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Medigap High Deductible Plan F

The high deductible option of Plan F presents a viable alternative to the standard version, with the key distinction being the inclusion of a high deductible that the member is responsible for paying before receiving full coverage benefits. Upon meeting the deductible, the plan covers all costs at a rate of 100%. The advantage of this option is the lower monthly premiums that come with the higher deductible.

Medigap High Deductible Plan F Coverage Details

Medigap High Deductible Plan F is a type of Medicare supplement plan that offers first-dollar coverage, meaning that once Original Medicare has paid its share, Plan F covers the remaining cost, leaving the member with no out-of-pocket expenses. However, before Plan F coverage kicks in, members must first pay a high annual deductible, which is $2,370 in 2021.

Medigap High Deductible Plan F Covers:

  • Part A coinsurance and up to an additional 365 days of hospital costs after Medicare benefits are exhausted
  • Part B coinsurance/copayment
  • Blood (3 pints)
  • Part A hospice coinsurance/copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible
  • Part B excess charge
  • 80% of foreign travel exchange
  • No out-of-pocket limit

Who is Best Suited for High Deductible Plan F?

This plan is great for Medicare beneficiaries who need a lower monthly premium but are still comfortable with paying a high deductible. Individuals who only see the doctor infrequently, live in states that allow Part B excess charges, and like to travel outside of the United States are well-suited for High Deductible Plan F.

The Deductible of High Deductible Plan F

In 2023, the deductible was $2700. Beneficiaries will pay this amount out-of-pocket, and then all remaining expenses would be 100% covered.

Enrolling in Medigap High Deductible Plan F

To enroll in High Deductible Plan F, individuals need to be already enrolled in Original Medicare – Parts A and B. The optimal time to enroll is during the open enrollment period, which starts on the effective date of Part B. Beneficiaries have a six-month window to enroll in a plan with guaranteed issue rights. After that, enrollment may be denied based on an individual’s health history.

Medigap High Deductible Plan F Premiums

The premium for High Deductible Plan F will depend on various factors such as the state of residence, the insurance carrier, age, gender, tobacco use, and other individual details. On average, the cost of High Deductible Plan F ranges from $40 to $80 per month. However, it is important to note that premiums are generally higher in states with a higher cost of living.

Has High Deductible Plan F Been Discontinued?

Yes, all first-dollar coverage plans, including the standard Plan F, were discontinued starting from January 1, 2020. Plan C was also discontinued. The Centers for Medicare and Medicaid Services (CMS) no longer allows Medigap plans to include first-dollar coverage. However, beneficiaries who were already enrolled in or became eligible for these plans before January 1, 2020, are still allowed to keep their coverage.

Is High Deductible Plan F a Good Option?

High Deductible Plan F may not be suitable for everyone due to the high deductible amount. However, it can be a beneficial plan for those who want to reduce their monthly premiums while maintaining other areas of coverage. This plan is particularly attractive to individuals who previously had employer-sponsored coverage with a high deductible. As long as beneficiaries have some funds set aside to cover the deductible, this plan can be a great option.

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