How much does Medicare Plan F cost?
Premiums for Medigap plans vary between insurers. Medigap Plan F, or Medicare Plan F, is a comprehensive plan that covers many out-of-pocket costs. However, it is not available to people who are new to Medicare.
People can keep Plan F if they were already enrolled in it before January 1, 2020, or, in some cases, if they were eligible for Medicare before this date.
Medicare includes Medicare supplement plans, or Medigap, which a person can purchase from a private insurance company to reduce some out-of-pocket Medicare costs.
This article will describe Medigap Plan F, including its availability, coverage, enrollment, and options. It also provides a comparison with Plan G.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
What costs does Medicare Plan F cover?
This article originally appeared on Medical News Today
Although private insurance companies sell Medigap plans, Medicare requires these plans to offer standardized coverage.
If someone enrolls in a Medigap plan, they will have to pay a monthly premium, which varies depending on the insurer. This is in addition to the Medicare Part B monthly premium, which is $174.70 or more each month in 2024. The amount depends on a person’s income.
A person can only have Medicare Plan F if they have Original Medicare. If a person has Medicare Advantage, they cannot have Medigap coverage as well.
Also, each Medigap policy is individual, and spouses cannot buy one policy to cover both people.
Plan F benefits
Plan F coverage includes:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
Part B coinsurance or copayment
blood (first 3 pints)
Part A hospice care coinsurance or copayment
skilled nursing facility care coinsurance
Part A deductible
Part B deductible
Part B excess charge
foreign travel exchange (up to plan limits) at 80% of costs
Out-of-pocket limits
In comparison with other Medigap plans, Medigap Plan F is one of the most comprehensive in terms of coverage. One of the few aspects that this Medigap plan does not cover is an out-of-pocket limit.
However, plans K and L create an out-of-pocket limit. In 2024, the out-of-pocket limit for Plan K is $7,060, and the limit for Plan L is $3,530. After a person reaches this limit, their Medigap plan will cover any future costs.
High deductible plan
In some states, a person may be able to purchase Plan F as a high deductible plan. This means that a person will pay for their Medicare-covered costs up to a deductible, which is $2,800 for policyholders in 2024.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Availability of Medicare Plan F in 2024
Starting from January 1, 2020, Medigap Plan F (and Plan C) will not be available to people who are new to Medicare. These people are those who turned 65 years old on or after January 1, 2020, or got Medicare Part A on or after January 1, 2020.
However, if a person previously had Medicare Plan F, or the high deductible version of Plan F, before January 1, 2020, they can keep their plan.
Also, if a person who was eligible for Medicare before January 1, 2020, has not yet enrolled, they may be able to buy Medigap Plan F.
The reason for the changes is because as of January 1, 2020, Medigap plans no longer cover the Part B deductible for people new to Medicare.
Difference between Medicare Plan F and Plan G
Medicare Plan G is similar to Medicare Plan F and is still available to new Medicare enrollees.
This plan offers the same benefits as Medicare Plan F except that it does not pay the Medicare Part B deductible. For 2024, the Medicare Part B deductible is $240 before Original Medicare starts to pay.
As with Medicare Plan F, some states offer Medicare Plan G as a high deductible plan. For 2024, the deductible amount is $2,800.
Some states, including Massachusetts, Minnesota, and Wisconsin, may standardize their plans differently.
Enrollment in Medicare Plan F
Medicare requires Medigap plans to be standardized, but health insurance companies do not have to charge a standard premium for the policies. Insurance companies may quote a person different rates for the same plan.
When a person first signs up for Medicare, they can sign up for a Medigap plan, and the plan cannot take into account their preexisting medical conditions.
After the initial Medicare enrollment period, a Medigap insurance company can require a physical examination or review of a person’s health history before qualifying.
Also, after the Initial Enrollment Period (IEP), a Medigap plan does not have to accept a person into the plan.
The average monthly cost for Medicare Plan F depends on where a person lives and at what point in their life they are applying for Medigap.
Options to get Medicare Plan F
While a person who is new to Medicare can no longer purchase a Medicare Plan F plan, they can purchase other plans in several ways:
Search for available Medigap plans online at Medicare.gov.
Contact an insurance company directly to ask about Medigap plans.
Call Medicare at 800-MEDICARE (800-633-4227) to find out about available plans.
A person must contact a Medigap plan company individually before purchasing a Medigap policy.
Summary
If someone enrolls in a Medigap plan, they will have to pay a monthly premium, which varies depending on the insurer. This is in addition to the Medicare Part B monthly premium.
People should note that Medicare Plan F is no longer on offer to people new to Medicare as of January 1, 2020. This is because Medicare regulations now state that Medigap policies cannot pay for the Part B deductible.
People who turned 65 years old on or after January 1, 2020, or get Medicare Part A on or after January 1, 2020, can no longer get Medigap Plan F.
However, people who already have Medicare Plan F can keep their plan. In some cases, people who were eligible for Medicare before this date but have not yet enrolled may also be able to buy Medicare Plan F.
A person does not have to purchase a Medigap plan to have a Medicare policy.
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View the original article on Medical News Today
