Medigap Plan F: What You Need to Know

There are ten different Medicare Supplement policies including Medigap plan F that are available across most states. It has gained significant popularity, especially with Baby Boomers, as it is considered the most comprehensive plan. Through providing extensive coverage, beneficiaries have more assistance with out-of-pocket costs associated with the original Medicare plan.

While Plan F covers most costs associated with hospital and doctor visits, premiums can be high. According to America’s Health Insurance, approximately 53% of the Medigap policies currently in place are for Medicare Plan F.

what is medicare plan f

Medigap Plan F Benefits

Popularity in the Plan F policy comes from the standpoint that coverage pays for all gaps contained within Medicare Part A and Part B, such as hospital and outpatient deductibles. There are significant benefits to the plan and they are relatively consistent across the country. Even though benefits may be the same, premiums tend to vary significantly. Let’s take a look of the pros and cons of obtaining Plan F.

Benefits

  • Covers Part A hospital deductibles and Part B outpatient deductibles.
  • Provides coverage for the 20% that Medicare Part B does not pay.
  • Excess charges are fulfilled and insureds never pay the 15% in excess.
  • Any doctor can be chosen as part of the plan.
  • Referrals are not required to see specialists.
  • Renewals are guaranteed and coverage cannot be cancelled due to claims or health conditions.
  • Foreign travel emergency coverage of up to 80%.

Drawbacks

  • Rates vary among carriers.
  • It doesn’t cover all of the costs in Original Medicare.
  • If you haven’t worked enough to qualify for Medicare Part A, you may owe an additional premium for Part A.

There are two options for individuals who opt to obtain Plan F coverage. Those who don’t mind paying for out-of-pocket costs up front, there is a high deductible plan which begins to pay after meeting the deductible, resulting in lower premiums. There are plans with lower premiums, but if you visit the doctor often, require significant healthcare services, or have mounting expenses, the comprehensive coverage will provide the most benefits.

To Help Better Explain What is Medicare Plan F

A woman applies for Medigap Plan F and is approved by the insurance provider. Within a few months, she develops knee problems and needs to see an orthopedic specialist. She does not have to go through her primary care physician for a referral as part of the program and is able to seek out a doctor immediately. After her visit, she learns she is a candidate for a knee replacement surgery at her local hospital. In addition to the surgery, she will require a home healthcare nurse to visit multiple days each week for recovery.

The total cost for the surgery, hospital fees, and follow-up support is a whopping $70,000. With the Medicare coverage, the remainder balance is approximately $14,000. Thanks for the Medigap Plan F insurance coverage, the carrier pays the entirety of the balance and the only amount owed is a minimal copay for prescription medications. This would not have been possible without the comprehensive coverage option paired with the original Medicare plan. There is also a medicare supplement plan G.

While the original Medicare plan has nine gaps within its coverage, Medicare Part F can fills all of these. Additionally, Medigap gives you an additional 365 days of hospitalization coverage, meaning that you would only be responsible for hospital stays extending past 515 days, nursing care beyond 100 days, and the a small portion if you have a foreign travel emergency. If you would like to learn more about Medicare options and Supplemental plans, reach out to a licensed agent at. Professionals will help you understand all of your options and find the best possible plan and rate for your specific needs.

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