Medigap is offered by private insurance companies as an add-on to your original Medicare plan. The purpose of having a Medigap plan is to help cover your Medicare costs, such as deductibles, copayments, and coinsurance. There are 10 Medigap plans that insurance companies can offer, including A, B, C, D, F, G, K, L, M, and N.
Medigap Plan F, sometimes called Medicare Supplement Plan F, is the most comprehensive Medigap plan offered. It covers almost all your Medicare Part A and Part B costs so that you owe very little money out-of-pocket for healthcare services.
Medigap Plan F may a good option if you:
- require frequent medical care and visit the doctor often
- require financial assistance with nursing care or hospice care
- travel out of the country often but don’t have traveler’s health insurance
If you are enrolled in Medigap Plan F, you are responsible for the following costs:
- Monthly premium. Each Medigap plan has its own monthly premium. This cost will vary depending on the plan you choose and company you purchase your plan through.
- Yearly deductible. While Medigap Plan F itself does not have a yearly deductible, both Medicare Part A and Part B do. However, unlike some of the other options offered, Medigap Plan F covers 100 percent of the Part A and Part B deductibles.
- Copayments and coinsurance. With Medigap Plan F, all your Part A and Part B copayments and coinsurance are completely covered, resulting in an almost $0 out-of-pocket costs for medical or hospital services.
Plan F monthly premiums
Here are a few examples of Medigap Plan F premiums in different cities across the country:
|City||Plan option||Monthly premium|
|Los Angeles, CA||standard deductible||$157–$377|
|Los Angeles, CA||high deductible||$34–$84|
|New York, NY||standard deductible||$305–$592|
|New York, NY||high deductible||$69–$91|
|Chicago, IL||standard deductible||$147–$420|
|Chicago, IL||high deductible||$35–$85|
|Dallas, TX||standard deductible||$139–$445|
|Dallas, TX||high deductible||$35–$79|
Plan F deductibles
Medigap Plan F also includes a high-deductible option available in many areas. With this plan, you’ll owe an annual deductible of $2,370 before Medigap pays out, but the monthly premiums are usually much less expensive.
High-deductible Medigap Plan F is a great option for people who prefer to pay the lowest monthly premium possible for this coverage.
Plan F copays and coinsurance
Plan F covers copays and coinsurance associated with Medicare parts A and B. If you have a Plan F policy, you won’t be responsible for these costs.
Plan F out-of-pocket costs
There are some things that Medigap typically doesn’t cover, although this can vary by policy. When a service isn’t covered, you’ll need to pay the cost out-of-pocket.
Some examples of servicesthat often aren’t covered in Medigap policies are:
Unlike some other Medigap plans, Plan F doesn’t have an out-of-pocket limit.
Medigap Plan F is the most comprehensive of the Medigap plan offerings, as it covers almost all of the costs associated with Medicare parts A and B. All Medigap plans are standardized, meaning that the coverage offered must be the same from state to state (with the exceptions of Massachusetts, Minnesota, or Wisconsin).
Here’s what Medigap Plan F covers:
- Part A coinsurance and hospital costs
- Part A hospice care coinsurance or copayments
- Part A nursing facility care coinsurance
- Part A deductible
- Part B coinsurance or copayments
- Part B deductible
- Part B excess charges
- Blood transfusions (up to 3 pints)
- 80 percent of foreign travel costs
There is no out-of-pocket limit with Medigap Plan F, and it does not cover either of your MedicarePart A and Part B monthly premiums.
As noted above, all Medigap plans are standardized by law – except if you live in Massachusetts, Minnesota, or Wisconsin. In these states, Medigap policies are standardized differently, so you may not be offered the same coverage with Medigap Plan F.
If you already have Medicare Advantage, you may be considering switching to original Medicare with a Medigap policy. Previously, anyone enrolled in original Medicare could purchase Medigap Plan F. However, this plan is now being phased out.
As of January 1, 2020, Medigap Plan F is only available to those who were eligible for Medicare before 2020.
If you were already enrolled in Medigap Plan F, you can keep the plan and the benefits. Also, if you were eligible for Medicare before January 1, 2020, but missed the enrollment, you may still be eligible to purchase Medigap Plan F.
If you are planning to enroll in Medigap, there are certain enrollment periods that you should take note of:
- Medigap open enrollment runs 6 months from the month you turn 65 years old and enroll in Medicare Part B.
- Medigap special enrollment is for people who may qualify for Medicare and Medigap before turning age 65, such as those with end stage renal disease (ESRD) or other pre-existing conditions.
It is important to note that during the Medigap open enrollment period, you cannot be denied a Medigap policy for pre-existing health conditions. However, outside of the open enrollment period, insurance companies can deny you a Medigap policy because of your health, even if you qualify for one.
Therefore, it’s in your best interest to enroll in Medicare Supplement Plan F as soon as possible if you still qualify.
Private insurance companies sell Medigap policies. You can use Medicare’s search tool to find out which plans are offered in your area. You’ll need to enter your ZIP code and select your county to see available plans. Each plan will be listed with a monthly premium range, other potential costs, and what is and isn’t covered.
You can also look at the companies that offer each plan and how they set their monthly premiums. Because the cost of a Medigap policy can vary by company, it’s very important to compare several Medigap policies before selecting one.
Medigap Plan F is a comprehensive Medigap plan that helps cover your Medicare Part A and Part B deductibles, copayments, and coinsurance. Medigap Plan F is beneficial for low-income beneficiaries who require frequent medical care, or for anyone looking to pay as little out-of-pocket as possible for medical services.
Since Medigap Plan F is no longer offered to new enrollees, Medigap Plan G offers similar coverage without covering the Part B deductible.
If you’re ready to move forward and enroll in a Medigap plan, you can use Medicare.gov’s website to search for policies near you.