What Is Medicare Part F and What Does It Cover?

a doctor doing a medical examination

If you are researching your medicare options. you may be at least somewhat familiar with Medicare Supplement Plan F. It is the Medicare supplement (aka Medigap Plan) with the most insurance coverage because it cover 100% of the deductibles, copays and coinsurance that Medicare leaves as the patients responsibility. Plus it covers 100% of Medicare Part B excess charges.

Although not every person that is eligible for Medicare plans can purchase Medigap Plan F (more about it later), even those that are eligible may decide against this supplement because it is not a great financial value relative to your alternatives.

From our guide, you will learn who can enroll in Medicare Supplement Plan F, what are the costs of this insurance and how one can purchase it. We will also discuss alternatives for this Plan. Plus we will discuss some of the other Medicare plans you may wish to consider.

Who Is Eligible for Medicare Plan F?

Not every person eligible for Original Medicare will be able to purchase Medicare Plan F. This coverage is available for those who were eligible for Medicare on or before January 1, 2020.

If you were eligible for Medicare and Medicare supplement insurance prior to January 2020, you can shop Plan F. However, you are likely to find it’s not a good value. The reason for this is that the only difference between Plan F and Plan G is that Plan F will pay the Medicare Part B deductible, which is $226 for 2023. But, Plan F often cost $300 or more per year than Plan G. That means that with Medicare Plan F, you will pay $300 or more per year for a $226 benefit.

This is why many people who currently have a Plan F are converting them to Plan G to save money.

What Is Medigap Plan F?

Medicare Supplement Plan F coverage was designed to pay the gaps that Original Medicare (Part A and Part B) left to the consumer to pay. Medicare Plan F is one of ten Medicare Supplement Insurance plans. Medicare supplement plans are operated by private health insurance companies, and are designed to complement Original Medicare. Like all Medicare supplement insurance policies you are required to first have Medicare Part A and Part B.

Medicare Plan F is the most comprehensive Medigap plan offered in the U.S. of all the Medigap plans available, you will have the lowest out of pocket cost for medical bills with Plan F. But what does Medigap Plan F cover?

What Does Medicare Plan F Cover?

Medigap Plan F covers all the gaps that are left in the Original Medicare. You have 100% Medicare Part A inpatient coverage. This supplement will pay your Part A deductible and all coinsurance so you can spend up to a year as an inpatient in the hospital and it will not cost you a dime. Your out of pocket costs for inpatient care should be zero.

For outpatient care your out of pocket expenses for any medicare approved service or treatment should also be zero. Of course, this does not include prescription drug coverage.

In practice, these are the benefits of Medicare Plan F:

  • Medicare Supplement Plan F pays for your Part A hospital deductible, as well as Part B outpatient deductible and coinsurance;
  • It pays the Medicare Part B excess charges. Some doctors are allowed to charge up to 15% more than Medicare compensates them. This 15% is called an Excess Charge;
  • This plan pays for skilled nursing facility care coinsurance;
  • Medicare supplement Plan F covers blood transfusion up to the first three pints;
  • Medicare Plan F pays for foreign travel emergency coverage up to $50,000 over your life-time after hitting a $250 deductible.
  • Plan F Medicare pays all excess charges where the provider bill more than the Medicare approved amount.

It is worth mentioning that all Medigap policies are standardized. This means the benefits are the same no matter which insurance provider you choose. The only difference is the cost you pay in premiums today and in the future.

What Is Not Covered by Medicare Supplement Plan F?

If Medicare does not cover a service or procedure, then Medicare supplement insurance cannot cover it either. Plan F as well as other Medicare supplement plans can only pay the deductibles and coinsurance of Medicare. A supplement supports you Medicare covered costs. If Medicare pays their portion of the bill, your supplement will pay its portion.

Among the things not covered by Original Medicare include:

  • Hearing health care services not disease or injury related;
  • A supplement does not cover Prescription drugs that you self administer;
  • Corrective Vision care (Medicare does cover diseases and conditions like Glaucoma and cataracts;
  • Dental care;
  • Cosmetic surgery.

When you are ready to shop for prescriptions drug coverage we recommend visiting this article Medicare Part D and our website PartDShopper.com. Part D is designed to help pay for the costs of prescription drugs. Our Part D website helps you get the most out of your Medicare benefits.

To learn more about dental insurance and what Medigap Seminars has to offer to help you pay for these services please see our article and video titled Does Medicare Cover Dental?.

Medigap Plan F Cost

Medicare Plan F premiums vary greatly depending on your age, gender, state of residence and tobacco use, in addition to whether or not you qualify for a household discount.

Typically, Medigap Plan F costs about $300 to $600 a year more than the supplement plan with the next most benefits, Medicare Plan G.

Medicare Supplement Plan F Premium Increase

Because no new young 65-year old’s can enroll in Plan F, every year the age pool for Plan F gets older and more in need of medical services. This puts greater pressure on price increases than with any of the other Medicare supplement policies.

