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What You Need To Know About Medigap Plan F

Medicare is a health insurance program for people aged 65 and over or with certain disabilities. Medigap is a type of supplemental insurance that can help cover some of the…

July 18, 2022

Written by Nikki Grillo

Medicare is a health insurance program for people aged 65 and over or with certain disabilities. Medigap is a type of supplemental insurance that can help cover some of the costs that Medicare doesn’t, such as copayments, deductibles, and coinsurance. Plan F is one of the 10 standardized Medigap plans available in most states.

Plan F is the most comprehensive of all the Medigap plans, covering all of the Medicare Part A and Part B gaps. However, this plan is now being phased out. If you’re close to enrolling in Medicare or are already enrolled and considering a Medigap plan, knowing about each type of coverage can help you decide which plan is right for you.

Reading this article will help you better understand Medigap Plan F. We’ll discuss the coverage gaps that Plan F closes, some of the benefits of this type of Medigap plan, its availability, and more. Keep reading.

What Is Medigap Plan F?

As mentioned, Medigap Plan F is a type of supplemental insurance that can help cover some of the costs that Medicare doesn’t. Private insurance companies sell Medigap plans, and the federal government standardizes each plan. Since they’re standardized, Plan A policies must give the same basic benefits regardless of which insurance company offers them. Premiums and other features, on the other hand, may differ. 

As with all plans, you should read your contract and review the benefits provided by this plan. To ensure that you qualify for all benefits, you should always check with your insurance company for actual costs and benefits. In addition, ask for any exceptions or restrictions that may not appear on the face of the policy.

10 Benefits Provided to Individuals Covered by Medigap Plan F

According to the Medicare official website, all individuals covered by Medigap Plan F are entitled to the following benefits:

  1. Part A Coinsurance And Hospital Costs

Part A coinsurance and hospital costs are the expenses you share with Medicare for inpatient hospital care. You’ll no longer have to pay these costs with Plan F since the plan covers them. This can save you a lot of money, especially if you require a lot of hospital care.

  1. Part B Coinsurance or Copayment

Part B coinsurance is the percentage of covered outpatient medical costs you share with Medicare. Plan F also covers the cost of Part B coinsurance. You may still have to pay a copayment for certain services, but this is usually a set amount that is much lower than your coinsurance would be.

  1. Blood Transfusions

If you need a blood transfusion, Medigap Plan F will cover the cost of the first three pints of blood. After that, you’ll be responsible for any additional charges.

  1. Part A Hospice Care Coinsurance or Copayment

Plan F covers the coinsurance or copayment for Part A hospice care. Hospice care is end-of-life care that focuses on comfort and quality of life rather than curative treatment.

  1. Skilled Nursing Facility Care Coinsurance

A skilled nursing facility is a nursing home that provides intense care for people recovering from an illness or injury. If you need to go to one of these facilities, Medigap Plan F will cover the coinsurance for received services.

  1. Part A Deductible

The Part A deductible is the amount of money you have to pay before Medicare starts to cover your inpatient hospital costs. Medigap Plan F covers this deductible, so you won’t have to pay it out of pocket.

  1. Part B Deductible

Much like the Part A deductible, the Part B deductible is the amount of money you have to pay before Medicare starts to cover your outpatient medical costs. Medigap Plan F also covers this deductible.

  1. Part B Excess Charge

An excess charge is an amount that a doctor can charge you for a covered service above the Medicare-approved amount. With Medigap Plan F, you won’t have to pay any Part B excess charges.

  1. Foreign Travel Emergency Coverage

If you have an emergency while traveling outside of the United States, Medigap Plan F will cover up to 80% of the costs. This benefit is particularly useful if you’re a frequent traveler or like to go on international vacations.

  1. No Out-Of-Pocket Limit

Unlike some other Medigap plans, Plan F has no out-of-pocket limit. This means that there’s no maximum amount of money you’ll have to pay for covered expenses in a given year. Once you reach your deductible, the plan will cover 100% of the costs.

