Medigap Plan F Benefits
By definition, Plan F is the Medigap policy with the most benefits:
- Medicare Part A copayments for inpatient hospital care — up to an additional 365 days after Medicare benefits are used up
- Medicare Part B copayment
- First 3 pints of blood
- Part A hospice care copayment
- Medicare Part A deductible
- Medicare Part B deductible
- Skilled nursing facility coinsurance
- Medicare Part B excess charges
- Foreign Travel Emergency — up to plan limits
For those who are eligible, Medigap Plan F pays after Medicare to help with your deductibles, copayments, and coinsurance that you’d otherwise have to pay on your own. When you visit the doctor, you won’t have to pay a copay again.
Plan F Eligibility and Enrollment
As we mentioned, Plan F is no longer available to new beneficiaries. And there are certain eligibility rules you should know when buying any Medigap plan:
- You must have Original Medicare A and B, and you can’t have Medigap and Medicare Advantage.
- A Medigap policy just covers one person. Your spouse will need to buy a seprate policy.
- Insurers aren’t legally required to sell Medigap plans to those under 65. If you’re under 65 and on Original Medicare, you may not be able to buy the plan you want.
If you’re interested in a Medicare Supplement plan, you can first enroll during Medigap Initial Enrollment — a six-month period that begins when you turn 65 and enroll in Medicare Part B. If you don’t sign up during this period, you may not be able to get the plan you want or it might cost more.
How the Companies Charge You
Every Medigap policy has a monthly premium. The exact amount may vary by area, gender, and tobacco status. Insurers can set monthly premiums for their policies in three ways:
- Community rated — Everybody who buys the plan pays the same monthly amount no matter their age.
- Issue-age rated — Monthly premiums are based on the age when you first buy a plan. Younger buyers will have lower premiums, and the premiums don’t go up as you get older.
- Attained-age rated — Monthly premiums are based on your CURRENT age. So, your premium will increase as you get older.
With most companies, the cost for Plan F will be slightly higher for males than females. And tobacco users will often have a higher cost than non users.
What Else You Should Know
Plan F policyholders won’t have to worry about their coverage being cancelled due to health reasons or the number of claims filed. The coverage is guaranteed renewable.
If you’re not eligible for Plan F, consider Plan G or Plan N which also offer great value for the premiums you pay.