What Is Medicare Supplement Plan F?
Medicare Supplement Plan F, also known as Medigap Plan F, is one of the most comprehensive options for individuals enrolled in Original Medicare (Part A and Part B). Medigap plans are sold by private insurance companies to help cover out-of-pocket costs not paid by Medicare, such as copayments, coinsurance, and deductibles. Plan F stands out as the most expansive Medigap plan, offering extensive coverage for medical expenses.
Key Takeaways:
- Eligibility: Plan F is available only to individuals who became eligible for Medicare before January 1, 2020.
- Comprehensive Coverage: It covers nearly all out-of-pocket costs, including the Medicare Part B deductible, which no other Medigap plan offers.
- Cost Considerations: It is often more expensive than other Medigap plans due to its extensive coverage.
- Alternatives: Plan G is a popular alternative for those who are not eligible for Plan F, providing almost the same benefits minus the Part B deductible.
Medicare Supplement Plan F is an excellent choice for those seeking maximum coverage, but it’s not available to new Medicare beneficiaries. Additionally, it can be more expensive than alternatives like Plan G, which offers nearly identical coverage minus the Part B deductible. Whether Plan F is the right option for you depends on your individual health needs, budget, and eligibility.
How Does Medicare Supplement Plan F Work?
Medicare Supplement Plan F helps cover the costs that Medicare doesn’t pay, including the deductible, coinsurance, and copayments for both Medicare Part A (hospital insurance) and Part B (medical insurance). As of 2024, this includes covering the annual Part B deductible of $240, which no other Medigap plan provides. Plan F also covers additional benefits like skilled nursing facility coinsurance, emergency healthcare when traveling abroad, and the first three pints of blood used in medical procedures.
What Does Plan F Cover?
- Part A Benefits: Covers the Part A deductible, hospital costs, skilled nursing facility coinsurance, and hospice care copayments.
- Part B Benefits: Covers Part B coinsurance and the Part B deductible. It also covers Part B excess charges (if a provider charges more than the Medicare-approved amount).
- Other Coverage: Includes up to 80% of foreign travel emergency healthcare costs, as well as coverage for the first three pints of blood.
Note: Plan F does not cover prescription drugs, long-term care, dental, vision, or hearing aids.
The Pros and Cons of Plan F
Pros:
- Maximum Coverage: Plan F offers the most comprehensive coverage of any Medigap plan.
- Simplicity: It covers most out-of-pocket costs, so you don’t need to worry about copays, coinsurance, or deductibles.
- Availability: Plan F is available through most insurance companies to individuals who qualify.
Cons:
- Cost: Plan F premiums can be significantly higher than other Medigap plans due to the extensive coverage.
- Eligibility: If you became eligible for Medicare on or after January 1, 2020, you are not eligible to enroll in Plan F. For new Medicare beneficiaries, Plan G is a similar option.
- Value: While Plan F provides the most coverage, it may not always offer the best value compared to alternatives like Plan G, which costs less and covers nearly all of the same benefits.
Plan F vs. Plan G: A Close Comparison
The major difference between Plan F and Plan G is that Plan F covers the Medicare Part B deductible, while Plan G does not. In 2024, the Part B deductible is $240, and although Plan G has lower premiums, you will need to pay this deductible out-of-pocket. For those who qualify for Plan F, it remains an appealing option for its comprehensive coverage, but for others, Plan G might be a better deal in terms of overall cost.
Plan F Premiums and Costs
Premiums for Plan F can vary significantly based on factors such as age, location, tobacco use, and the insurance company offering the plan. On average, premiums can range from $250 to $400 per month, but this varies widely by region. A high-deductible version of Plan F, which requires you to meet a higher deductible before coverage kicks in, is also available in some states. For instance, the high-deductible version of Plan F has an annual deductible of $2,800 in 2025.
While the premiums may seem high, the comprehensive coverage Plan F provides can make it worth considering for those who need extensive medical care and prefer to avoid significant out-of-pocket costs.
What Plan F Doesn’t Cover
Despite its extensive benefits, Plan F does not cover the following:
- Prescription drugs
- Long-term care (nursing home care)
- Dental care, vision care, and hearing aids
- Private-duty nursing
These gaps mean that while Plan F is comprehensive in terms of healthcare costs, it doesn’t cover all aspects of your health needs, requiring you to potentially purchase additional coverage, such as a standalone Part D plan for prescriptions.