You are eligible for Medicare Supplement Plan F (Medigap Plan F) only if you were eligible for Medicare before January 1, 2020, meaning you turned 65 or qualified for Medicare due to disability before that date, but haven't enrolled yet; if you became eligible on or after January 1, 2020, Plan F is not available, and you'd look at Plan G instead, as it's the closest alternative.
If you turned 65 years of age before January 1, 2020, or if you are younger but don't have ESRD and you became eligible for Medicare before January 1, 2020, you can buy plans C or F (including high deductible F).
Plan F and Plan C are only available to people who turned 65 before January 1, 2020 or were first eligible to receive Medicare benefits due to age, disability or end-stage renal disease (ESRD) before January 1, 2020.
Medicare Plan F is worth it if you were eligible for Medicare before January 1, 2020, prefer maximum coverage with zero out-of-pocket costs for Original Medicare gaps, and don't mind higher premiums for that peace of mind, but for newer beneficiaries, Plan G offers nearly identical benefits (minus the Part B deductible) for a potentially lower cost, making Plan F less of a "best value" now, especially with rising premiums for existing members, according to GoHealth and Solace Health.
On average, Plan F costs somewhere between $150 – $250. However, there are a number of factors that go into your Medicare supplement premiums. Your zip code, age, and gender all play large parts in setting your rate. In addition, some insurance companies have higher rates than others.
High Deductible Plan F Cons
The plan requires you to pay a high deductible out of pocket before it begins to provide coverage, which can be a disadvantage for people with frequent healthcare needs or limited financial resources.
Medicare Plan F is no longer available for most new beneficiaries after January 1, 2020, due to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which banned Medigap plans that cover the Part B deductible for newly eligible enrollees to encourage more "skin in the game," reduce overuse, and control Medicare spending, though existing members can keep their plans.
Medicare Part B pays 80% of approved services, while Plan F covers the remaining 20% at full cost. Plan F does not cover services that Medicare denies, such as cosmetic surgery, hearing aids, and other similar services.
Overall Savings: Long-Term Considerations
Plan F offers zero out-of-pocket costs, but its higher premiums may not always be worth it if you don't frequently need medical care. Plan G's lower monthly premium can result in significant savings over time, especially for those who don't hit the Part B deductible every year.
Key Takeaways. Plan G offers nearly identical coverage to Plan F, except it doesn't pay the Medicare Part B deductible. Plan F is only available to people who became eligible for Medicare before January 1, 2020. Plan G may save you money overall, especially if you don't mind paying a small deductible each year.
Medicare Plan F covers all Part B excess charges. You will never pay the standard 15% excess charges that doctors under Medicare are allowed to charge for Part B services. You can choose any doctor in the United States who accepts Medicare insurance. No referrals are required!
Medicare Supplement Plans F, G, and N have different cost structures, which can impact your out-of-pocket expenses. Plan F typically has the highest premium among the three plans, but it offers the most comprehensive coverage, including coverage for Medicare Part B excess charges.
Companies now sell 10 plans: A, B, C, D, F, G, K, L, M and N. But plans C and F aren't available for people who became eligible for Medicare after Dec. 31, 2019. Every policy with the same letter designation must have the same coverage, regardless of which insurer sells it, although premiums vary by company.
Is Plan F still available for me? Unfortunately, no. You can join other Medicare Supplement plans, but any plan that has the Part B deductible coverage (like Plan F) is out of the running. We have other suggestions for coverage though – keep reading for more.
The only difference between Plan F and Plan G is coverage of the Part B deductible. The only difference between Plan F and Plan C, which was much less popular than F, is coverage of the excess charges associated with doctors who do not accept Medicare assignment.
Of course, as with all Medicare and Medicare Supplement coverage, you're still responsible for your Original Medicare and Medigap premiums. The drawback to Plan F is its high upfront cost compared to other available Medicare Supplement plans.
Medicare Plan G doesn't cover prescription drugs (requiring a separate Part D plan), routine dental, vision, or hearing care, or long-term care, and beneficiaries must first pay the annual Medicare Part B deductible before Plan G starts paying for covered gaps like Part B excess charges and foreign travel emergencies. Essentially, Plan G covers everything Original Medicare doesn't, except for the Part B deductible and services not covered by Medicare at all, like dental, vision, and prescriptions.
You can sign up for Medicare Supplement Plan F if you were eligible for Medicare before January 1, 2020. If you aren't eligible for Plan F, consider Plan G or N as alternatives. If you choose Plan F, you will usually only pay the premium and little else.
Here are some of the biggest Medicare mistakes to avoid:
Yes, your Medicare premiums can be tax deductible as a medical expense if you itemize deductions on your federal income tax return. You can only deduct medical expenses after they add up to more than 7.5 percent of your adjusted gross income (AGI).
The extra $144 added to Social Security usually comes from the Medicare Part B Giveback benefit, offered by some Medicare Advantage (Part C) plans, which pays back some or all your Part B premium, showing up as extra money in your check if it's deducted from your Social Security. To qualify, you need Original Medicare (Parts A & B), pay your own Part B premium, live in a plan's service area, and enroll in a specific Medicare Advantage plan that offers this "rebate," with the amount varying by plan and location.
People leave Medicare Advantage (MA) plans due to difficulty accessing needed care (especially with worsening health), restrictive provider networks, complex prior authorization rules, and dissatisfaction with care quality, often feeling trapped as their health needs grow despite initial low costs and extra perks that become limiting. Issues with provider availability, network changes, and sometimes misleading marketing also drive disenrollment, pushing people back to Traditional Medicare for greater freedom, notes KFF.
If you became eligible for Medicare in 2020 or later, you can only buy Plan G, not Plan F. The coverage difference is that Plan F covers the Medicare Part B deductible, but Plan G doesn't. Plan G might be the better deal, even if you're eligible for either Plan F or Plan G.