Is Medicare Plan F Going Away What You Need To Know
Medicare Plan F is the most comprehensive Medicare Supplement plan, but starting in 2020 the plan will not be available to everyone enrolled in Original Medicare.
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Comparing Medicare Supplement plans to find the right fit for you? If youre enrolled in Original Medicare Part A and Part B, you might have considered purchasing the common Medicare Supplement insurance plan, Medicare Plan F.
According to AARP, Medicare Supplement Plan F provides the most coverage, and as a result, its the most popular plan among those eligible for Medicare. But with recent changes, Plan F is no longer available to everyone as of January 1, 2020.
Medicare Supplement Plans Comparison
Medicare Plan F is no longer available for purchase. However, several other Medigap supplement plans can help cover the out-of-pocket costs associated with Original Medicare.
The current Medicare supplement insurance plans offered are Plan A, B, C, D, F, G, K, L, M, and N. Some providers also sell high-deductible Plan F and high-deductible Plan G, which have a lower monthly premium. You can purchase Medigap insurance from private insurance providers.
Each Medicare supplement insurance plan offers varying levels of coverage. For instance:
- Medigap Plan A doesnt cover the Medicare Part A or Part B deductible.
- Medigap Plan B covers the Medicare Plan A deductible only.
- Medigap Plans K and L cover a smaller percentage of costs like skilled nursing coinsurance and hospice coinsurance and also have out-of-pocket maxes.
Before you choose a Medigap plan, its a good idea to compare Medicare supplement plans. Every plan offers a different level of coverage and has a unique premium. Also, keep in mind that not all insurance providers offer every plan.
Plans F and G are similar. Heres a look at how Plans F and G compare:
|Standard Plan F|
Also, remember that you need Part D for Medicare prescription drug benefits. Medicare supplement plans dont help with prescription drug costs. You can also choose a Medicare Advantage plan rather than Original Medicare and most of Medicare Advantage plans offer prescription drug benefits, too.
How Much Does Plan F Cost
Many private insurance companies will compete for your business by offering different prices. Depending on where you live, you can expect to pay from $231 to $649 per month.1 Keep in mind though that, in most cases, you will pay the premium and little else for medical services. That means that by choosing a monthly premium that fits your budget, you should not have to worry about large, unexpected medical bills.
Plan F also comes in a high deductible option. In exchange for a lower monthly premium, you pay an up-front deductible for medical care. In 2021, the deductible is set at $2,370 and premiums range from $44 to $91 based on a search through medicare.gov for a 65-year-old woman in New York or Seattle who does not use tobacco.
Can I Enroll In Medicare Part F If Im Enrolled In Medicare Part C Or Medicare Advantage
If you have a Medicare Part C or Medicare Advantage plan, you cant have a MedSup plan, too.
If you have Original Medicare plus a MedSup plan and youd like to switch to a Medicare Advantage plan that offers the same or similar coverage, you can do that. Drop the MedSup plan before you do so, though, as it won’t pay out after you enroll in Medicare Advantage.
See If You Are Eligible To Enroll
The first step to enrolling in Medicare Plan F is to enroll in Original Medicare. Thenif you were eligible for Medicare before January 1, 2020you can still apply for Plan F. If you became eligible after January 1, 2020, you’re ineligible to apply for Plan F because the Medicare Access and CHIP Reauthorization Act went into effect, phasing out Plan F for new enrollees.
If you already have Plan F, you can keep your coverage.
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Can Anyone Enroll In Medicare Part F Or Who Is Eligible To Enroll In Part F Plans
You should be able to buy Medicare Supplement Plan F coverage if:
- Youre over 65.
- Youre enrolled in both Medicare Part A and Part B.
- Youre not enrolled in a Medicare Advantage plan.
- You live in the plans service area.
- You didnt become eligible for Medicare on or after Jan. 1, 2020.
If you go to buy Plan F or any other MedSup plan outside of a Medicare open enrollment period, you might have to jump through a few extra hoops. One is that you may have to pass a medical screening, which means answering a number of questions about your medical and health history. Another is that your doctor or physician may have to get involved in various ways.
Also, if youre under the age of 65 and you have Medicare coverage due to a disability or end-stage renal disease, you may not be able to buy any MedSup or Medigap policy. Or you may not be able to get the one you want.
Is Medicare Plan F Going Away
Starting in January 2020, new enrollees will not be able to purchase Medigap Plan F. However, if you were eligible for Original Medicare before 2020 then you would still be allowed to enroll and keep your current Plan F policy. Furthermore, Plan F is still one of the best Medicare Supplement plans available on the market. The change is due to legislation in Congress focused on giving doctor better pay when they provide services to a Medicare patient.
