Medicare Supplement Plan F Reviews: Medigap Plan F in 2021
- Medicare Supplement Plan F covers more benefits than any other standardized type of Medicare Supplement (Medigap) plan. It isn’t available for beneficiaries who became eligible for Medicare after Jan. 1, 2020. Learn more about Plan F, what it covers and the insurance companies that offer it.
Many Medicare beneficiaries may have heard that Plan F is the best Medicare Supplement Insurance plan and are curious about reading some reviews of the plan. It’s important to note that people who first became eligible for Medicare after January 1, 2020 won’t be able to apply for Plan F. If you were eligible for Medicare before 2020, you can still apply for Plan F if it’s available where you live. And if you already had Plan F, you can keep your plan or switch to Plan F from another Medicare Supplement provider if you wish.
Below is our comprehensive review of Medigap Plan F to help you in your shopping decision.
Which Medicare Supplement Insurance Companies Provide Plan F?
Plan F is sold by the majority of insurance companies that offer Medicare Supplement (also called Medigap) plans. Just some of the major insurers that sell Medigap Plan F in certain markets include:
You can visit each company’s website or consult with an independent licensed Medicare insurance agent or Medicare insurance broker to learn which companies sell Medigap Plan F in your location.
Is Medicare Plan F the Best?
The popularity of Medicare Supplement Plan F is backed up by the numbers. 85% of all insurance companies that sell Medigap insurance offer Plan F as part of their plan selection. That is the most of any of the 10 available standardized Medigap plans.
53% of all beneficiaries with a Medicare Supplement Insurance plan are enrolled in Plan F. The next most popular plan (Plan G) has just 17% of the market share but is quickly becoming the next most popular Medicare Supplement plan type.
How Much Does Medicare Supplement Plan F Cost?
Because of its comprehensive coverage and because fewer new Medicare beneficiaries will be able to enroll in Plan F going forward, the cost for Plan F may rise to be higher than other Medicare Supplement plans, though plan availability and pricing can vary from one location to the next.
Medigap costs can be influenced by a number of factors, such as your age and gender and the timing of when you apply for Plan F.
If you apply for Medigap Plan F outside of a period when you have a guaranteed issue right – such as during your Medigap open enrollment period – your health could potentially affect your monthly plan premiums. When you don’t have a guaranteed issue right, a Medicare insurance company can use medical underwriting to determine your Medicare plan policy premiums. When a policy is underwritten, it means the insurance company can ask you a series of health questions to determine your plan costs or whether to deny you coverage altogether.
You could also potentially have a guaranteed issue right if your current Medigap plan is cancelled through no fault of your own, or if you move to a new address that’s outside of your current plan’s service area.
Some insurance companies may offer Medigap plan discounts for non-smokers, married couples and for other reasons, so be sure to shop around and to ask about any potential discounts you may qualify for.
What Does Medicare Plan F Cover?
The popularity of Plan F may be attributed to the benefits it offers. There are 9 benefit areas covered by Medicare Supplement Insurance plans, and each type of Medigap plan offers its own combination of these benefits. Plan F is the only one to cover all 9 benefit areas.
The chart below illustrates how Plan F’s coverage compares to the other Medicare Supplement Insurance plans offered in most states (Massachusetts, Minnesota and Wisconsin standardize their Medicare Supplement plans differently).
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,220 in 2021. Plan L has an out-of-pocket yearly limit of $3,110 in 2021.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Here’s how Plan F coverage breaks down in more detail.
Part A Deductible
Medicare Part A requires beneficiaries to meet a deductible of $1,484 for each benefit period in 2021 before Part A coverage begins. This means that if you’re admitted to the hospital for inpatient care, you have to pay $1,484 out of your own pocket before your benefits kick in.
A Part A benefit period can reset multiple times within the same calendar year, which means you could have to pay this deductible more than once in a given year if you don’t have a Medigap plan that covers these costs.
Your benefit period starts as soon as you are admitted for inpatient care and ends once you’ve been discharged and haven’t received inpatient hospital care for 60 days.
This means if you were re-admitted to the hospital within 60 days of first being released, you’d still be in the same benefit period and wouldn’t have to meet the Part A deductible again if you met it the first time. However, if you were hospitalized again after you’ve been out of the hospital for 60 days, a new benefit period would start over and you’d have to pay the Part A deductible again.
Plan F covers your Medicare Part A deductible in full, no matter how many benefit periods you experience in a year.
