Comparing Medicare Supplement (Medigap) Plan F and High-Deductible Plan F
This article was updated on: 12/17/2016
As you may know, Original Medicare (Part A and Part B) may leave you with out-of-pocket hospital and medical costs, like copayments, coinsurance, and deductibles. To help cover these “gaps,” you can consider purchasing one of the 10 standardized Medicare Supplement (Medigap) plan options available in 47 states (Massachusetts, Minnesota, and Wisconsin have their own versions).
Medicare Supplement Plan F (also called Medigap Plan F) is a popular choice because it generally features the most benefits. Some insurance companies may also offer a high-deductible version of Plan F. As the name implies, Medicare Supplement insurance like Plan F “supplements” your Original Medicare coverage by paying for some of your out-of-pocket costs; it’s not meant to be stand-alone coverage.
Plan F’s comprehensive coverage may be valuable if you have frequent and unpredictable medical costs. Here is an overview of the differences between Medicare Supplement F and the high-deductible Plan F, including covered benefits and costs.
What is Medicare Supplement Plan F (Medigap Plan F)?
Medicare Supplement plans are offered by private insurance companies. Medicare Supplement Plan F, like other Medigap plan options signified by a letter (A-D, F-G, K-N), contains standardized benefits in most states. This standardization means you’ll get the same coverage for a Plan F wherever you buy from (except in Massachusetts, Minnesota, and Wisconsin). Some companies may offer additional innovative benefits.
You can also choose a high-deductible Plan F offered by select insurance companies in some states. The high-deductible Plan F offers the same benefits as the standard plan; the only difference is you’d need to pay all costs for Medicare-covered services until a deductible amount is reached.
What benefits does Medigap Plan F cover?
Here are the extensive benefits that Medicare Supplement Plan F and the high-deductible Plan F provide:
- First three pints of blood
- 100% of Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits have been used)
- 100% of Medicare Part B coinsurance or copayment
- 100% of Medicare Part A hospice care coinsurance or copayment
- 100% of skilled nursing facility care coinsurance
- 100% of Medicare Part A deductible
- 100% of Medicare Part B deductible
- 100% of Medicare Part B excess charges
- 80% of foreign travel emergency (up to plan limits)
Please note that you can’t use your Medigap plan to pay for costs associated with your Medicare Advantage plan, and in most cases, you can’t enroll in both a Medigap plan and a Medicare Advantage plan. Also, Medigap plans don’t include prescription drug coverage, so you’ll need to enroll in a Medicare Prescription Drug Plan if you have Original Medicare and want prescription drug coverage.
What are the costs of Medicare Supplement Plan F?
Because Plan F generally offers the broadest coverage of the 10 Medigap plans, it is usually the most expensive plan. This might not always be the case, however, and it’s recommended that you shop around to consider all the options in your area. Please remember that though Medigap Plan F benefits are broad, they don’t cover all of Original Medicare’s costs. You’ll still need to pay your Medicare Part B premiums each month, and if you haven’t worked enough years (usually at least 10 years) to qualify for premium-free Medicare Part A, you may also have to pay a premium for that coverage.
Plan F costs will vary depending on your county and chosen insurance company. Costs for the standard Medicare Supplement Plan F may include:
- Monthly premiums (usually higher than the high-deductible Plan F premiums)
- Annual deductibles (usually lower than the high-deductible Plan F deductibles)
- Coinsurance payments
What are the costs for the high-deductible Plan F?
Costs for the high-deductible Plan F may also include monthly premiums, which are usually lower than the premiums for the standard plan because of the higher deductible amount. If you choose this option, you’ll need to pay for all out-of-pocket Original Medicare costs until you reach a designated amount ($2,180 in 2016), before your policy pays anything.
You may be able to find other Medigap plans with lower premiums than Plan F. But if you see your doctor frequently, need many health-care services, or face high out-of-pocket costs, Plan F generally gives you the most help with Original Medicare costs.
Remember that Medicare Supplement insurance pricing can vary by company, and you may wish to consider all the available options in your area to find the right price point. A good time to enroll is during the Medicare Supplement Open Enrollment Period, which is a six-month period that starts automatically when you are 65 or older and have Part B. During this period, Medigap insurance companies can’t turn you down for coverage – even if you have pre-existing conditions or health problems. After this period is over, it may be harder for you to enroll in a Medicare Supplement plan or switch plans if you have health problems.
Do you have questions about the Medicare Supplement Plan F or other Medigap plan options? I can share more with you about the availability of Medigap Plan F or other Medigap plans in your area. Please schedule a phone consultation with me or request more information via email using the links below. You can also browse plan options using the Find Plans or Compare Plans buttons on this page. If you’d like help quickly, please call us and speak to one of our licensed insurance agents. To learn more about me, click “View profile” below.
Call Medicare.com’s licensed insurance agents at 1-844-847-2660, TTY users 711; Monday through Friday, 8AM to 8PM ET.
- The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
- Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
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