Medicare Supplement Plan F is the most popular Medigap plan, and it boasts the most benefits. Also known as the “Cadillac” of Medigap plans, the luxury of Plan F is that when you have it, you don’t have to worry about another Part B medical bill as long as you pay your monthly payment.
What does a plan F cover?
Medicare Supplement Plan F covers all your Part B out-of-pocket expenses – the 20% that Medicare doesn’t cover, including the annual Part B deductible of $185 (in 2019). Plan F also covers hospitalization, which includes your Part A deductible, coinsurance and an extra 365 emergency days in addition to skilled nursing facility coinsurance. Other benefits covered by Plan F include Foreign Travel Emergency and coverage for “excess charges” also known as balance billing – which isn’t a concern for seniors in Ohio, where the practice is banned – but snowbirds (on a Plan F) who like to travel won’t have to worry about excess charges in other states, either.
Many seniors believe that Plan F will cover nursing home care, but that’s a popular misconception – Medigap Plan F only covers skilled nursing care, which is another term for rehabilitation. If a senior is sent to a Skilled Nursing Facility and her health doesn’t improve on schedule, she may be sent home or to a nursing home for custodial care – which is not covered by Plan F. Seniors wanting to guard their assets from a nursing home visit should buy long-term care insurance, or an annuity or life insurance policy with built-in long-term care benefits.
How much does a plan F cost?
The cost of a Medicare Supplement Plan F starts around $120 per month for a 65-year-old. A 70-year-old can expect to pay around $170 or more per month. An 80-year-old will pay $250 or more per month, and a 90-year-old will pay about $300 per month or more. Seniors who pay annually can get a discount. If you’re applying together with a domestic partner or spouse, you can possibly get a Household Discount – ask your broker for more details.
How does plan F compare to plan G or N?
When comparing Medigap plans, seniors seem to gravitate around three choices: F, G and N. All three plans have the exact same Part A hospitalization benefits – so the task at hand is comparing Part B benefits. We already learned that Plan F covers all Part B out-of-pocket expenses, including the Part B deductible. Comparing Plan F with Plan G, you’ll see that Plan G has a cheaper premium, but you have the added responsibility of paying the Part B deductible of $185 (2019). Plan N is cheaper still, but in addition to paying the Part B deductible on your own, you’re now responsible for Part B excess charges and you also have to pay a $20 copay to see a doctor and a $50 copay to go to the ER. The difference in pricing between Plan F and G or N usually makes up for any potential out-of-pocket costs – although technically, you could probably surpass the savings of a Plan N if you had to go to the doctor more than 20 times in a year, which is uncommon but not impossible.
Is plan F going away in 2020?
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) included a clause that would prohibit Medicare Plan F from being sold after the year 2020. Basically, Congress believed that seniors who had “first-dollar” coverage – meaning they didn’t have to pay a deductible or coinsurance beyond their monthly premium – would be quick to visit the doctor or ER for the slightest ache or pain. Congress thought seniors with Medicare Plan F were unnecessarily over-burdening the health care system, so they decided to outlaw the “Cadillac” of Medicare Supplement plans (Plan F) as well as Plan C and High-Deductible Plan F.
That means seniors turning 65 after January 1, 2020, will no longer be able to obtain a Medicare Supplement Plan C, Plan F, or High-Deductible Plan F. If you have one of those plans before 2020, you’ll be able to keep your coverage – and you can even switch to another plan from any company that offers them – as long as you already had Medicare coverage before 2020.
