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Medicare Supplement (Medigap) Plan F

medigap plan f
Finding the cheapest Medicare supplement Plan F rates can be simple, but anyone who has reached the enrollment period for Medicare knows that understanding what is Medicare Part F and what exactly is covered by the various plans is complicated and often frustrating to figure out.  Here are the basics: Everyone who enrolls in Medicare gets Medicare Part A, which covers hospital stays and other costs.  For a small monthly premium, most people also enroll in Medicare Part B, which covers doctor’s appointments.  Additionally, many people choose a Medicare Part D plan to help pay for the cost of their prescriptions.  THEN there are options like Medicare Supplement (Medigap) Part F, which helps to cover what Medicare does not.

Medical Costs Can Be Overwhelming

Medicare A and B leave behind a significant number of copays and coinsurances.  For someone who is very healthy and rarely sees the doctor or a hospital, this might be fine; for someone who has regular visits with doctors or frequent hospital stays, these costs can quickly become overwhelming.  Part D also has coverage gaps and donut holes, which can be incredibly overwhelming for those who take several medications. Between hospital visits, surgeries, in-home care, medications, and other medical necessities, costs can quickly add up. Supplement plans such as F seek to alleviate some of this financial burden. Some people who have very low-income levels may be able to qualify for state programs that can help pay for extra Medicare costs.  For others, there are various Medicare Supplement programs – often called Medigap programs – that help to pay for these coverage gaps, coinsurances, and deductibles.  Medicare Plan F falls into this group of programs.

What Does Medigap Plan F Cover?

Many different companies offer Medicare Supplement plans.  Due to federal legislation, all plans must offer the same coverage within their Medigap Plan F.  So three insurance companies may all offer Plan F, and each Plan F will have the same benefits to the insured person.  Medicare Supplement Plan F covers:
  • Hospitalization: Plan F covers Medicare Part A coinsurance, and also pays for 365 days of hospitalization after Part A coverage ends.
  • Medical Expenses: Plan F pays for Medicare Part B coinsurance
  • Deductibles for both Medicare Part A and Part B
  • Excess charges on Part B (if your doctor bills you for the difference between what they charge and what Medicare will payIn other words, this supplement plan will pay 20% that Medicare Part B often requires you to pay.
  • Doctor Office Copays: Part of why this plan is so popular is because it covers all the gaps in Original Medicare Part A and Part B. This includes your hospital and outpatient deductible. Say goodbye to out-of-pocket expenses for you at your doctor’s office!
Here are more great benefits Medicare Supplement Plan F offers:
  • Choose any doctor—from over 880,000 physicians nationwide.
  • Referrals not required—Medigap plans allow you to see any Medicare specialist whenever you choose to do so. You do not need a referral from your primary doctor.
  • Renewal Guaranteed—Your coverage will not be canceled due to the condition of your health or the number of claims filed.

Example of Medicare Plan F Coverage:

David was just approved for Medicare Plan F.  As his arthritis has been causing him a lot of pain, he decides to see a specialist. Medicare pays for 80% of David’s visits to this specialist. Medicare Supplement Part F covers the remaining 20%, and David owes nothing out of pocket. From there, David’s doctor orders further testing at an imaging lab. Medicare pays for 80% of the cost of this order. Medigap Plan F pays for the remaining 20%, and again, David pays absolutely nothing out of pocket. David’s doctor informs him he is a candidate for surgery. After a hospital stay, David returns home. He has a nurse check in on him a couple of times a week. Between the surgery, hospital stay, and in-home visits, the total bill runs in upwards of $60,000. Medicare covers $48,000, and Medicare Supplement Part F pays the remaining $12,000. Bottom line: In this scenario, other than the premium for Plan F, the only out-of-pocket spending for David is for his medications. If Medigap Plan F isn’t right for you, there are several other options.  Some people find that the coverage in Plan F is more than what they need and that the premium is too high.  If this is the case, other Plans have more affordable coverage at a smaller premium, or our agents can help you find the cheapest Medicare supplement Plan F that will fit your budget.

The Sooner You Act, the Better

medicare supplement plan f
It is important to note, however, that when you enroll in a Medigap plan is important; if you enroll as soon as you’re eligible for Medicare, you will be able to enroll without your health being examined.  If you enroll after that initial period or want to switch between plans (From Plan H to Plan F, for example), the insurance company will review your health and may charge you a higher premium, or they may refuse to cover you at all.

Is Medicare Supplement Plan F on its Way Out the Door?

Yes.  As of the year 2021, Medigap Plan F will no longer be available to new enrollees. At this time, new enrollees will not be able to acquire this specific coverage. However, those who are already enrolled will be able to keep their existing plan. There are other similar plans available, as well, such as Plan G, which has quickly gained popularity. Ask an agent today to learn what supplement plan works best for you.
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