What is a Medigap Plan?
When first researching your Medicare options, you may be wondering, “What is a Medicare Supplement plan?”
The primary purpose of a Medicare Supplement plan, or Medigap plan, is to cover the “gaps” in coverage left by Medicare Part A and Medicare Part B, also known as Original Medicare.
Although Medicare covers a large portion of your healthcare costs, it does not cover everything. Medicare pays a portion of your approved claims and services but leaves you paying the remaining portion of the costs. These gaps in coverage include things such as:
These are items that you will have to pay when you need to access any of your approved healthcare services. Medicare will always pay it part of any services you need if it falls under the category of medically necessary services, or preventative services. After that, your supplement policy will start and will pay its share. This is sometimes what’s left of the remaining bill, but it does depend on which plan or policy you choose.
Remember that Medigap plans will not take the place of Part B of Medicare. In fact, you must be enrolled in both Parts A and B before you become eligible for any supplement plans.
Adding either Plan F or G to your Original Medicare will give you more comprehensive coverage for your healthcare needs and peace of mind. Out of all the plans, Medigap Plan F offers the most benefits — including no copays.
Give us a call at 877-88KEITH (53484), and an experienced agent will walk you through the benefits of a Medicare Supplement plan.
Medigap Plan F Benefits
There are numerous Medigap plans, but Plan F is going to be the most comprehensive in coverage and benefits.
Medigap Plan F Benefits Chart
- Medicare Part A costs and coinsurance for any hospitalizations. You are also covered for an additional 365 days past your Medicare lifetime reserve days.
- Medicare Part B coinsurance and copayments — this is your 20% coinsurance.
- Your first three pints of blood for a transfusion. Original Medicare will pay the rest once your supplement plan has paid for the first 3 pints.
- Coinsurances if you are in a skilled nursing facility or hospice care under Medicare Part A
- Your deductible for Part A — the deductible for any hospitalizations. This deductible is per benefit period and can occur more than once in a calendar year.
- Your deductible for Part B — the deductible for any outpatient procedures, services, or appointments. This is an annual deductible and only occurs once per calendar year.
- All excess charges for Part B of Medicare. Excess charges will occur if your doctor or provider does not accept Medicare Assignment.
- 80% of Foreign Travel Emergency (up to plan limits)
Other benefits include:
- You can use any doctor or provider who accepts Medicare. That’s right! There are no networks with Medicare Supplement plans. As long as a provider accepts Medicare, they accept your Medicare Supplement plan. You can use your plan across the entire country.
- Medicare Supplements plans are accepted without referrals for specialists. Unless required by the specific specialist, you can see your primary care doctor without specialist referral with Medicare Supplement Plan F.
- You also do not need pre-authorization for services with a Medicare Supplement plan. If any item or service is covered by Original Medicare, it is also covered by your Medicare Supplement plan and at no additional cost with Plan F!
- Also, you are guaranteed renewable. No matter the claims that are files or your current health conditions, your coverage won’t ever be canceled as long as you pay your monthly premiums.
Choosing Medicare Supplement Plan F
Why choose that one?
Simply put — it covers all of the gaps left by Original Medicare with no additional out-of-pocket expense to you. This means you have a full-coverage plan with no copayments and no out-of-pocket expenses for your healthcare. Plan F gives you as the consumer peace of mind that all of your healthcare is covered by your monthly premium and takes away the worry of receiving bills in the mail for your hospital and outpatient expenses.
Without a Medicare Supplement plan, you are responsible for the gaps left by Original Medicare. This includes the Part A deductible of $1,484 per benefit period and the Part B deductible of $203 annually. You are also responsible for the 20% coinsurance of Medicare Part B, as well as other copayments, coinsurance, and excess charges associated with Medicare Part A and Part B.
Give us a call at 877-88KEITH (53484), and one of our experienced agents will walk you through the benefits of Medicare Supplement Plan F.
What Does Medigap Plan F Cost?
The premium for Plan F will vary based on a few different factors. Primarily, premiums are determined based on your age, gender, and zip code. In some states, if you are a tobacco user, this will factor into your premium. Premiums are also rated in three different ways depending on what state you live in:
- Community-rated: When it comes to this type of rating system, everyone will pay the same no matter their age. However, when it comes to inflation, this will directly affect the pricing, but it will not increase as you get older.
- Issue-age-rated: This part of the premium will be based on how old you were when you made the plan’s purchase. It means to you that the younger you are, the less it’s going to cost you when you purchase your plan. However, the price will not go up as you get older.
- Attained-age-rated: With this type of rating system, your premium will start low and increase as you get older.
Remember, no matter which private insurance carrier you choose, Plan F will be the same across the board. This means all the benefits and coverage will match. When you shop for Plan F, you will want to assess not only the plan’s premium but the financial rating and history of increases associated with the insurance company.
