What Is Medicare Supplement Plan F?

However, people who became eligible for Medicare after Dec. 31, 2019, will be unable to get a Plan F policy.

Plan F is designed to address most of the coverage gaps in Medicare Parts A and B. You may buy this plan directly from health insurance providers during the Medigap open enrollment period. As with other health insurance policies, premiums for Plan F are tax-deductible.

What is Medicare Plan F?

Plan F is the most comprehensive of the 10 Medigap plans offered in the U.S. Plan F is a supplemental policy to Original Medicare (Parts A and B) and can fill many of the gaps of Original Medicare 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. You would only pay the monthly rates, which start at $0 for Part A and $164.90 for Part B. You would not have to pay the deductible, which is $1,600 for Part A and $226 for Part B.

Medicare Supplement Plan F will cover:

However, there are some medical expenses that Plan F will not cover, such as:

The most important of these coverage gaps to note is prescription drug coverage. We 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 Medigap policies cover dental care. If you have a Medigap plan and are looking for dental coverage, then you can buy a stand-alone dental insurance policy.

How much does Medicare Plan F cost?

Medicare premiums, deductibles and out-of-pocket costs are established each year by the government. Since Medicare Plan F is the most comprehensive Medigap policy, the premium can be costly.

However, your exact cost could be determined by your location, plan provider, current health condition, 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?

High-deductible Plan F differs from standard Plan F in that it has an annual deductible.

For 2023, the annual deductible for the high-deductible Plan F is set at $2,700. 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 $2,700 if you incurred a large medical cost.

For example, say you needed to get a colonoscopy costing $3,500. Under a standard 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. Based on the average premium of $179 per month, your Plan F would cost at least $2,148 per year.

If you instead had the high-deductible Plan F policy, the first 80% would still be covered through Medicare Part B, but you would pay the next $700, which is the remaining 20% of $3,500, unless you had already reached the $2,700 deductible. However, rates for a high-deductible plan can be much lower than rates for 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 — less than one-fourth of the annual cost for the standard plan.

In this scenario, you would save $968 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. 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 be large. During the itemizing process, you would only be able to deduct expenses that exceed 7.5% of your adjusted gross income.

When and where to buy Medicare Plan F

If you qualify, you may buy Medicare Plan F policies directly from private health insurance companies. Although insurers aren't required to offer Plan F, many do so because of its popularity.

Medicare Plan F is a supplemental (Medigap) health insurance plan that is offered to people who became eligible for Medicare prior to 2020.

You can get Medigap policies during the Medigap open enrollment period, which lasts six months and begins on the first day of the month you turn 65 or older and are enrolled in Medicare Part B. During this time, you can apply to any Medicare Advantage (Part C), Part D or Medigap plan (A, B, C, D, F, G, K, L, M or N, depending on your Medicare eligibility date), 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 still available?

Since January 2020, new enrollees have not been able to buy Medigap Plan F. However, if you were eligible for Original Medicare before 2020, then you are still allowed to enroll or keep your current Plan F policy. Plan F is still one of the best Medicare Supplement plans available on the market. The change occurred due to legislation focused on giving doctors better pay when they provide services to Medicare patients.

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 get. Medicare Plan F has a slightly higher average rate when compared to Plan G — $179 versus $145, respectively — and has a larger rate increase from year to year. The increased premiums are because of the more comprehensive coverage that you get through Plan F.

Here's a comparison of the coverage differences between the two Medigap plans:

Medigap Plan G will not provide coverage for the Medicare Part B deductible. This means if you were to get Plan G, you would have to pay the deductible for Part B, which is $226 for 2023, as you get health services.

Frequently asked questions

Methodology

Medicare Supplement policy details are based on information from Medicare.gov and CMS.gov. Plan F costs were calculated using actuarial data for a 65-year-old female who doesn't smoke based on preferred or guaranteed issue rates without a household discount. Averages exclude Select plans and plans in states that don't use national standardization.