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Medigap Plan F

Medigap Plan F used to be the most popular Medicare supplement plan due to its comprehensive coverage, including 100% cost-sharing on medical services. It was an ideal option for those seeking full coverage on all out-of-pocket costs, such as Part A and B deductibles, copayments, and coinsurance. However, Plan F is no longer available to individuals who turn 65 after January 1, 2020.

What is Plan F?

Plan F is the only Medigap plan that covers every gap in Original Medicare coverage. It leaves the plan member with $0 in out-of-pocket expenses for covered services. The only thing the member will pay is the monthly premium.

Medigap Plan F Coverage Details

Medigap Plan F is a first-dollar coverage plan. “First-dollar” means that after Original Medicare has paid its portion, Plan F pays for the remaining cost. This leaves the member with $0 in out-of-pocket expenses.

Medigap 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

Medigap Plan F Premiums

The cost of the premium for Medigap Plan F varies depending on the state where the plan member resides and the insurance carrier they choose. Other individual factors such as age, gender, tobacco use, and more also play a role in determining the premium. On average, the monthly cost for Plan F ranges from $130 to $230. This plan has a higher premium due to the comprehensive coverage it provides. Opting for a different Medigap plan will lower the premium, but it will also result in less coverage.

Medigap Plan F Eligibility

To be eligible for Plan F, individuals must already be enrolled in Medicare Parts A and B which then allows them to be enrolled in any Medicare supplement plan. Those who would like to enroll in Plan F must have been eligible for Medicare prior to January 1, 2020.

Plan & Prescription Drug Coverage

Medigap Plan F provides coverage for prescription drugs that are administered during inpatient care. However, it does not cover medications that are prescribed by a doctor and self-administered at home. Therefore, individuals who want prescription drug coverage under their Medigap plan need to enroll in a stand-alone Part D plan.

Enrolling in Medigap Plan F

To be eligible for Medigap Plan F, individuals must first enroll 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. During this six-month period, beneficiaries have guaranteed issue rights to enroll in a plan. However, after this period, enrollment may be denied based on an individual’s health history.

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