Medicare Supplement Plan F, often called Medigap Plan F, was once one of the most popular ways to help cover out-of-pocket costs left behind by Original Medicare.
People often ask whether Plan F is still available. The short answer is: it may be available to some people, but not everyone. Your eligibility mostly depends on when you first became eligible for Medicare.
Understanding this rule can help you avoid spending time comparing a plan you may not be able to buy. It can also help you see why many people who are new to Medicare consider Plan G instead.
What is Medicare Supplement Plan F?
Plan F is a standardized Medicare Supplement insurance plan. Medicare Supplement plans work alongside Original Medicare, which includes Part A for hospital care and Part B for medical care.
Original Medicare generally pays its share of covered services, but you may still have deductibles, copayments, and coinsurance to pay. A Medicare Supplement plan can help pay some or all of those remaining costs.
Plan F has historically offered broad coverage. When paired with Original Medicare, it may help pay:
- Medicare Part A hospital deductible and hospital coinsurance
- Medicare Part B coinsurance and copayments
- The Medicare Part B deductible
- Part B excess charges, when they apply
- Skilled nursing facility coinsurance
- Blood costs under Medicare rules
- Foreign travel emergency care, up to plan limits
Plan F benefits are standardized in most states. This means a Plan F from one insurance carrier generally has the same basic medical benefits as Plan F from another carrier. Premiums, customer service, household discounts, and underwriting rules can vary by carrier and state.
Is Medicare Plan F still available?
Medicare Plan F is still available for people who became eligible for Medicare before January 1, 2020. In general, this includes people who were eligible for Medicare because of age or disability before that date.
If you first became eligible for Medicare on or after January 1, 2020, you generally cannot buy Plan F. This rule applies even if you delayed enrolling in Medicare Part B because you were still working.
Congress changed the rules for plans that pay the Medicare Part B deductible. New Medicare-eligible beneficiaries cannot purchase Medigap plans that cover that deductible. Plan F is one of those plans.
People who already had Plan F before the rule changed may generally keep it as long as they continue to pay their premium. They may also have the option to apply to change carriers, although acceptance can depend on medical underwriting unless they have a guaranteed-issue right.
Why can some people buy Plan F while others cannot?
The key date is when you first became eligible for Medicare, not necessarily the date you enrolled. This detail can be confusing for people who kept employer coverage past age 65.
For example, someone who turned 65 in 2019 but delayed Part B because of active employer coverage may still be eligible to buy Plan F later. They first became eligible for Medicare before January 1, 2020.
On the other hand, someone who turned 65 in 2021 generally cannot buy Plan F, even if they wait until retirement to enroll in Part B.
If you are unsure of your original Medicare eligibility date, it is wise to check your situation carefully before narrowing your plan choices.
How does Plan F compare with Plan G?
For people who are newly eligible for Medicare, Plan G is often the closest available alternative to Plan F. Plan G generally covers many of the same gaps in Original Medicare that Plan F covers.
The main difference is the Medicare Part B deductible. Plan F may pay that deductible for eligible members. Plan G does not pay it, so you would generally pay the Part B deductible yourself before Plan G begins paying Part B coinsurance and copayments.
After you meet the Part B deductible, Plan G may leave you with few out-of-pocket costs for Medicare-approved Part A and Part B services. However, it does not include prescription drug coverage, routine dental care, routine vision care, or long-term custodial care.
When comparing Plan F and Plan G, eligible shoppers may want to look beyond the benefit chart. Consider the monthly premium, the carrier's rate history, available discounts, and how comfortable you are paying the Part B deductible yourself.
Should you keep Plan F if you already have it?
Keeping Plan F may make sense for some people, especially if they value its broad coverage and are comfortable with the premium. There is no requirement to leave Plan F simply because it is no longer sold to newly eligible beneficiaries.
Still, it can be reasonable to review your coverage from time to time. Premiums may change, and another Medicare Supplement plan may fit your needs differently. Moving to a new plan could require health questions and medical underwriting, depending on your state and circumstances.
It is important not to cancel a current Medicare Supplement plan until you have been approved for a replacement plan and have reviewed the effective dates. Plan availability and switching rules can vary by state.
What if you are new to Medicare?
If you are turning 65 now, Plan F is generally not an option. You may instead consider plans such as Plan G or Plan N, depending on your budget, how often you expect to use medical care, and your comfort level with copayments or possible excess charges.
Medicare Supplement plans are only used with Original Medicare. Another path is Medicare Advantage, which combines Medicare-covered services through a private plan and may include additional benefits. Medicare Advantage plans often have provider networks and plan rules, while Medicare Supplement plans can offer broader access to providers who accept Medicare. Both options have tradeoffs worth reviewing carefully.
Plan F can still be a valuable option for certain Medicare beneficiaries, but it is not available to most people enrolling in Medicare for the first time today. If you would like help confirming your Plan F eligibility or comparing Medicare Supplement choices, reach out to Eric for free, no-pressure guidance based on your situation.