What Is Medigap Plan F? What You Need to Know
Medigap Plan F, which helps pay out-of-pocket Medicare costs, isn't available for new enrollees. There are alternatives.
Plan F is part of Medicare Supplement Insurance, also known as Medigap. This is insurance that’s sold by private companies and fills gaps in Original Medicare coverage, such as copayments, coinsurance and deductibles.
How it works: Medicare pays its share of the approved amount for covered health care costs and services. Then, the Medigap policy pays its share. (You’ll pay a separate monthly premium for Medigap benefits.)
» Learn about Medicare Advantage Plans
Here’s the catch for most new enrollees: If you’re newly eligible for Medicare after Jan. 1, 2020, you cannot purchase a Medigap Plan F policy. Why? After that date, new policies aren't allowed to pay a Medicare Part B deductible, one of the prime features of Plan F.
If you already have or were covered by Part 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 Part F plan.
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 hospice care coinsurance or copayment.
Part A deductible.
Part B coinsurance or copayment.
Part B deductible.
Part B excess charge.
Blood (first three pints).
Skilled nursing facility care coinsurance.
80% foreign travel exchange (up to plan limits).
What Medigap Plan F doesn't cover
Medigap Plan F doesn’t cover the following:
Prescription drugs.
Supplemental health benefits: Medigap plans don't offer coverage for hearing aids, vision care, dental care and long-term care, among other things.
Medigap plans are standard in every state except Massachusetts, Minnesota and Wisconsin, which have their own plans.
Medigap Plan F, when it was fully available, was considered one of the most comprehensive Medigap policies on the market, since it covers all of the out-of-pocket costs of Original Medicare (Medicare Part A and Medicare Part B). If Plan F isn’t available to you, the closest Medigap plan is Plan G, which offers the same coverage except for the Part B deductible.
When you shop for a Medigap policy, be aware that insurance companies may charge different premiums for the same plan. It’s smart to compare prices at several companies before making a purchase.
For questions about Medicare coverage, go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). You can also get help from your local State Health Insurance Assistance Program (SHIP).
What Medicare covers
Medicare covers a lot of things — but not everything. Find out where Medicare stands in the following areas:
The parts of Medicare
Read more about the different parts of Medicare and what they cover.
