Most Comprehensive Medigap Plan
Out of the 10 standardized Medicare Supplemental Insurance (Medigap) plans, Plan F is the most popular option. It offers the most benefits compared to other alternatives and is considered a first-dollar coverage plan. Because Original Medicare (Part A and Part B) only covers certain hospital and medical expenses, Medigap Plan F covers the remaining expenses and leaves beneficiaries with little to no out-of-pocket expenses. Beneficiaries should be aware that, as the most comprehensive Medigap plan, Plan F is often more expensive than other Medigap plans that offer fewer benefits.
Plan F Coverage
Plan F provides basic gap coverage, for the following:
- Part A hospital co-insurance costs up to an additional 365 days after Medicare benefits are exhausted
- Part B co-payment or co-insurance coverage of outpatient services, supplies, treatment, physician services, and more
- First three pints of blood used in an approved medical procedure
- Part A hospice care co-insurance or co-payment
In addition, Medigap Plan F also provides coverage for:
- Skilled Nursing Facility (SNF) care co-insurance
- Medicare Part A deductible for hospitalization
- Medicare Part B deductible for hospital outpatient services
- Medicare Part B excess charges (the difference between what a provider charges and what Medicare will pay up to its limit)
- Foreign travel emergency coverage (up to plan limits)
- Medicare preventive care Part B co-insurance
Plan F Costs
In general, Medicare Supplement insurance costs include monthly premiums, annual deductibles, co-payments, and co-insurance payments. Medigap Plan F pricing may vary by carrier; certain carriers may use age-related pricing methods while others may offer a set pricing schedule for monthly premiums. Despite these different methods, every company must notify its enrollees in advance if it plans to increase premiums. Along the same lines, companies generally cannot cancel coverage unless an enrollee does not pay the plan premium.
High-Deductible Plan F
In addition to the standardized Medigap Plan F, there is also a ‘high deductible’ version of Plan F. Under this plan, beneficiaries are required to pay for all fees up to a certain annual deductible, which was $2,180 in 2016. After the deductible has been met, the Medigap plan covers the remainder of your health care costs for the year. Because you are responsible for higher out-of-pocket costs associated with your plan deductible, a high-deductible Plan F usually has a lower monthly premium than a standard Medigap Plan F.
Our Medigap plan benefit chart allows you to compare the comprehensive benefits of Plan F to the other standardized Medicare Supplement plans.