blood is donated to you, you pay for the first three units of blood you get in a calendar year that a hospital or provider has to buy for you. This benefit helps cover the hospital or provider costs.4|
|Part A hospice care coinsurance or copayment||Yes||This benefit helps pay the 5% coinsurance of the Medicare-approved amount for inpatient respite care and/or the copayment of up to $5 for each prescription and other pain relief products you get while under hospice care.3|
|Skilled nursing facility (SNF) care coinsurance||Yes||This benefit helps pay the coinsurance amount for days 21-100 of SNF care, which is $204 per day for each benefit period.3|
|Part A deductible||Yes||The plan pays your Part A hospital insurance deductible, which is $1,632 in 2024 for each benefit period.3|
|Part B deductible||Yes||This plan covers the annual Part B medical insurance deductible, which is $240 in 2024.3|
|Part B excess charge||Yes||A provider who doesn’t accept the Medicare-approved amount for a covered service as full payment can charge you extra. Medicare Supplement Plan F is one of the few plans that covers this charge|
|Foreign travel exchange up to plan limits||80%||This benefit has a lifetime limit of $50,000 to help pay the costs for certain emergency care you receive outside the U.S. after you’ve paid a $250 annual deductible.5|
|Out-of-pocket limit||N/A||Some Medigap plans have an annual out-of-pocket limit that you must meet before the plan begins to pay all the costs for covered services. This doesn’t apply to Medigap Plan F. An out-of-pocket limit is different from a deductible.|
2 things Medicare Supplement Plan F doesn’t cover
1. Prescription drug coverage
Medicare Supplement policies sold after January 1, 2006, do not cover prescription drugs.
- Original Medicare doesn’t cover prescriptions either. So you can only…
- Get Part D prescription benefits if you enroll in a Medicare Part D prescription drug plan, or…
- Buy a Medicare Advantage policy that includes coverage for prescription drugs.
2. Supplemental health benefits
Like other supplemental Medicare plans, Medicare Supplement Plan F doesn’t include coverage for things like:
- Hearing aids
- Vision care
- Dental care
- Long-term care
- Private-duty nursing
You can get some of these benefits through a supplemental health insurance plan or through Medicare Part C, also known as Medicare Advantage.
Medicare Supplement Plan F: 8 things you need to know
1. New enrollment isn’t available
This plan has been discontinued as of December 31, 2019. If you already have Medicare Supplement Plan F, you’re all set. But this plan is no longer available for new enrollments.
2. You can’t have both Medigap and Medicare Advantage
If you have a Medicare Advantage plan and want to enroll in Medicare Supplement Plan F, you must first make sure you can leave your plan and return to Original Medicare before your Medigap coverage begins.
3. You can’t have Medigap if you have a Medicare MSA plan
An insurance company cannot legally sell you a supplemental Medicare policy if you have an MSA (medical savings account) plan through Medicare.
4. Medicare Supplement Plan F has a separate premium
The premium you pay for Medigap Plan F is completely separate from the monthly premium you pay for Medicare Part B.
- Medicare premiums are billed directly through the Medicare program.
- Medicare Supplement insurance premiums are billed through the company that sold you the plan.
5. Guaranteed renewability
Medicare Supplement plans (F included) are guaranteed renewable, regardless of any health problems you may have. As long as you pay your premiums on time, an insurance company cannot cancel your policy.
6. Covers one person
You can only buy a Medicare Supplement policy for yourself. Your spouse would have to buy his or her own policy to get Medicare Plan F coverage.
7. No networks
You can use your Plan F or Plan F+ coverage nationwide at any provider that accepts Medicare.
8. High-deductible Plan F
The high-deductible version of Medicare Plan F has a lower monthly premium and higher out-of-pocket expenses.
- You pay for Medicare-covered costs up to the $2,800 deductible (in 2024) before the plan begins to pay for anything.7
- If you currently have Medicare Supplement Plan F, you can switch to high-deductible Plan F by contacting your insurance provider.
Medicare Supplement Plan F Comparison: Plan F versus other plans
To understand the benefits of Medicare Supplement Plan F, it helps to do a side-by-side comparison with other plans.
- The chart below shows the percentage rate at which benefits are covered under each plan.
- Sections with “No” means the plan does not cover that benefit.
You will notice that Plan C and Plan G are the most similar to Medicare Supplement Plan F in terms of the level of coverage available. The only differences are:
- Plan C does not cover Part B excess charge while Plan F covers at 100%.
- Plan G does not cover Part B deductible while Plan F covers at 100%.
You will also notice that Plan K and Plan L provide the least amount of coverage—many benefits are covered at less than 100% and some have no coverage at all. Plus, those plans have out-of-pocket limits.
|Medigap Benefits||Plan A||Plan B||Plan C||Plan D||Plan F||Plan G||Plan K||Plan L||Plan M||Plan N|
|Part A coinsurance and hospital costs up to an extra 365 days after Medicare benefits are used up||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Part B coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%***|
|Blood: first 3 pints||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A hospice care coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled nursing facility care coinsurance||No||No||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A deductible||No||100%||100%||100%||100%||100%||50%||75%||50%||100%|
|Part B deductible||No||No||100%||No||100%||No||No||No||No||No|
|Part B excess charge||No||No||No||No||100%||100%||No||No||No||No|
|Foreign travel exchange up to plan limits||No||No||80%||80%||80%||80%||No||No||80%||80%|
|**The plan pays 100% of the costs for covered services for the calendar year after the out-of-pocket yearly limit and yearly Part B deductible has been met.
***Plan N’s Part B coinsurance is covered at 100%, except for up to $20 in copayment for some doctor’s office visits and up to $50 in copayment for emergency room visits that don’t require inpatient admission.
The big benefit of Medicare Supplement Plan F
Medicare Supplement Plan F’s main advantage is that it covers all the Medicare supplemental benefits—some of which only a few other plans cover.
Medicare Supplement Plan F is the only plan that covers both your Part B deductible and Part B excess charge.
- You could pay an excess charge of up to 15% more than the Medicare-approved amount to a provider who doesn’t accept Medicare assignment.
- An assignment is when a provider accepts the Medicare-approved amount as full payment.
- While most providers accept assignment, there are some who don’t accept assignment for all services covered under Medicare.
Is the most comprehensive Medicare coverage right for you?
Having the most comprehensive coverage often means paying a higher monthly premium than you would with other plans—unless you go with the high-deductible Plan F option.
If you do choose this option, there’s still that $2,800 deductible (in 2024) to think about.
Look at it is like this:
- Would you rather pay a specific monthly premium (and deductible, if applicable) to get the most coverage, or…
- Not know how much you may pay out-of-pocket for certain expenses like excess charges?
Looking for Medicare Supplement Plan F?
If you meet the eligibility requirements for Medicare Supplement Plan F, we can help you evaluate your current plan if you have one, identify your Plan F options, or recommend something else.
Give us a call at (800) 827-9990, talk with a licensed insurance agent in your area, or compare plans online.