Medigap Plan F: Comprehensive but Costly
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Medigap Plan F is the most comprehensive Medicare Supplement Insurance plan.
Only people who became eligible for Medicare prior to 2020 are eligible to purchase Plan F.
Plan G is a good alternative if you’re not eligible for Plan F or want a lower premium.
Medigap Plan F is a Medicare Supplement Insurance plan sold by private companies to cover "gaps" in Original Medicare coverage, such as copayments, coinsurance and deductibles. Plan F covers more than any other Medigap plan, but it’s only available if you turned 65 before 2020.
Even if you’re eligible, Medicare Supplement Plan F can be significantly more expensive than its Medigap alternatives, so you may spend more than the additional coverage you’d get. If you’re not eligible to buy Plan F, you can purchase other Medigap plans with nearly as much coverage.
Medicare Supplement Insurance Plan F is often called Medigap Plan F. You might also see it referred to as "Medicare Plan F" or even "Medicare Part F," even though those labels aren't quite accurate.
Still deciding on the right carrier? Compare Medigap plans
What is Medicare Supplement Plan F?
After Medicare pays its share of the approved amount for covered health care costs and services, Medigap Plan F helps pay for the remaining copays, coinsurance and deductibles. As the most comprehensive Medigap plan, Plan F covers nearly all out-of-pocket costs associated with Original Medicare.
Plan F is the most popular Medicare Supplement Insurance plan, covering about 39% of all Medigap members as of 2022. But it’s losing market share because new Medicare members can no longer enroll in Plan F. Plan G and Plan N are common alternatives.
Medigap plans are only for Original Medicare members, not for Medicare Advantage beneficiaries. And if you became eligible for Medicare in 2020 or later, you can't purchase a Medigap policy that covers the Medicare Part B deductible, which rules out Plan F (and Plan C).
If you were already covered by Plan F before Jan. 1, 2020, you can keep your plan. And if you were eligible for Medicare before that date but haven't yet enrolled, you may be able to buy a Plan F policy.
But even if you’re eligible, you should check the monthly premiums — you may be paying a lot more now for Plan F than you will for its closest alternative, Medigap Plan G plus the Part B deductible.
Medicare Supplement Plan F pros and cons
Medigap Plan F has pros and cons:
Coverage: Plan F covers more benefits than any other Medigap plan.
Availability: Most companies offer Medigap Plan F to those who qualify.
Simplicity: Plan F covers most out-of-pocket costs for Medicare Part A and Part B, so you don’t need to worry much about copays, coinsurance and deductibles.
Cost: Plan F premiums can get expensive.
Eligibility: If you turned 65 in 2020 or after, you can’t buy Medigap Plan F (Plan G is the closest alternative).
Value: Even if you qualify for Plan F, Plan G or Plan N might be a better deal overall.
What Medigap Plan F covers
Here’s what Medigap Plan F covers, according to Medicare.gov:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
Part A deductible.
Part A hospice care coinsurance or copayment.
Part B coinsurance or copayment.
Part B deductible. (Since 2020, new Medicare members can’t buy any plan that covers the Part B deductible. However, this coverage is available for Medicare beneficiaries currently enrolled in Medigap Plan C and Plan F.)
Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).
Skilled nursing facility care coinsurance.
Blood transfusion (first three pints).
Emergency health care services for the first 60 days when traveling outside the U.S.
Plan F is also available as a high-deductible plan in some states, in which case coverage kicks in only after you meet a deductible of $2,800 in 2024.
What Medigap Plan F doesn't cover
Medigap Plan F offers the most comprehensive coverage of any Medigap plan. There isn't a Medigap plan that covers more than Plan F, but you should know that Medigap plans don’t cover everything.
Medigap Plan F doesn’t cover the following, nor do any Medigap plans sold to new Medicare members:
Long-term care (like non-skilled care you get in a nursing home).
Private-duty nursing.
Shopping for Medigap plans? We have you covered.
MEDICARE SUPPLEMENT, or Medigap, is private health insurance that covers “gaps” in traditional Medicare coverage. Compare options from our Medigap roundup. | |
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Medigap Plan F alternatives
If you’re not eligible for Medigap Plan F but want a similar option, Plan G is the closest alternative. Medigap Plan G covers everything in Plan F except for the Medicare Part B deductible, since plans sold to new members can’t include that coverage.
You can compare the coverage of all of the Medigap plans to decide what plan would work best for you.
Medigap plans are standard in every state except Massachusetts, Minnesota and Wisconsin, which have their own policies. Plans are regulated by the government, but they’re sold by private insurance companies, and it’s the companies that set the prices.
Buy Medicare Supplement Plan F during Medigap open enrollment
You can get the best price and have the smoothest enrollment experience if you sign up for a Medigap plan during your Medigap open enrollment period.
This period happens only once. It starts once you’re 65 and enrolled in Medicare Part B, and lasts for six months. (If you're still working after 65 and covered by a group employer plan that is deemed creditable coverage, your six-month period starts after you’ve ended active employment or no longer have that insurance.)
Medigap policies are cheapest and easiest to get during this open enrollment period because insurance companies aren’t allowed to factor your health or medical history into your price. After the period ends, the prices may go up or you may be denied coverage due to your health status or medical history.
In some states, insurance companies sell Medigap plans to those under 65 who are living with a disability and are eligible for Medicare. You can find more information through your State Health Insurance Assistance Program, or SHIP.
Get details on Medicare Supplement Insurance options | |
Coverage | Medigap Plan |
Basic benefits | |
Basics plus some extras | |
Highest coverage | |
Lower premiums, but higher copays | |
Lowest premiums — partial coverage | |
No longer for sale to new Medicare members | |
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