Medicare Supplement Plan F vs Medicare Supplement Plan G
When comparing the benefits, you may notice there is only one minor difference in coverage levels. The only difference in benefits between these two Medicare Supplement plans is the Part B annual deductible. That’s it! Plan F covers the Part B deductible at 100%, and Plan G does not. Other than this small benefit, these two plans are pretty much identical.
Why would I choose Plan G Over Plan F?
Although Medigap Plan F is the highest coverage plan of all the Medicare Supplement plans available, it isn’t always the most cost-efficient. The only coverage difference between Plan F and Plan G is a $198 (Part B) annual deductible. Oftentimes, the difference in premium for the year is more than this deductible, with Plan F having a significantly higher premium than Plan G. When this is the case, Plan G is a fantastic option to maintain coverage extremely similar to Plan F, but with one small deductible to pay initially.
Give us a call at 877-88KEITH (53484), and an experienced agent will walk you through the benefits and cost differences between these two plans.
Changes in Your Plan will Require Underwriting in Many Areas
What if you want to change plans? Can I change my plan at any time?
When it comes to Medicare Supplement plans, you can change your plan any month of the year. There is one catch, though. You must be able to pass medical underwriting. Medicare underwriting is the process where the insurance company assesses your health history to determine if they will accept or decline your application to join their plan. Now, there are some states where there is no medical underwriting during certain points or throughout the entire year. Still, most states do have medical underwriting as a factor to change your Medicare Supplement plan.
Medical underwriting assesses both your health and prescription history. Give us a call at 877-88KEITH (53484), and an experienced agent will walk you through the process of medical underwriting and everything it entails.
MediGap Plan F - FAQS
What exactly is Medicare Supplement Plan F?
It is a full coverage Medicare Supplement plan option designed to fill the gaps left by Original Medicare. Plan F will cover all copays, deductibles, and coinsurance leaving you not worrying about any out-of-pocket costs.
Will I be able to get Medicare Supplement Plan F?
If you were eligible for Medicare before January 1, 2020, then you will have this option to purchase.
Is there an average cost for Plan F?
The price for this plan will vary. Several factors, like area, zip code, gender, and tobacco use, will affect your costs. It’s best to work with an independent agent to give you a range of premium prices from multiple insurance carriers.
What is covered under Plan F?
It will cover all your Original Medicare cost-sharing, including copayments, coinsurance, deductibles, excess charges, and more.
Will it cover my prescription drugs?
Like all Medigap plans, Plan F will cover most medications given to you in the hospital or a clinical setting. There are no Medicare Supplement plans that will cover prescription drugs that you take or administer yourself. Coverage for the majority of prescriptions falls under a separate, standalone plan known as Medicare Part D.
Will my dental, vision, and hearing benefits be covered?
Unfortunately, no. In fact, none of the Medigap plans cover these services. Private insurance companies offer standalone plans that provide many of these benefits at an affordable cost.
Which Medigap plans are the most popular?
Medicare Supplement plans F and G are the top two for many individuals seeking full coverage options to supplement Original Medicare. It’s best to get quotes for each to see which one will give you better yearly savings.
Which Medicare Supplement companies are the best?
This is going to vary by region. Keep in mind that all Medigap plans are standardized, so there’s no need to worry if Plan F will be different in one country compared to the one next door. Your best bet is to compare the rates in your area, as these will differ due to where you live, age, gender, and even your tobacco use. Also, your current eligibility and any discounts will affect the rate you’ll be given.
Is it best to switch from Medigap Plan F to Plan G?
This is dependent on your premium and where you live. Medicare Supplement Plan G usually comes with lower premiums for more of a value. Compare the numbers from both plans to see which one will save you more throughout the year.
Signing Up for Medigap Plan F
Medicare Supplement Plan F is the most comprehensive plan when it comes to Medicare Supplements. To make it simple, it will fill in all of the gaps left by Original Medicare with no out-of-pocket cost to you for your hospital or outpatient services. This is the most worry-free and peace of mind plan of all the Medicare Supplement plan options available.
However, it isn’t the only or oftentimes most cost-efficient option. Medicare Supplement Plan G also offers coverage that is very similar to Medigap Plan F. It is important to compare not only the benefit coverage but also the cost differences between these two plans before making your decision.
While there are many Medicare supplement plans available, Plan F has been the most popular, with Plan G gaining popularity. Having the best plan to cover the holes in your Original Medicare coverage is essential to your peace of mind and overall health. Your retirement is meant to be a time to relax, not to worry about expensive medical bills. It is important to assess all of your options when it comes to healthcare to make sure the choice you make is right for you.
We’re proud to offer you the resources to make informed decisions about your future. Check our:
- Free Medicare Guides
- Medicare Explainer Videos
- Medicare Supplement Plans Explained
- Medicare Eligibility Breakdown
- And more!