Plan F Pros and Cons

Plan F Pros and Cons

Medicare Supplement Plan F is one of the most comprehensive plans available for Medicare beneficiaries in 47 states (excluding Massachusetts, Minnesota, and Wisconsin which have their own versions of Medicare Supplement insurance). This plan covers most out-of-pocket costs for Medicare-covered services, making it an attractive option for those with frequent medical expenses. However, it may also be the most expensive plan among the Medigap offerings, and as of January 1, 2020, it is no longer available to new Medicare enrollees. If you are an existing Plan F holder, you can continue to keep your plan. For those who were eligible for Medicare before January 1, 2020, there is still a possibility of buying Plan F. There are two versions of Plan F available – standard and high-deductible – and beneficiaries should compare prices from different insurance companies to find the best option for their needs. That is applicable to Plan G as well, where there is a high-deductible Plan G and regular Plan G.

Medigap Plan F Pros

Medicare Plan F is a popular choice because it covers all gaps in Original Medicare Part A and B, including deductibles and the 20% that Part B doesn’t cover, resulting in zero out-of-pocket expenses for doctor visits. It also covers all Part B excess charges and allows patients to choose any doctor without referrals. It is a comprehensive plan that pays for deductibles and co-insurance, meaning patients have $0 out-of-pocket expenses after Medicare pays its share. For example, without a Supplement, patients would owe a $1,600 deductible for hospital visits and 20% of expensive procedures like surgery.

This to be said, Plan F offers the same set of benefits, regardless of which insurance provider you select. These benefits include coverage for Part A coinsurance and hospital costs for an additional 365 days after Medicare benefits have been exhausted, the Part A deductible, hospice care coinsurance or copayment, Part B coinsurance or copayment, the Part B deductible, excess charges for Part B, skilled nursing facility care coinsurance, the first three pints of blood transfusion, and foreign travel emergency coverage up to a maximum of $50,000, subject to a $250 deductible. While Plan F was designed to address most expenses not covered by Original Medicare, it does not cover all medical costs or concerns.

Plan F also has a High Deductible Plan version. In order for your Medicare plan to cover your out-of-pocket costs, you must first satisfy the Medicare Supplement deductible for the year, which may vary annually and is currently set at $2,700 for high-deductible plans in 2023. Those types of plans also have the same set of benefits, the only difference is that you pay deductible upfront.

Medigap Plan F Cons

While Medigap Plan F has many benefits, it also has some drawbacks to consider. The biggest downside is that it is no longer available to new Medicare beneficiaries as of January 2020. This means that only those who were eligible for Medicare before this date can enroll in Plan F. Additionally, the plan may have higher premiums compared to other Medigap plans, and some people may not need as much coverage as Plan F offers.

The expenses of Medicare Plan F are subject to fluctuations depending on the region, sex, postal code, and tobacco usage. Typically, females who turn 65 can expect to pay between $120 to $140 per month for Medicare Plan F in many localities, but it’s recommended to request personalized quotes to get accurate pricing information for your area.

Generally, males may encounter slightly elevated prices for Medicare Plan F compared to females when dealing with most providers. Additionally, tobacco users will likely incur higher costs for Medigap Plan F compared to those who do not smoke. Moreover, some insurers extend household discounts for their Medicare Supplement policies.

While Plan F offers comprehensive coverage, it still has certain limitations that leave gaps in its coverage. For example, it does not provide coverage for prescription drugs, hearing health, dental care, vision care, or surgeries considered to be cosmetic. If you require coverage for any of these benefits, you will need to purchase additional coverage. It is important to carefully review your healthcare needs and choose a plan that adequately meets your requirements.

Finally, because Plan F covers all out-of-pocket costs, some argue that it encourages overuse of medical services and higher healthcare costs overall.

What is the Alternative if I’m Not Eligible For Plan F?

Although people newly eligible for Medicare cannot sign up for Plan F, there are still other Medigap plans available to them. The first best alternative to Plan F is Medicare Plan G.

Plan G for Medicare Supplement offers almost the same benefits as Plan F, with the exception that it does not cover the Part B deductible. The premium for Medicare Part G varies depending on the plan you choose, with options for a normal plan with no deductible or a high-deductible version. Plan G covers a range of medical expenses, including the Medicare Part A deductible, coinsurance, hospital costs, hospice coinsurance or copay, skilled nursing coinsurance, and the first three pints of blood. It also covers 80% of foreign travel emergencies.

People who sign up for Plan G will have a high level of coverage and peace of mind as they won’t face unexpected medical bills. Despite having to pay slightly more for this coverage, they are willing to do so for the comprehensive benefits.

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