Medicare Supplement Insurance, also known as Medigap, is a policy designed to pay some of the extra healthcare expenses that traditional Medicare doesn’t cover. Because of its comprehensive coverage, Medicare Supplement Plan F is one of the most popular policies among seniors using Medicare. However, for some, this policy may not be sold past 2019. Read on to discover if you should consider a Medicare Supplement Plan F before it’s discontinued.
Medicare Supplement Plan F Explained
Medicare Supplement Plan F is one of the standardized Medigap plans offered to help cover some of the out-of-pocket expenses that Medicare Parts A and B don’t cover. These expenses can include deductibles, copayments or coinsurance. Standardized plans are referred to as such because they offer the same benefits no matter what state you purchase your plan in or what company you purchase it from. However, if you purchase in Massachusetts, Minnesota or Wisconsin you will have to select another standardized plan option.
Also noteworthy is that Medicare Supplement Plan F comes with a high-deductible option called Plan F+. While this option may help policyholders lower their monthly premium, it comes with higher out-of-pocket expenses. Keep in mind, you’ll pay a deductible of up to $2,300 per year before the plan kicks in.
According to America’s Health Insurance Plans (AHIP), 55% of people with a Medigap standardized plan held Plan F in 2016. That may because this plan provides the most comprehensive coverage and helps policyholders fill in the gaps of the coverage that traditional Medicare offers.
What Does Medicare Supplement Plan F Cover?
Anyone who is 65 years or older and a U.S. citizen or a permanent resident residing in the U.S. for at least five years is eligible for Medicare Supplement Plan F. This plan is designed to help pay for out-of-pocket expenses that traditional Medicare won’t cover. Below are some of the out-of-pocket expenses Medicare Supplement Plan F covers.
- Plan F helps pay for Medicare Part A coinsurance once you use up your traditional Medicare benefits. If you stay at a hospital for more than 90 days, you must pay $682 in coinsurance for each “lifetime reserve” day. Plan F helps cover the cost of “lifetime reserve” days.
- Medicare Part B coinsurance and copayments are usually 20% of Medicare-approved services. Plan F helps cover these costs.
- Unless someone donates blood to you, you’re responsible for payment of the first 3 pints of blood. Plan F will help pay for this including hospital and provider expenses.
- Plan F will help pay for 5% of coinsurance for the Medicare-approved amount or up to $5 of copayment for each perception or pain relief treatment you need due to hospice care.
- This plan helps seniors pay for the coinsurance amount for days 21-100 in a skilled nursing facility. This amount is usually $170.50 per day.
- Plan F pays your Medicare Part A deductible of $1,364 for 2019.
- This plan pays your Medicare Part B deductible of $185 for 2019.
- If a healthcare provider doesn’t accept the Medicare-approved amount as a complete payment, they can charge an excess amount. This is also covered with Plan F.
- If you’ve received emergency care outside of the U.S., Plan F offers up to $50,000 to help pay for the costs (once you pay the annual deductible of $250).
What Medicare Supplement Plan F Does Not Cover
While Medicare Supplement Plan F aids with the payment of a lot of out-of-pocket expenses, there are a few things that this Medigap plan doesn’t cover. First, these plans no longer cover prescriptions drugs if you purchased the plan after January 1, 2006. Since Medicare Parts A and B don’t offer prescription coverage, eligible applicants will have to enroll in the Medicare Part D prescription plan or buy a Medicare Advantage policy.
Additionally, Medigap Plan F doesn’t cover supplement health benefits which can include hearing aids, vision or dental care. You can receive some of these benefits through other plans offered such as Medicare Part C or a Medicare Advantage policy.
How Much Does Medicare Supplement Plan F Cost?
The premium on Plan F is contingent on several factors, including where you live. You can shop for pricing by going to Medicare.gov’s Find-A-Plan section and entering your personal information. It’s important to note that the government requires every plan that goes by the same letter to offer the same coverage, but the prices will vary greatly between companies and location.
For example, the monthly premium for an Ohio resident who is in good health can range from $124 to $222 per month. The Ohio high-deductible plan premium can range from $28 to $69 per month with a deductible of up to $2,300. Be sure to evaluate which option is best for your unique situation.
How to Enroll in Medicare Supplement Plan F
You’re first eligible to buy Plan F when you turn 65 and enroll in Medicare Part B. Open enrollment lasts for six months from your 65th birthday. If you wait until after your six-month open enrollment, you may have to pay a Part B late-enrollment penalty. However, if you’re still under your employer’s healthcare plan, you have six months from the termination of your employment to enroll.
When you select a Plan F policy that works best for you, you’ll fill out your application including your medical details. The answers you provide will determine your eligibility and confirm that you’re applying within your open enrollment period. Therefore, it’s essential you fill out the application completely. If your insurance agent completes the form, you may want to double check it for accuracy.
Usually, you can pay for your policy by check, money order or bank draft. All payments are made payable to the insurance company that you chose to work with. You can communicate with your insurance agent to determine when your policy should start. The standard is for coverage to begin the first day of the month following the month that you apply.
Should You Get Medicare Supplement Plan F?
Unfortunately, enrollment in Plan F is no longer available after Dec. 31, 2019. If you become eligible after Jan. 1, 2020, you may have the opportunity to apply for a similar plan. You can compare other plans side-by-side on the Medicare.gov comparison page. The closest plan to Medicare Supplement Plan F is Plan G. The most noticeable difference is that it does not include the Part B deductible.
The Bottom Line
Medicare Supplement Plan F helps policyholders pay for out-of-pocket costs that traditional Medicare won’t cover. If you’re eligible for Medicare beginning in 2020 or later, you may have to find another option. Medicare Supplement Plan G has the basic benefits that Plan F offers without the Part B deductible. If you live in Massachusetts, Minnesota or Wisconsin, you’ll need to contact your state health insurance program. They can then help you learn more about your options for a Medicare Supplement plan.
Healthcare Savings Tips
- If you want help figuring out Medicare and other retirement topics, consider working with a financial advisor. Finding the right financial advisor that fits your needs doesn’t have to be hard. SmartAsset’s free tool matches you with financial advisors in your area in five minutes. If you’re ready to be matched with local advisors that will help you achieve your financial goals, get started now.
- A health savings account (HSA) might be a good option for young people who are worried about potential healthcare costs. HSAs can greatly reduce monthly premiums and may be offered through your health insurance.
Photo credit: ©iStock.com/Kameleon007, ©iStock.com/Yuri_Arcurs, ©iStock.com/baona