Individuals can choose from ten Medicare Supplemental Insurance Plans to cover the gaps in Medicare coverage. While each plan covers a different number/combination of gaps, Medigap Plan F is the most comprehensive (and also the most popular). Keep reading to get all the information you need to help you decide if this plan is for you.
Medigap Plan F Coverage
There are nine gaps in your Medicare coverage. Supplemental Plan F fills in those gaps. With a Plan F policy, you pay the monthly premiums for your supplement Medicare Part B and those for your prescription drug coverage (Medicare Part D). There are no additional charges for medical services. At first, you may need to make three monthly payments. Once you are receiving your Social Security benefits, the premiums will automatically be deducted before your check is deposited into your account.
Medicare Plan F, like all supplement plans, is billed through Medicare. There are no out-of-pocket expenses. It will go to Medicare for the primary coverage before being billed directly to your Medicare Plan F carrier. Overall you will have fewer problems with this policy. The following chart shows how Plan F works should you be hospitalized:
|Medical Service||What Medicare Pays||What Plan F Pays||Your Cost|
|Hospitalization—First 60 Days||All but $1,556||$1,556||$0|
|Hospitalization—Days 61-90||All but $389 per day||$389 per day||$0|
|Hospitalization—Days 91-150||All but $778 per day||$778 per day||$0|
|Hospitalization—Next 365 Days||$0||All Medicare Eligible Expenses||$0|
|Hospitalization—More than 365 days||$0||$0||All Costs|
Medigap Plan F pays all your expenses and gives you an additional 365 days of hospitalization coverage. This goes for all nine gaps left by Medicare. The only charges you may incur would be if you required hospitalization past 515 days or skilled nursing care past 100 days, and the first $250 and a 20% coinsurance if you were to have an emergency when traveling out of the country.
The best way to determine the cost of any Medicare Supplement Insurance Plan is to get a quote specific to your age and health. The cost for someone who is 75 and has health issues will be different than an individual who is 69 and in perfect health.
Another cost factor is how the insurance company rates your coverage. There are three ways to rate Medicare Supplement Insurance: attained-age, community, and issue-age.
- Attained-Age Rating means your premiums are based on your current age. In all likelihood, your premiums will rise as you age.
- Community Rating means everyone in a community has the same rates regardless of age.
- Issue-Age Rating means your premiums are based on your age at the time your policy is issued. It will remain the same for the life of your policy. While this rating tends to be slightly higher compared to the attained age, over time you could save money if you purchase your policy when you are 65.
With each of these ratings, it is important to enroll in your Medigap Plan within six months of starting Medicare Part B coverage. During this time–referred to as the open enrollment period–insurance companies are not legally allowed to take your health into consideration when issuing your policy. Only your age and other demographic factors can be taken into account.
Alternatives to Medicare Supplement Plan F
While Medicare Supplement Plan F is the most popular, individuals often select another plan. That is because the cost of Plan F can exceed the charges and premium you receive from another supplement plan or the individual can afford to have less coverage. The most popular options are Plan G and the High Deductible Plan F.
Medicare Supplemental Plan G has the same coverage as Medicare Plan F. However, the $233 annual deductible that comes with Medicare Part B isn’t covered. Here is how the numbers break down.
If Plan G’s monthly premiums are $20 lower, you would spend $240 less per year. Even after paying your deductible, you are still saving $93 annually for Plan G over Medicare Supplement Insurance Plan F. If the monthly savings for Plan G were lower, Plan F would be the better choice.
High Deductible Plan F
The difference between the standard Medigap Plan F and the high deductible version is simple. You will have a $2,490 annual deductible in exchange for a lower monthly premium. That includes the Medicare Parts A and B deductibles along with any other coinsurance and copays covered by the standard plan. Who would benefit from this plan? Anyone with substantial cash savings and good health can save considerable money on monthly premiums by going with High Deductible Plan F.
The only way to know which plan is right for you is to get a Medicare supplement quote and compare them and their pricing.