Medicare Supplement Plan F Review (Printable Cheat Sheet!)
Medicare Plan F is one of ten Medicare Supplement Insurance (“Medigap”) policies that Americans can buy if they need help paying for their Medicare Part A and Part B out-of-pocket expenses.
Medigap Plan F is one of the most popular Medicare supplement policies on the market. It covers a wide range of medical expenses and is offered by many health insurance providers.
If you’re wondering exactly what your Medicare benefits will look like under Plan F, you’re in the right place. Let’s dive in.
What Is Medicare Supplement Insurance?
Medicare supplement plans are private health insurance plans that supplement Original Medicare.
You can purchase Medicare supplement insurance at any point after you become eligible for Medicare.
Medicare Supplement Vs. Original Medicare
Original Medicare refers to Medicare Part A & Part B. It covers inpatient and outpatient medical services. However, it does not cover some key health care needs, including prescription drugs, dental care, vision care, or eye care.
Medicare Supplement Insurance policies do NOT cover additional medical services. It helps pay for your out-of-pocket expenses from Original Medicare.
The purpose of Medicare supplementary insurance is to fill in the financial gaps in Original Medicare’s coverage; in other words, your out-of-pocket costs (coinsurance, copayments, and deductibles).
Depending on the plan purchased and what type of medical coverage is desired rather than just medically necessary coverage, different supplemental policies will focus on various parts of healthcare expenses such as prescription drug benefits or vision benefits.
What Do Medigap Policies Cover?
There are a variety of Medigap plans. As of 2021, there are ten different plans (and in some states, high-deductible versions of Plan F and Plan G).
Medical Supplemental Insurance is sold by private insurance companies, such as Aetna, UnitedHealthcare, Cigna, and Humana.
They cover, among other items, the coinsurance and deductibles for hospitalization, hospice care, or skilled nursing services that Medicare does not cover.
For many seniors, this extra coverage can make it much more practical to use the benefits of Original Medicare. Others may be able to get help paying their medical bills through Medicaid or a different program.
What Is Medicare Supplement Plan F?
First, the bad news, Plan F has been phased out for new enrollees as of 2020. This is due to new legislation that no longer allows Medicare Supplement Insurance plans to cover your Part B deductible ($203 in 2021).
Both Plan F and Plan C paid this deductible, so they are no longer offered to new Medicare enrollees.
Medicare Supplement Plan F is available only to Medicare beneficiaries who were eligible for Medicare before Jan. 1, 2020.
The good news, however, is that Medicare Plan G is, for all intents and purposes, the same as Plan F. Here’s why:
- Part B Deductible: While Plan G does not cover this, your premium savings with Plan G will far exceed this $203 deductible
- Part B Excess Charges: These are very rare (and in fact, illegal in 8 states). According to MedicareSupplement.com, less than 1% of doctors nationwide have opted out of Medicare. All other doctors cannot charge you in excess of the rate they agreed to with Medicare.
Table: Medicare Supplement Plan F Benefits (vs. Plan G)
Medigap Plan F Benefits Cheat Sheet (Printable PDF)
If you’re like me and understand things better on paper, we’ve put together a printable, one-page cheat sheet to help you get your head around Plan F.
In the sections below, we’ll go through each of these benefits in more detail.
Covered Services and
What You Owe
|Part A Inpatient Hospital Deductible||0% ($0)|
|Annual Part B Deductible||0% ($0)|
|Out of Pocket Maximum||$0|
|Part B Excess Charges||Covered|
Medicare Plan F has comprehensive coverage. While you still have to pay your Part B premium, your Parts A & B deductibles are $0. Your out-of-pocket costs will be $0 as well.
While Part B excess charges are rare (and illegal in several states), if you do happen to encounter them, Plan F will cover them.
|Primary Care Visits||$0|
|Referral To Specialist Required?||No|
|Provider Network Required?||No|
|Preventive Services||$0 for Medicare Covered Services|
If your Medicare supplement insurance is Plan F, you will pay nothing to visit the doctor. (And you can see any Medicare doctor.)
Primary care and specialist visits have a $0 copay. And you have a $0 copay for preventative services, as long as these are Medicare Covered Services.
Unlike Medicare Advantage plans, which have networks (HMO or PPO), you are not limited to a network with Medigap Plan F.
That means you can see any provider who takes Medicare, and you will not need a referral to visit a specialist.
|Ground Ambulance Services||$0|
|Air Ambulance Services||$0|
|Foreign Travel Emergency||$250 Annual Deductible then 20% |
($50,000 Lifetime Max)
If you have Medicare Supplement Plan F, you won’t pay anything for urgent care, emergency room care, ground ambulance services, or even air ambulance services. This could save you tens of thousands of dollars.
Most Medigap plans do not cover foreign travel emergency care, as it is not valuable for enough Americans. However, if you plan to travel internationally, this coverage would be a nice perk of Plan F! After a $250 annual deductible, you will pay only 20% up to a $ 50,000-lifetime maximum.
|Inpatient Hospital Care||For Days 1-60: $0 |
For Days 61-90: $0
For Days 91+: See Note
|Skilled Nursing Facility||For Days 1-100: $0 |
For Days 101+: All Costs
This is where it gets somewhat confusing. For inpatient care at a hospital or a skilled nursing facility, you will have a certain number of days at no cost, after which you will pay all expenses.
For inpatient hospital care, you pay nothing for days 0-90. The following 60 days you use are counted against your Medicare Part B lifetime reserve days under. Finally, if you exhaust these, your Plan F coverage will cover the next 365 days.
So for your first 515 days, you would pay nothing for inpatient care. After this, you would be responsible for all costs.
|Ambulatory Surgical Center||$0|
|Outpatient Hospital Services||$0|
|Mental Health - Outpatient||$0|
Under Medigap Plan F, you pay nothing for services at ambulatory surgical centers, outpatient hospital services, and outpatient mental health care.
Lab & X-Ray
|Diagnostic Radiology Services||$0|
|Durable Medical Equipment||$0|
Under Plan F, you also pay nothing for lab services, diagnostic radiology services, x-rays (done on an outpatient basis), and durable medical equipment.
Frequently Asked Questions
Medicare Plan F (also referred to as Medigap Plan F) is the most comprehensive Medicare supplement plan. This plan covers Medicare deductibles and all copays and coinsurance (including Part B deductibles), which means you pay nothing out of pocket throughout the year.
Plan F is only available if you first became eligible for Medicare before January 1, 2020 (which means your 65th birthday occurred before January 1, 2020, or you qualified for Medicare due to a disability before this date).
Plan F is going away due to new legislation that no longer allows Medicare Supplement plans to cover Medicare Part B deductibles. Since Plan F (and Plan C) pay this deductible, private insurance companies can no longer offer these plans to new Medicare enrollees.
We hope you found this overview helpful! If you have a question we did not cover, however, don’t hesitate to leave a comment or send us an email at email@example.com. We’ll be sure to get back to you within 24 hours.
The GetSure Team