As of January 1, 2020, Medicare Plan F is no longer available to new enrollees, but if you were eligible for Medicare before January 1, 2020, you can keep or enroll in Plan F.
If you currently have it or are eligible, you may be wondering if it's worth keeping or exploring other options.
Let's take a closer look at Medicare Plan F, its coverage, and alternatives so that you can decide if it's right for you.
What Is Medicare Plan F?
Medicare Plan F is a type of Medicare Supplement Insurance Plan, also known as a Medigap plan, sold by private insurance companies.
These plans are designed to bridge the gaps left by Original Medicare (Part A and Part B) and help beneficiaries cover out-of-pocket costs of Medicare-covered services like deductibles, coinsurance, and copayments.
Think of Medicare Plan F as the top-tier luxury option among Medicare Supplement plans. While it typically comes with a higher premium, it offers extensive coverage, leaving you with almost 0 out-of-pocket expenses for services covered by Medicare.
It was a pretty popular plan in the past for those who wanted comprehensive coverage without any unexpected expenses.
What Does Plan F Cover?
Medicare Supplement plans follow certain standards set by Medicare and the government, but the costs are determined by the private insurance companies that sell them. Those prices can vary depending on your location and your medical history.
The main thing Medicare Plan F covers that others don't is the Part B deductible.
Here's a breakdown of what Medicare Plan F covers:
- Part A Coinsurance and Hospital Costs: Covers inpatient hospital care coinsurance under Medicare Part A.
- Part B Coinsurance or Copayment: Covers coinsurance or copayment for services under Medicare Part B, including doctor visits, outpatient care, and durable medical equipment.
- Blood Transfusion (First Three Pints): Covers the cost of the first three pints of blood needed for a medical procedure.
- Part A Hospice Care Coinsurance or Copayment: Provides coverage for hospice care services coinsurance under Medicare Part A.
- Skilled Nursing Facility Care Coinsurance: Covers coinsurance costs for skilled nursing facility care under Medicare Part A.
- Part A Deductible: Covers the deductible for Medicare Part A.
- Part B Deductible: This covers the deductible for Medicare Part B, which you would otherwise have to pay out of pocket.
- Part B Excess Charges: If healthcare providers charge more than the Medicare-approved amount for services covered under Part B, Plan F covers the excess charges.
- 80% of Foreign Travel Emergency Coverage: Offers coverage for emergency medical care received outside of the United States, up to certain limits, after meeting a deductible.
In layman's terms, Medicare Plan F leaves with you $0 in out-of-pocket costs for all Medicare-approved services.
Is Medicare Plan F Still Available in 2024?
As of 2024, Medicare Plan F is no longer available for new enrollees. However, if you were eligible for Medicare before January 1, 2020, you can still enroll in or keep your existing Medicare Plan F coverage.
To be eligible, individuals must be enrolled in both Medicare Part A and Part B. Additionally, some insurance companies may require you to undergo a health screening, also known as medical underwriting, to qualify for their Plan F coverage.
Why Was Plan F Discontinued?
Plan F is being phased out as part of efforts to cut Medicare spending.
Plans that cover the Part B deductible and all out-of-pocket expenses, like Plan F, essentially allow beneficiaries to visit the doctor for free.
This type of coverage, known as first-dollar coverage, has sparked controversy because it encourages more frequent visits to the doctor.
Some view that as positive because it can prevent or detect health issues early, leading to overall better health. However, it also costs Medicare a lot more money.
And as the Medicare program faces financial challenges and the looming possibility of running out of funds, something had to be done to cut spending.
So Medicare worked with Congress to phase out these plans for new enrollees. Eventually, as those who are still eligible no longer choose these plans or no longer require Medicare, the plans will cease to exist permanently.
For more information, check out: Why Exactly Is Plan F Being Phased Out?
Is Medicare Plan F Worth It?
One of the biggest selling points for Plan F is that it covers the Plan B deductible so that you don't have any out-of-pocket expenses.
But is it worth keeping or enrolling in if you are eligible?
A simple calculation can help you decide if the higher premium you'll pay is worth it.
In 2024, the Plan B deductible is only $240. So, if you'd pay less overall with another plan, it might be a better option for you.
Take Plan G, for example. It's similar to Plan F but doesn't cover the Part B deductible. If the Plan F premium you're considering is more than $20 higher than the Plan G premium, opting for Plan G is a smarter choice.
Our experts at Sams/Hockaday can help run this calculation for you.
But in all honesty? Plan F just isn't a good buy anymore.
Medicare Plan F Alternatives
If you're drawn to the benefits offered by Plan F, Plan G is a really competitive alternative. The main difference between Plan G and Plan F is the Part B deductible.
Another popular choice is Plan N, which offers comprehensive Medicare Supplement coverage.
Note: Both plans C and F are being phased out and are not available to new enrollees, and not all plans may be available to you or in your area so check with a Medicare agent.
*Plans F & G offer a high deductible plan in some states.
**Plans K & L show how much they'll pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible. After you meet them, the plan will pay 100% for approved services.
***Plan N pays 100% of the costs of Part B services, except for copayments for some office visits and some emergency room visits.
Making Informed Medicare Choices
If you are currently enrolled in Plan F and already work with an agent here at Sams/Hockaday, we will be monitoring your Plan F premiums and let you know if there is a better plan available to you.
If you haven't yet teamed up with an agent and want to make sure you are enrolled in the best plan for you, don't hesitate to reach out to us today.
We're here to help you navigate the complexities of Medicare and find the right coverage for your needs.
