Medicare Supplement (Medigap) Plan F Coverage and Costs
Medicare Supplement Plan F is one of ten different types of Medicare Supplement plans, which are also often called Medigap plans. Because Original Medicare doesn’t cover 20% of costs, many Medicare recipients add a Medigap plan to limit their out-of-pocket spending. Of the ten types of Medigap plans, Plan F is the most comprehensive. Unfortunately, it is not available to people who turn 65 after January 1, 2020. Many people have turned to Medigap Plan G because it’s almost the same as Plan F! The only difference is that Plan F covers your Part B deductible and Plan G does not.
In this article, we’ll first explain the ins and outs of Medicare Supplement (Medigap) plans. If you’re already familiar with how Medigap plans works, skip to the second half of this article to learn more about how Plan F works and how much it costs!
What are Medicare Supplement plans?
Medigap plans are additional Medicare insurance that stack on top of Original Medicare coverage. Medigap plans help fill the gaps in Medicare coverage, helping cover the 20% of costs that Original Medicare doesn’t pay.
All but three states have ten different types of Medigap plans, plus one high-deductible option for two types (F and G). Every Medigap plan of the same type has identical coverage, even if the pricing or the insurance carrier is different.
Benefits of Medicare Supplement plans
Generally, Medicare Supplement plans improve your access to care. These plans have few limitations and barriers to getting care when you need it, including red tape and high costs.
No restrictive provider networks
When you’re on Original Medicare and Medicare Supplement, you can see any doctor who accepts Original Medicare—which is about 90% of doctors nationwide. This is particularly important for people who travel often or for snowbirds who split time between two homes.
No need for prior authorization
With Original Medicare and Medicare Supplement plans, you won’t need to get prior authorization for covered services. One of the biggest downsides of Medicare Advantage plans is that they often require prior authorization for covered services. Furthermore, many prior authorizations are denied!
Low out-of-pocket costs
The biggest advantage that comes with Medicare Supplement plans is incredibly low out-of-pocket costs. In fact, with a Plan F, you really just need to pay your premiums, then all of your out-of-pocket Medicare expenses are covered.
Eligibility for Medicare Supplement plans
If you’re enrolled in both Medicare Part A and Medicare Part B and not enrolled in a Medicare Advantage plan, then you’re eligible to enroll in a Medicare Supplement plan!
Enrollment for Medicare Supplement plans
The best time to enroll in a Medicare Supplement (Medigap) plan is during the Medigap Open Enrollment Period. This is a six-month window of time that starts when your Part B coverage goes into effect. If you try to enroll outside of the Medigap Open Enrollment Period or a handful of other guaranteed issue periods, insurance companies can ask you questions about your health history and may deny you Medigap coverage. Learn more about Medigap enrollment periods and rules here.
Comparing Medicare Supplement plans
There are ten types of Medicare Supplement plans, each covering a different set of out-of-pocket costs. Consult this chart to see the differences.
Medigap Plan F provides the most comprehensive coverage, but it’s not an option for those who turn 65 after January 1, 2020. As a result, Plan G, the second most comprehensive Medigap plan, is becoming more and more popular among new Medicare beneficiaries.
If you want help understanding the differences between Medigap plans and your other options, our licensed Medicare Advisors are here to help! Schedule a free consultation to ask questions about Medicare and Medigap or give us a call at (855) 900-2427 to receive your personalized advice.
Medicare Supplement Plan F coverage
In 2023, about 40% of Medicare Supplement enrollees were enrolled in Plan F (compared to 32% on Plan G). As Plan F becomes unavailable to a larger percentage of Medicare beneficiaries, Plan G will take first place as the most popular Medigap plan.
Important note: Massachusetts, Minnesota, and Wisconsin offer a different set of standardized Medigap plans and therefore do not offer a Medigap Plan F.
What’s covered under Medigap Plan F?
Plan F covers:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
Part B services (except for some copayments and emergency room visits)
Blood you receive (up to 3 pints)
Part A hospice care coinsurance and copayments
Skilled nursing facility coinsurance
Your Part A deductible
Your Part B deductible
Medicare Plan F also covers 80% of foreign travel exchange.