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High Deductible Plan F
In addition to regular Plan F, some states also offer a high-deductible version. This plan covers everything a regular Plan F does, but in 2020, youll be responsible for paying the first $2,340 of costs out of your own pocket before coverage kicks in. In return, you could pay lower premiums each month.
Who Can Enroll In Medicare Supplement Plan F
If you already have Medicare Advantage, you may be considering switching to original Medicare with a Medigap policy. Previously, anyone enrolled in original Medicare could purchase Medigap Plan F. However, this plan is now being phased out.
As of January 1, 2020, Medigap Plan F is only available to those who were eligible for Medicare before 2020.
If you were already enrolled in Medigap Plan F, you can keep the plan and the benefits. Also, if you were eligible for Medicare before January 1, 2020, but missed the enrollment, you may still be eligible to purchase Medigap Plan F.
If you are planning to enroll in Medigap, there are certain enrollment periods that you should take note of:
- Medigap open enrollment runs 6 months from the month you turn 65 years old and enroll in Medicare Part B.
- Medigap special enrollment is for people who may qualify for Medicare and Medigap before turning age 65, such as those with end stage renal disease or other pre-existing conditions.
It is important to note that during the Medigap open enrollment period, you cannot be denied a Medigap policy for pre-existing health conditions. However, outside of the open enrollment period, insurance companies can deny you a Medigap policy because of your health, even if you qualify for one.
Therefore, its in your best interest to enroll in Medicare Supplement Plan F as soon as possible if you still qualify.
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Medicare Supplement Plan F Review
Medicare Plan F is one of ten Medicare Supplement Insurance policies that Americans can buy if they need help paying for their Medicare Part A and Part B out-of-pocket expenses.
Medicare Supplement Plan F is one of the most popular Medicare supplement policies on the market. It covers a wide range of medical expenses and is offered by many health insurance providers.
If youre wondering exactly what your Medicare benefits will look like under Plan F, youre in the right place. Lets dive in.
Should I Choose Medigap Plan F
The true cost of a Medigap plan is not limited to just the monthly premium. You may also want to consider how much you will end up spending on out-of-pocket Medicare costs over the course of the year that your Medigap plan doesnt cover.
One potential benefit of choosing Plan F is that it covers many out-of-pocket Medicare costs.
The chart below shows how Plan F compares with of other types of Medigap plans.
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Decide If A Regular Or A High
Some providers offer two versions of Plan F: regular and high deductible. As the name suggests, the main difference is the deductible amount, and beyond that, the timing of the coverage. With a high-deductible Plan F, the coverage doesn’t activate until the deductible amount is met, but in exchange, you can expect much lower monthly payments than the regular Plan F, which works the same as other Plans, with lower deductibles and higher monthly payments.
What Benefits Are Covered Under Medicare Supplement Plan F
Plan F basic benefits, like other Medigap plans, are standardized in most states. This means that regardless of where you live or which insurance company you purchase from, youâll get the exact same basic benefits for a Plan F sold anywhere in your state . However, keep in mind that even though basic benefits are the same, premiums may vary.
Below is a list of costs and benefits covered by Medicare Supplement Plan F:
- Part A hospital and coinsurance costs up to an additional 356 days after Medicare benefits are exhausted
- Medicare Part A hospice care copayment or coinsurance
- Medicare Part B coinsurance
- Medicare Part B excess charges
- Medicare Part A deductible
- First three pints of blood used in an approved medical procedure
- Skilled nursing facility coinsurance
- Foreign travel emergency coverage
Even though Medicare Supplement Plan F offers the broadest coverage of any of the 10 standard Medigap plans available in most states, it doesnât cover all of the costs you may have in Original Medicare. For example, youâll still need to keep paying your Medicare Part B premium payments each month. If you havenât worked enough quarters to qualify for premium-free Medicare Part A , you may owe a premium for Part A as well. Medicare Supplement Plan F doesnât cover these out-of-pocket costs.
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Who Can Enroll In Plan F
Any Medicare beneficiary who was Medicare-eligible prior to January 1, 2020, can enroll in Plan F. If you are within the first six months of having enrolled in Medicare Part B, you are able to enroll in Plan F under the guarantee issue period.
If your 6-month period has ended and you dont qualify for a Special Enrollment Period you can apply to enroll in Plan F by completing an application that asks about your health history. The insurance company can decline your application and/or request medical records to determine whether it will accept you.