Part A Coinsurance
If you’re in the hospital or other inpatient care facility for more than 60 days within the same benefit period in 2021, you’re required to pay a $371 daily coinsurance payment per day until day 90 of your stay. If you’re still in the hospital after 90 days, the daily coinsurance requirement doubles to $742 per day until you’ve used up all of your Medicare lifetime reserve days. You only have 60 lifetime reserve days. After those days are used up, you’re responsible for 100% of your hospital coinsurance costs.
Plan F covers your Part A coinsurance costs in full.
Part B Deductible
Medicare Part B requires beneficiaries to first satisfy an annual deductible before Part B benefits kick in. In 2021, the Part B deductible is $203 for the year. Medigap Plan F and Plan C are the only two plans that cover the Part B deductible.
Part B Coinsurance
Once the Medicare Part B deductible has been satisfied, a 20% coinsurance payment is typically required for covered services and items, such as doctor’s office visits, durable medical equipment and supplies. Part B coinsurance costs can add up quickly for more expensive treatments and services, such as cancer treatment.
Plan F covers 100% of your Part B coinsurance costs.
First 3 Pints of Blood
If you need a blood transfusion, Original Medicare doesn’t pay for the first 3 pints of blood that are used. Unless your hospital offers free blood from a blood bank, you’ll have to pay for the first 3 pints out of your own pocket. Plan F covers 100% of these costs, though.
Part A Hospice Care Coinsurance and Copayments
Medications and other products used for symptom control and pain relief during hospice care require a copayment of no more than $5. Respite care requires a coinsurance payment of 5%. If you have Plan F, these costs are covered in full.
Skilled Nursing Facility Care Coinsurance
More than 20 days of inpatient care within the same benefit period at a skilled nursing facility will incur a daily coinsurance payment of $185.50 per day in 2021. If more than 100 days of inpatient care are accumulated in the same benefit period, the beneficiary becomes responsible for all costs. If you have Plan F, however, these costs are covered in full.
Part B Excess Charges
Some doctors and other health care providers maintain a contract with Medicare that allows them to charge up to 15% more than the Medicare-approved amount for certain services and items. This additional cost is what is known as an “excess charge.” If you’re ever faced with Medicare Part B excess charges and you have Plan F, the additional costs will be covered by your Medigap plan.
Foreign Travel Emergency Care
Original Medicare doesn’t typically cover health care administered outside of the U.S. or U.S. territories unless it’s an emergency. If you have Plan F, your plan will cover 80% of the costs of your covered foreign emergency medical care.
What Is High-Deductible Plan F?
A high-deductible version of Medigap Plan F is also available in certain areas. High-deductible Plan F offers the exact same coverage as traditional Plan F, but members must meet an annual deductible for covered services before the plan’s coverage takes effect. Some beneficiaries choose this option because the monthly premiums are typically much lower than the monthly premiums for traditional Plan F and other Medigap plans.
In 2021, the deductible amount for the high-deductible Plan F is $2,370.
Why Is Medicare Plan F Being Phased Out?
Although Plan F is the most popular Medigap plan, that is likely to change in coming years. Federal legislation passed in 2019 changed the eligibility rules for Plan F and Plan C, making them only available to those who became eligible for Medicare before January 1, 2020.
The reason for the change was to end Medigap coverage of the Part B deductible, for which Plan F and Plan C are the only Medigap plans to provide coverage. The rationale is that if a beneficiary does not have to pay anything out-of-pocket to see a doctor, they might visit the doctor for every minor issue and further overwhelm the health care system by virtue of over-utilization.
Stripping away coverage of the Part B deductible forces all beneficiaries to be more invested in their coverage, which may make beneficiaries think twice about making a doctor’s appointment for small health issues.
Is Medicare Plan G Better Than Plan F?
Plan G will most likely become the most popular Medigap plan for new enrollees and will probably one day take over as the dominant plan in the marketplace. Plan G offers all of the same benefits as Plan F except that it doesn’t pay for the Part B deductible. Of the 8 Medigap plans open to new Medicare beneficiaries, Plan G offers the most comprehensive coverage.
The main benefit of being enrolled in Medigap Plan F or Plan G is having little to no out-of-pocket Medicare expenses. Because Plan F and Plan G pay for more out-of-pocket Medicare costs than other types of Medigap plans, it’s rare that Plan F or Plan G members are forced to reach into their own pocket for health care costs.
Such comprehensive coverage means easier health care budgeting, more predictable spending and less concern about encountering any surprise or unexpected medical bills.
Plan G also offers a high-deductible option that works in the same way as high-deductible Plan F. Because doctors and providers who accept Medicare also accept Medicare Plan F and Plan G, there aren’t network restrictions or surprise medical bills that beneficiaries of either plan are likely to face.