What’s not covered?
Plan F, like all Medigap plans, provides coverage for out-of-pocket costs leftover by Original Medicare. It does not provide coverage for additional healthcare services.
Medicare Supplement Plan F costs
One of the reasons to enroll in a Medicare Supplement plan, and specifically a Medicare Plan F, is to have better financial predictability. With Plan F, you’ll pay for your Original Medicare and Medigap premiums, then your out-of-pocket costs are covered!
Medicare Plan F premiums
There are a handful of factors that may impact your Plan F premium:
Where you live
Your smoking status
Your age
Your gender
The insurance carrier
Household discounts (offered by some Medigap plans)
Below you'll find a range of monthly premium costs for Plan F by state. (Data from Medicare.gov - 2023)
Alabama: $0-$812
Alaska: $131-$836
Arizona: $138-$770
Arkansas: $146-$580
California: $178-$1,262
Colorado: $0-$1,053
Connecticut: $260-$484
DC: $140-$871
Delaware: $0-$4,939
Florida: $182-$1,727
Georgia: $0-$4,725
Hawaii: $148-$935
Idaho: $202-$512
Illinois: $114-$794
Indiana: $112-$702
Iowa: $105-$765
Kansas: $129-$861
Kentucky: $119-$1,296
Louisiana: $0-$1,305
Maine: $224-$545
Maryland: $148-$1,021
Massachusetts: N/A
Michigan: $142-$941
Minnesota: N/A
Mississippi: $0-$1,740
Missouri: $0-$1,053
Montana: $0-$1,147
Nebraska: $116-$927
Nevada: $147-$1,007
New Hampshire: $0-$1,010
New Jersey: $156-$803
New Mexico: $112-$713
New York: $330-$766
North Carolina: $113-$1,920
North Dakota: $0-$783
Ohio: $116-$857
Oklahoma: $115-$675
Oregon: $167-$989
Pennsylvania: $129-$942
Rhode Island: $143-$831
South Carolina: $106-$644
South Dakota: $117-$1,939
Tennessee: 113-$1,931
Texas: $112-$759
Utah: $116-$726
Vermont: $165-$779
Virginia: $104-$859
Washington: $252-$363
West Virginia: $116-$726
Wisconsin: N/A
Wyoming: $121-$716
Will my Medicare Supplement premium change over time?
There are three pricing or “rating” structures for Medicare Supplement plans.
Community-rated (aka no-age-rated)
Community-rated Medigap policies charge everyone the same premiums, regardless of age.
Issue-age-rated (aka entry age-rated)
Issue-age-rated Medigap policies charge different premiums based on the age you were when you purchased (when you were “issued”) the policy. In other words, prices will be lower for those who purchase these policies when they’re younger.
Attained-age-rated
Attained-age-rated Medigap policies charge different premiums based on the age you currently are (the age you’ve “attained”). In other words, these policies have lower premiums when you first enroll, but they’ll go up as you age.
Medicare Plan F deductibles
There is no Plan F deductible. Additionally, if you’re enrolled in a Medigap Plan F, your Part A and Part B (Original Medicare) deductibles are covered.
Medicare Plan F out-of-pocket costs and maximums
There’s no out-of-pocket maximum for Medigap Plan F because out-of-pocket costs are eliminated.
How to enroll in a Medicare Supplement Plan F
Unfortunately, if you turn 65 after January 1, 2020, you are unable to enroll in a Medigap Plan F. Instead, we would recommend enrolling in a Medigap Plan G, which covers the same costs, excluding the Medicare Part B deductible.
How to choose the right Plan F
Because all Plan Fs have identical coverage, you can focus your decision on premiums and insurance carriers. Our Medicare Advisors will help you sort through each option, provide insight on insurance carriers’ customer service, and compare premiums (both for today and the future).
Get started: schedule a free consultation or call us at (855) 900-2427!