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(417) 633-7200

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Springfield, Missouri

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Plan F

Medigap Plan F has been the most popular Medicare supplement plan in the recent past. It offers 100% of cost-sharing when it comes to medical services. Plan F is a great option for Medicare beneficiaries who are searching for full coverage on all out-of-pocket costs, including the Part A and B deductible, copayments, and coinsurance. However, Plan F is no longer available to those who turn 65 after January 1, 2020.

What is Plan F?

Plan F is the only Medigap plan that covers every gap in Original Medicare coverage. It leaves the plan member with $0 in out-of-pocket expenses for covered services. The only thing the member will pay is the monthly premium.

Coverage Details​

Medigap Plan F

Medigap Plan F is a first-dollar coverage plan. “First-dollar” means that after Original Medicare has paid its portion, Plan F pays for the remaining cost. This leaves the member with $0 in out-of-pocket expenses.

Medigap Plan F covers:

  • Part A coinsurance and up to an additional 365 days of hospital costs after Medicare benefits are exhausted
  • Part B coinsurance/copayment
  • Blood (3 pints)
  • Part A hospice coinsurance/copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible
  • Part B excess charge
  • 80% of foreign travel exchange
  • No out-of-pocket limit

Medigap Plan F Premiums

The premium for Plan F will differ between carriers and in which state the plan member resides. There are other individual factors that go into setting the premium like age, gender, tobacco use and more, but the average cost for Plan F is between $130-$230 each month.

Plan F has one of the higher premiums because of the comprehensive coverage it provides. Selecting a different Medigap plan will reduce your premium, but there will not be as much coverage.

How can my Plan F premium be reduced?

If you would like to enroll in Plan F, but the premiums are more than you’d like to spend, the high-deductible Plan F may be a great option. This plan offers the same coverage, but does have a higher deductible that plan members must meet before the coverage begins. The premium is less than those seen in the original Plan F.

Will Plan F premiums increase in 2023?

Medigap plans often increase each year, but the increase will depend on which pricing method your insurance carrier uses. Generally speaking, the premium usually increases with age. In the last five years, Plan F rate increases have averaged between 3% and 6%.

When first enrolling in a Medigap plan, it’s important to look at the history of rate increases with each carrier. One insurance company might be offering a lower rate now, but if they have a history of increasing their rates at rapid speed, they may quickly become more expensive than other carriers. Our agents will look at the history of rate increase with any of the insurance companies we recommend. It’s just another part of our service that we offer completely free of charge.

What has Medigap Plan F been discontinued?

Neither Plan F nor Plan C are available to Medicare beneficiaries who turn 65 after January 1, 2020. The Centers for Medicare & Medicaid Services (CMS) has discontinued all first-dollar coverage plans, which included these plans.

Beneficiaries who were already enrolled in these plans can continue their coverage, but will likely see a dramatic rate increase over the next few years.

Medigap Plan F Eligibility

To be eligible for Plan F, individuals must already be enrolled in Medicare Parts A and B which then allows them to be enrolled in any Medicare supplement plan. Those who would like to enroll in Plan F must have been eligible for Medicare prior to January 1, 2020.

Plan F and Prescription Drug Coverage

Medigap Plan F does cover prescription drugs administered while under inpatient care. However, it does not cover medications that have been prescribed by a doctor and are administered at home. Medigap plan members will need to enroll in a stand-alone Part D plan to get prescription drug coverage.

Differences Between Plan F and Plan G

Plans F and G are very similar in coverage. The only difference between the two is that Plan F pays the Medicare Part B deductible. However, since Plan G has lower premiums, it may actually cost less to have Plan G, even if the member does have to pay the Part B deductible. Of course, we’ve also mentioned that Plan F is only available to those who turned 65 before January 1, 2020.

Enrolling in Medigap Plan F

Individuals can enroll in Plan F as long as they have already enrolled in Original Medicare – Parts A and B. The best time to enroll is during your open enrollment period, which begins on your Part B effective date. Beneficiaries will have six months from that day to enroll in a plan with guaranteed issue rights. After that time frame, enrollment may be declined based on an individual’s health history.

How to Compare

Medigap Plan F Rates

There is a lot of information about each plan online, but to get an accurate quote, you’ll need to enlist the help of a licensed Medicare agent. Instead of calling each insurance carrier to get a quote, we can compare premiums across many different carriers, ensuring that you enroll with one that gives you the best rate.

We’ll need to collect some information from you in order to provide quotes since your premium is based on your information and health history, but our services come at no additional cost to you! If you choose to enroll in a Medigap plan through our agency, we also offer unlimited support. If you have problems with your coverage or have questions about how your plan works, we will be here to help.

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Questions to be advised on:

The Missouri Medicare Advisor website character Cam Meers discussing Questions to be advised on.

There is no difference. “Part F” is incorrect terminology. The only “parts” to Medicare are Parts A, B, C, and D.

You can stay on your current Plan F if you move to a new state. Your premium may change based on which state you move to.

Since Medicare supplements are standardized, that means each letter plan is the same, no matter which insurance company is selling the plan.

Yes, but only to Medicare beneficiaries who turned 65 prior to January 1, 2020.

The best Medigap plan for you is the one that offers you the most value for a price you can afford. Plan F does offer the most comprehensive coverage of all the Medigap plans.

Plan F does offer slightly more coverage than Plan G, but it is not available for Medicare beneficiaries who turned 65 after January 1, 2020. For those individuals, Plan G offers the most coverage. Also, the premium for Plan F will be higher than Plan G, which may negate the extra coverage it provides.

As with most things in Medicare, there is not often one right answer that applies to everyone. The answer will depend on many factors, as well as individual preferences in coverage. If you want more freedom to choose doctors, Plan F is the better choice. If having a low premium is most important to you, then a Medicare Advantage plan may be the better option.

  • We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options. Health Insurance sold on moinsuranceadvice.com is processed through the licensed entity: Temmen Insurance, Inc. 2024 All rights Reserved.
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