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Medicare Plan F provides the most benefits out of all the supplemental Medicare plans available and can help reduce your out-of-pocket expenses. The policy is designed to address most of the coverage gaps in Medicare parts A and B. For this reason, many people covered by the standard Medicare policies are willing to pay the extra monthly premium to purchase Plan F.
You may purchase this plan directly from health insurance providers during the Medicare open enrollment period. Like other health insurance policies, premiums for Plan F are tax-deductible. However, new enrollees who become eligible after January 2020 will be unable to purchase a Plan F policy.
What is Medicare Plan F?
Medicare Plan F is a supplemental Medigap health insurance plan that is offered to individuals who are disabled or over the age of 65. Known better as simply Plan F, the policy is the most comprehensive of the 10 Medigap plans offered in each state. Plan F is a supplemental policy to the standard Medicare parts A and B plans and can fill many of the gaps of standard Medicare policy and provide broader assistance with out-of-pocket costs. However, not all health insurance gaps will be covered by Plan F.
What does Medicare Plan F cover?
Those who have Medicare Plan F won't pay out-of-pocket costs for Medicare parts A and B. Policyholders would only pay the premiums, which start at $0 for Part A and $135.50 for Part B. Additionally, individuals would not have to pay the deductible, which is $1,364 for Part A and $185 for Part B.
Supplemental Medicare Plan F will cover:
- Medicare Part A coinsurance and hospital costs
- Medicare Part A deductible
- Medicare Part B coinsurance and copays
- Medicare Part B deductible
- Medicare Part B excess charges
- Blood (first three pints)
- Part A hospice care coinsurance and copay (including room and board)
- Skilled nursing facility coinsurance
However, there are some medical expenses that Plan F will not cover, such as:
- Routine vision care
- Routine dental care
- Hearing aids and routine hearing tests
- Cosmetic surgery
- Prescription drugs
The most important to note of these coverage gaps are prescriptions drugs and we would recommend purchasing Medicare Part D if you need this coverage. Medicare Plan F does provide coverage for injectable or infusion drugs given in a clinical setting but does not pay for other prescription drugs. The ideal coverage package would include Medicare parts A and B, along with the Part D prescription drug plan and a supplemental Medigap policy such as Plan F.
Unfortunately, none of the Medicare and Medigap policies cover dental care. If you are looking for dental coverage, then you would need to purchase a stand-alone dental insurance policy.
How much does Medicare Part F cost?
Medicare premiums, deductibles and out-of-pocket costs are established each year by the government. Since Medicare Part F is the is the most comprehensive Medigap policy, the premium can be costly. Typically, these range from $120 to $140 per month for a 65-year-old. However, the exact cost will be determined by your location, plan provider, current health condition, and age and gender. For this reason, it is vital to compare rates for the same Medicare policies across different health insurance companies.
What is a high-deductible Medicare Plan F?
The benefits within the high-deductible Medicare Plan F policy are the same as the standard Part F policy, though you would have to meet the deductible before you can access its health benefits. For 2019, the deductible for the high-deductible Plan F is set at $2,300. If you want to switch from a high-deductible plan back to the standard Plan F, you may need to undergo a medical exam for underwriting.
A high-deductible Medicare Plan F policy could be useful if you are healthier and do not think you'll need many medical services. However, you should carefully evaluate your own medical situation before committing to the high-deductible plan, as you would be responsible for the entire $2,300 if you incurred a large medical cost.
For example, say you needed to get a colonoscopy, which can cost up to $3,500. Under a standard Medicare parts A and B plan with Medigap Plan F, the first 80% of that bill ($2,800) would be paid for by Medicare Part B. The remaining 20% ($700) would be covered by Plan F. You would end up paying nothing in medical expenses under this scenario, but you would pay the monthly premium of $140, which adds up to $1,680 per year.
If you instead had the high-deductible Plan F policy, the first 80% would still be covered through Medicare Part B, but the next 20% of the $3,500 would be paid by you out of pocket unless you had already reached the $2,300 deductible that year. However, premiums for a high-deductible plan can be significantly less than the standard Medicare Plan F. If you paid a rate of $40 per month for the high-deductible policy, that would come out to $480 a year — much less than the $1,680 you would have paid for the standard plan.
In this scenario, you would save $500 if you have the high- deductible policy. However, this assumes you have only one medical expense during the year. For most older adults, this would not be the case. You should carefully evaluate your expected medical expenses for the year before selecting the high-deductible version of Medigap Plan F.
Are Medicare Plan F premiums tax-deductible?
When filing your federal tax return, Medicare Plan F premiums would be tax-deductible. Additionally, any medical expenses that you pay for out-of-pocket can also be deducted on your taxes. You would need to itemize these medical expenses, but the tax deductions could provide valuable additional returns. During the itemizing process, you would only be able to deduct expenses that exceed 10% of your adjusted gross income.
When and where to buy Medicare Plan F
You may purchase Medicare Plan F policies directly from private health insurance companies. Although insurers aren't required to offer it, many do so because of its popularity.
Medigap policies can be purchased during the Medigap open enrollment period, which lasts six months and begins on the first day of the month you turn 65 years old. During this time, you can apply to any Medicare Advantage (C and D) or Medigap plan (F, G, K, L, M or N) and the policy would be guaranteed. This means you would not be denied coverage due to health issues, and the health insurance company would be required to sell you a policy at the best available rate. For this reason, it is best to know which policy you want before open enrollment starts.
If you decide you want Plan F later on or miss the open enrollment period, you would have to go through medical underwriting. During this process, you would be required to take a medical exam, which may make the policy more expensive or cause you to be denied coverage.
Is Medicare Plan F going away?
Starting in January 2020, new enrollees will not be able to purchase Medigap Plan F. However, if you were eligible for Original Medicare before 2020 then you would still be allowed to enroll and keep your current Plan F policy. Furthermore, Plan F is still one of the best Medicare Supplement plans available on the market. The change is due to legislation in Congress focused on giving doctor better pay when they provide services to a Medicare patient.
What is the difference between Medicare Plans F and G?
There are two main differences between plans F and G: the premium and the amount of coverage you receive. Here's a comparison of the coverage differences between the two Medigap plans:
|Benefit||Plan F||Plan G|
|Medicare Part A Coinsurance & Hospital Costs|
|Medicare Part A Deductible|
|Medicare Part B Coinsurance & Copays|
|Medicare Part B Deductible|
|Medicare Part B excess charges|
|Blood (first three pints)|
|Skilled nursing facility coinsurance|
As you can see, Medigap Plan G would not provide coverage for the Medicare Part B deductible. This means if you were to purchase Plan G, you would have to pay the deductible for Part B, which is $185 for 2019, as you receive health services.
Additionally, typical premiums for Medicare Plan F are slightly higher when compared to Plan G — $140 versus $110, respectively — and have a larger rate increase from year to year. The increased premiums are because of the more comprehensive coverage that you receive through Plan F.