Healing Patient Holding

High-Deductible Plan F

Medicare Supplement Plan F is one of two plans that also offers a high deductible version.

The high-deductible Medicare Part F has an annual deductible. This means you are obligated to pay the annual deductible before you can benefit from the coverage. That deductible is also your limit for maximum annual out of pocket costs. In other words, your out of pocket expenses can be no more than the yearly deductible.

We recommend a high deductible plan only in states where all supplement plans are required to be priced as either Issue Age or Community Rated. This keeps your annual price increases at a minimum.

Before you enroll in this Plan, you should consider all the pros and cons. You will end up paying less for this insurance in monthly premiums, but in a situation when you need to cover some medical expenses, you will need to pay the entirety of the deductible (which in 2023 is $2,700) out of pocket before the supplemental insurance pays anything.

For example, if you become an inpatient in the hospital (Part A) you will pay the $1,600 Part A deductible. In many sates, just paying that deductible once will completely several years of premium savings relative to other supplement plans.

In addition, the deductible is linked to inflation. It increases each year at the same rate as the annual CPI-U. This makes the high deductible plan vulnerable to inflation. While that may seem like an issue, the high deductible plan is still less vulnerable to inflation that Medicare Advantage Plans and has a lower maximum out of pocket. On occasion, a Group Medicare Advantage HMO may have a lower maximum out of pocket.

Keep in mind, in most states if you want to switch from a high-deductible Plan F to the standard Plan F, you may be asked to undergo a medical examination, which is another factor to consider.

Is Medicare Supplement Plan F Discontinued?

It is more accurate to say that Plan F is being phased out. Not discontinued. According to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), all the Medicare Supplement plans that help cover the costs of Medicare Part B’s annual deductible need to be phased out.

For this reason, only those who were eligible for Medicare up until January 1, 2020 still qualify to apply for this Medicare Supplement insurance. Of course, you may still have to qualify medically.

Medicare Supplement Plan G as an Alternative

Generally speaking, Plan G offers the same benefits as Plan F, with one small difference. With a Medigap Plan G you will pay the annual Part B deductible whenever you see a doctor for outpatient services for the first time during a calendar year.

Medicare supplement Plan G has identical coverage to Plan F, except for the Medicare Part B deductible. The annual Part B deductible is under $250 for the year.

Just like in the case of Medicare Plan F, there is also a high deductible Medicare Part G available. Your premiums will depend on what plan you choose, as well as where you live, your gender and age.

Plan G is considered the best Medicare Supplement Plan for new Medicare beneficiaries, as its coverage is comparable to the one offered by Plan F. With Plan G, your medical expenses are less than $300 a year.

Medicare Plan N

If you’re interested in less extensive but full coverage, then you might benefit from Medicare Plan N. This plan offers the same benefits as Plan G with the exclusion of Part B excess charges.

Health Insurance

How to Enroll for Medicare Supplement Plan F?

If you are eligible for a Plan F or wish to consider a Plan G or N to save money, this is where Medigap Seminars can help. Simply use this quote request form or Contact Us form to provide us with the information we will need in order to help you.

When is the best time to enroll for this Medicare Supplement policy? The most beneficial period for Medigap policies enrollments is during the Medigap open enrollment period. During this time, you can enroll in various plans including Part D, as well as any of the Medigap plans.

Medigap open enrollment period starts on the first day of the month you’re turning 65 (or the month your Medicare Part B started) and ends six months (180-days) later. Medicare beneficiaries can gain a lot by enrolling during this time, as within this period they cannot be denied coverage due to health issues.

The Bottom Line

Medicare Plan F currently is the most comprehensive coverage available for seniors. Although it’s not a widely accessible coverage, those who can enroll in Plan F often choose to do so due to the many benefits this insurance offers.

Considering the high and constantly increasing premiums for this Medigap plan, the decision to purchase it should be made with much consideration. It’s advisable to consult an insurance agent and consider all the possibilities, costs, and other factors.

For some, Part F Medicare might be a necessity, while others will be content with a high-deductible Plan F or some other Medigap plans.

Visit our site for more resources regarding Medigap plans and make an informed decision about your medical insurance.

Part F Medicare FAQs

Is plan F still available in 2022?

Plan F is not available to purchase for new Medicare beneficiaries. You are only eligible to buy this plan if you had Medicare or were eligible for Medicare before January 1, 2020.

Is Medicare Plan F better than plan G?

Medicare Plan F and Plan G offer very similar benefits, with the only difference being that Part G does not cover Part B deductible. For this reason, Medigap Plan G is more affordable and a better value than Plan F.

What is the plan F high deductible for 2023?

The annual deductible for Medicare supplement Plan F in 2023 is $2,700. With inflation increasing to the highest levels since the 1980s, the deductible will probably breach $3,000 within just a couple years.

Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.

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