About Medicare Supplement Plan F
Medicare Supplement Plan F, administered by Premera Blue Cross, allows the use of any Medicare contracted physician or hospital nationwide. The plan is designed to supplement your Medicare coverage by reducing your out-of-pocket expenses and providing additional benefits. It pays some Medicare deductibles and coinsurances, but primarily supplements only those services covered by Medicare.
There is no prescription drug coverage with this plan so a Part D prescription drug plan is also needed unless you have other creditable drug coverage .
In Medicare Supplement Plan F, benefits such as vision, hearing exams, and routine physical exams may have limited coverage or may not be covered at all.
If you select Medicare Supplement Plan F, any eligible family members who are not entitled to Medicare will be enrolled in UMP Classic.
Medicare Supplement Plan F does not include prescription drug coverage. If you select this plan, you may have to enroll in Medicare Part D to get your prescriptions, unless you have other creditable prescription drug coverage.
Note: The PEBB Program does not offer the high-deductible Plan F shown in the Outline of Medicare Supplement Coverage.
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Switching From Plan F To Plan G
If you enrolled in Plan F before 2020, you can continue your plan or switch to another Medigap plan, such as Plan G, if you prefer. You may want to make the change to reduce the price of your health insurance. However, every state has different rules worth considering before making the switch.
In some states, such as New York City, you can switch your Medigap plan at any time. There’s a birthday rule in California that allows you to switch Medigap plans around your birthday. Both of these states may automatically approve any applications to switch plans, even if you have pre-existing health conditions.
In some other states, you may need to apply for a Plan G policy. If you apply during a time when you dont have guaranteed issue rights, private insurance companies can use medical underwriting to determine your premium costs or to even deny you coverage altogether. In these states, sticking with your Plan F coverage may be your best Medigap option, or you may want to wait until you can switch to Plan G when you have guaranteed issue rights.
What Can Affect The Average Cost Of Plan F
The average cost of Medicare Supplement Insurance Plan F or any Medigap plan for that matter can be influenced by a number of factors.
- LocationAs you can see from the chart above, the average monthly cost of Medigap Plan F can vary quite a bit from one state to another. The cost of a Medicare Supplement Insurance plan can vary based on location in the same way that a gallon of gas or milk can.
- Insurance carrierMedicare Supplement Insurance is sold by private insurance companies. These companies can set their own premium rates. A licensed insurance agent can help you compare plans from several different Medicare Supplement Insurance providers.
- BenefitsBecause Plan F provides more benefits than any other type of Medigap plan, Plan F may have higher monthly premiums than other types of Medigap plans in some areas.
Other factors such as age, gender, smoking status and health can also affect Medigap plan rates.
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Deductible Amount For Medigap High Deductible Options F G & J For Calendar Year 2022
Medicare supplemental Plans F and G can be sold with a high deductible option. Before June 1, 2010, Medigap Plan J could also be sold with a high deductible. The high deductible version of Plan F is only available to those who are not new to Medicare before 1/1/2020. High deductible G is available to individuals who are new to Medicare on or after 1/1/2020. People new to Medicare are those who turn 65 on or after January 1, 2020, and those who first become eligible for Medicare benefits due to age, disability or ESRD on or after January 1, 2020.
Effective January 1, 2022, the annual deductible amount for these three plans is $2,490. The deductible amount for the high deductible version of plans G, F and J represents the annual out-of-pocket expenses that a beneficiary must pay before these policies begin paying benefits. CMS updates the deductible amount for plans G, F and J each year, after release of the August Consumer Price Index for all Urban Consumers figures by the Bureau of Labor Statistics, which generally occurs in mid-September.
Calculation of the Deductible:
For Further Information:
Contact: Martha Wagley at 410-786-3778 for actuarial issues or Derrick Claggett at 786-2113 for policy related issues.
Learn About Medicare Supplement Plans Available Where You Live
1 AHIP. . State of Medigap: Trends in Enrollment and Demographics. Retrieved from https://www.ahip.org/wp-content/uploads/AHIP_State_of_Medigap-2020.pdf.
2 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.
About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare Supplement Vs Original Medicare
Original Medicare refers to Medicare Part A & Part B. It covers inpatient and outpatient medical services. However, it does not cover some key health care needs, including prescription drugs, dental care, vision care, or eye care.
Medicare Supplement Insurance policies do NOT cover additional medical services. It helps pay for your out-of-pocket expenses from Original Medicare.
The purpose of Medicare supplementary insurance is to fill in the financial gaps in Original Medicares coverage in other words, your out-of-pocket costs .
Depending on the plan purchased and what type of medical coverage is desired rather than just medically necessary coverage, different supplemental policies will focus on various parts of healthcare expenses such as prescription drug benefits or vision benefits.