Medicare Supplement Plan F, often called Medigap Plan F, has long been one of the best-known Medicare supplement plans. It is popular because it may cover nearly all of the out-of-pocket costs left behind by Original Medicare.
But if you are approaching Medicare now, you may have heard that Plan F is no longer available. That is partly true. Some people can still buy it, while many people who are new to Medicare cannot.
Knowing the difference can help you focus on the plans that may actually be available to you.
What is Medicare Supplement Plan F?
Medicare Supplement insurance works alongside Original Medicare, which includes Part A for hospital care and Part B for medical care. Original Medicare generally pays its share of approved costs, and a Medicare supplement plan may help pay some of what remains.
Plan F is a standardized Medicare Supplement plan. In most states, a Plan F from one insurance company has the same basic medical benefits as a Plan F from another company. Premiums, customer service, underwriting rules, and added services can still vary by carrier and state.
Plan F may pay the Part A and Part B deductibles, Part B coinsurance, skilled nursing facility coinsurance, and several other Medicare-approved out-of-pocket costs. Its defining feature is that it may cover the Medicare Part B deductible.
That Part B deductible coverage is the reason Plan F is not available to everyone who is newly eligible for Medicare.
Who can still buy Medicare Supplement Plan F?
You may be able to buy Plan F if you became eligible for Medicare before January 1, 2020. In general, eligibility means you were eligible for Medicare because of age, disability, or certain health conditions before that date.
For example, a person who turned 65 in 2019 may still be eligible to apply for Plan F today, even if they did not enroll in a Medicare supplement plan at that time. Whether a carrier will accept an application can depend on your state, the plan’s availability, and your health history if you are outside a guaranteed-issue period.
If you first became eligible for Medicare on or after January 1, 2020, you generally cannot purchase Plan F. This rule also applies to Plan C, another Medicare supplement plan that covers the Part B deductible.
People who already had Plan F before 2020 were generally allowed to keep it. Plan F was not taken away from existing members.
Why was Plan F closed to newer Medicare enrollees?
A federal law changed which Medicare supplement plans could be sold to people who became newly eligible for Medicare beginning in 2020. New Medicare supplement plans can no longer cover the Part B deductible for those individuals.
The change did not affect Original Medicare benefits. It also did not mean that Medicare Supplement insurance went away. It simply meant that new Medicare beneficiaries need to consider other standardized options, such as Plan G or Plan N.
Plan G is often the closest alternative for people who cannot buy Plan F. In many states, Plan G covers the same major gaps as Plan F except for the annual Part B deductible.
Is Plan F better than Plan G?
Plan F and Plan G can both offer broad coverage for Medicare-approved services when paired with Original Medicare. The main benefit difference is usually the Part B deductible. Plan F may pay it, while Plan G generally does not.
Still, “better” depends on more than benefits. If you are eligible for both plans, it can be helpful to compare:
- Monthly premium: Plan F may have a higher premium than Plan G, although this varies by carrier, location, age, and rating method.
- Out-of-pocket costs: With Plan G, you would generally pay the Part B deductible yourself before the plan begins paying Part B cost-sharing.
- Future rate changes: Premiums can change over time. Plan F is no longer open to newly eligible Medicare beneficiaries, so its group of policyholders may change as time goes on.
- Your eligibility: If you became eligible for Medicare in 2020 or later, Plan F is generally not an option.
It is also important to remember that Medicare supplement plans do not usually include prescription drug coverage. Most people who choose Original Medicare and a Medicare supplement plan also consider a separate Part D prescription drug plan.
Can you switch from Plan F to another Medicare supplement plan?
If you already have Plan F, you may be able to keep it as long as you continue paying your premium. You may also choose to apply for another Medicare supplement plan, such as Plan G or Plan N, if one seems like a better fit.
However, switching is not always automatic. Outside certain protected enrollment situations, an insurance company may ask health questions and may review your health history before deciding whether to accept your application. There is generally no reason to cancel your current plan until you know whether the new coverage has been approved and when it would begin.
Your rights can be different if you are in a guaranteed-issue situation, such as losing certain other health coverage. Rules can also vary by state, so it is wise to review the details before making a change.
What should new Medicare beneficiaries consider instead?
If you are new to Medicare and cannot buy Plan F, Plan G and Plan N are often worth reviewing. Plan G may offer more predictable coverage after you pay the Part B deductible. Plan N may have a lower premium in some areas but can include copayments for certain office or emergency room visits and may not cover Part B excess charges.
Medicare Advantage plans are another way to receive Medicare benefits. These plans may offer extra benefits and often use provider networks, while Medicare supplement plans work with Original Medicare and are designed to help with Medicare cost-sharing. The right choice often depends on your budget, doctor preferences, travel needs, prescriptions, and comfort with networks.
Plan F may still be available to some people, but it is not a choice for most people entering Medicare today. If you would like free, no-pressure help understanding your Medicare Supplement options, reach out to Eric to review plans available in your state and discuss what may fit your needs.