What Does Plan F Not Cover?

There are a few things that Medigap Plan F doesn’t cover. These include:

  • Long-term care
  • Dental care
  • Vision care
  • Hearing aids
  • Private-duty nursing
  • Custodial care
  • Personal expenses, such as private rooms or TV rentals
  • Medical services that are not covered by Medicare Part A or Part B, such as cosmetic surgery
  • Prescription drugs (You’ll need to enroll in a separate Part D plan to get drug coverage)

How To Apply for Medigap Plan F

Medigap Plan F is only available to eligible persons for Medicare before January 1, 2020. You can keep Medigap Plan F and its advantages if you were previously enrolled in it. Additionally, if you were eligible for Medicare before January 1, 2020, but missed the enrollment, you may still be able to buy Medigap Plan F.

If you want to sign up for Medigap Plan F, you should know that there are 2 enrollment periods available:

  • Open enrollment for Medigap insurance begins 6 months after you turn 65 and enroll in Medicare Part B.
  • People who may qualify for Medicare and Medigap before reaching 65, such as those with end-stage renal disease (ESRD) or other pre-existing diseases, can enroll in Medigap special enrollment.

You can’t be denied a Medigap policy because of a pre-existing health condition during the open enrollment period. However, even if you qualify for a Medigap policy, insurance providers can deny you one outside of the open enrollment period due to your health.

How To Pick the Right Medigap Plan

When choosing a Medigap policy, you should consider your needs and requirements. You must select a plan that’s right for you. You can look at information about features offered by the different plans through your state’s department or go online to find out more information about which method best fits your needs. It would help to consider your health status, current prescription drug plan, and other health benefits.

Once you find a plan you like, contact the insurance company to compare the features and options of each plan. Even though Plan F is no longer offered to new enrollees, plenty of other great Medigap plans are available to choose from.

Medigap Plan Fees and Monthly Premiums

Various companies offer Medigap plans, and each company charges differently. You can find information about the premiums and fees for each plan by contacting the insurance company or going online to their website. The premium is the price you pay for your policy, and it’s paid each month. It will depend on your age, gender, tobacco use, location, and other aspects.

Medigap policies can be rated in 3 ways:

  • Community-rated: Your premium isn’t affected by your age and may only increase as a result of inflation or other factors. Everyone, regardless of age, is required to pay the same rate.
  • Issue-age rated: Your premium is set according to your age at the time of purchase, and it won’t rise as you become older. Still, your premium may increase due to inflation or other factors.
  • Attained-age-rated: Your premium is based on your age, and it may increase as you become older due to inflation and other factors.

Some companies may offer discounts on your premium if you pay annually or semi-annually. Others offer a discount for setting up automatic payments from your checking account or credit card.

Why Is It Important To Have A Medigap Plan?

It’s important to have a Medigap policy because it will help you cover the costs of Medicare deductibles, copayments, and coinsurance. This can save you a lot of money in the long run. Additionally, Medigap plans offer many other benefits not covered by Original Medicare, such as emergency care outside the United States and coverage for some preventive services.

Coverage is something everyone should consider, especially as we get older. No one knows what the future holds, and it’s always better to be prepared. With a Medigap policy, you can have relief knowing that you’ll be covered in case of an emergency or unexpected health event.

Nesso Senior Benefits – Find The Right Health Insurance Plan

If you plan to enroll in Medigap, you must understand what coverage each plan offers. While many plans have similar features, each has its benefits and exclusions. At Nesso Senior Benefits, we can help you compare plans and determine the best solution for your needs. We make sure that our clients get all of the information they need about their Medicare insurance so that they can make informed health decisions.

We’re also part of the Nesso Group, which provides expert guidance on several areas like Medicare, tax, accounting, asset management, insurance, and more. Our holistic advice considers all aspects of your financial life because we believe all moving parts are connected. We’ll be there to coach you through everything.


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