PLAN F

Medicare Supplement Plan

Medicare Supplement Plan F, often simply referred to as Plan F, is one of the standardized Medigap plans available to beneficiaries enrolled in Original Medicare (Part A and Part B). It has been one of the most comprehensive Medigap plans available, covering virtually all of the “gaps” in Original Medicare.

Here’s what the Plan F Medigap policy typically covers:

  • Part A Deductible and Coinsurance: Plan F covers the Medicare Part A deductible and the coinsurance for hospital stays. This means that once you’re admitted as an inpatient, all of your hospital expenses are covered.
  • Part B Deductible: Plan F covers the Part B deductible, which you normally pay for covered medical services and items before Medicare starts to pay.
  • Part B Coinsurance or Copayment: After the deductible, you usually pay 20% of the Medicare-approved amount for services. Plan F covers this 20%.
  • Blood: Plan F covers the first three pints of blood you might need during a medical procedure.
  • Part A Hospice Care Coinsurance or Copayment: Hospice care costs under Medicare Part A are covered by Plan F.
  • Skilled Nursing Facility Care Coinsurance: If you need care in a skilled nursing facility after a hospital stay, Plan F covers the associated coinsurance.
  • Foreign Travel Emergency: If a medical emergency occurs while you’re outside the U.S., Plan F will cover 80% of billed charges (after you meet a yearly deductible) up to plan limits.
  • Part B Excess Charges: If a doctor or provider does not accept Medicare assignment (meaning they don’t accept Medicare’s approved amount as full payment), they might charge up to 15% more than the Medicare-approved amount. Plan F covers these excess charges.

Notable Change for Plan F:

Starting January 1, 2020, Medigap plans that cover the Medicare Part B deductible, like Plan F and Plan C, are no longer sold to those newly eligible for Medicare. This change is due to the Medicare Access and CHIP Reauthorization Act of 2015. However, if you were eligible for Medicare before January 1, 2020, or already had a Plan F or Plan C, you can continue to keep or purchase these plans.

Due to its comprehensive coverage, Plan F’s premiums tend to be higher than other Medigap plans. Still, many beneficiaries have found its nearly complete coverage to be worth the cost, given the predictability it offers for healthcare expenses.

When considering a Medigap policy, always compare the benefits, premiums, and service of various insurance companies in your area. While benefits are standardized, premiums can vary significantly between providers.

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