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Medicare Supplement Insurance Plan F

There's new legislation affecting Plans F and C. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) makes changes to Medigap policies that cover the Part B deductible for "newly eligible" Medicare Beneficiaries on or after January 1, 2020. Plan F isn't going away for eligible customers.

Anyone who turns 65 before January 1, 2020, can enroll in Plan F or C even after 2020 and can keep their plans as long as they choose.

Anyone who turns 65 on or after January 1, 2020, will only be able to purchase Medicare Supplement Insurance Plans F or C if they have a Medicare Part A effective date prior to 2020.

Insureds already enrolled in Plans F and C don't need to take any action. Plans F and C will still be available for consumers eligible to purchase them in 2020 and beyond.

Medigap Plan F covers the basic set of benefits. These basic benefits include most Medicare Part A and B coinsurance amounts, blood, and additional hospital benefits not covered by Original Medicare. Plan F also covers the Part A Deductible, Part B Deductible, Skilled Nursing Facilities, Part B Excess Charges, Skilled Nursing Facilities and Foreign Travel Emergency.

Part A Hospital Coinsurance

  • Days 61-90 of a hospital stay in each Medicare benefit period.
  • Days 91-150 of a hospital stay. Medicare will only pay for these 60 days once during your lifetime.

Additional Part A Hospital Benefits

  • An extra 365 days of inpatient hospital care after you use your Original Medicare hospital benefits.

 

Part B Coinsurance

  • Pays for the Part B coinsurance after you meet your annual deductible.

Part A and B Blood Coverage

  • Pays for the first three pints of blood per calendar year.

Part A Hospice Coinsurance

  • Pays for outpatient prescriptions drug and inpatient respite care coinsurance.

Part A Deductible

  • In 2020, the Medicare Part A Deductible is $1,408. Medigap Plan F covers the deductible amount.

 

Part B Deductible

  • In 2020, the Medicare Part B Deductible is $198.00. Medigap Plan F covers the deductible amount.

Skilled Nursing Facilities

  • In 2020, the co-payment for skilled nursing is $176/day for days 21-100. Medigap Plan F covers the co-payment amount.

Part B Excess Charges

  • If you go to a provider that does not accept Medicare assignment, that provider is allowed to charge an additional 15%. Plan F will cover that additional 15% charge at 100%.

Foreign Travel Emergency

  • Pays only for emergency care
  • Pays only after you first meet and pay a $250 deductible.
  • Pays 80% of billed charges for Medicare eligible expenses for medically necessary hospital, physician, and medical care received in a foreign country. You would be responsible for the other 20%.
  • Has a $50,000 lifetime maximum benefit.

 

 

Medicare Supplement Plans Benefit Checklist
 
A
B
C
D
F*
G**
K
L
M
N
Basic Plan (Part A Coinsurance up to an additional 365 days)
x
x
x
x
x
x
x
x
x
x
Basic Plan (Part B Coinsurance/ Co-payment; 1st 3 Pints Blood; Part A Hospice Care Coinsurance/ Co-payment)
x
x
x
x
x
x
50%
75%
x
100% except up to $20 co-pay for office visits and $50 co-pay for ER visits
Skilled Nursing Co-payment ($176/day for days 21 - 100 for 2020)    
x
x
x
x
50%
75%
x
x
Part A Deductible ($1,408 for 2020)  
x
x
x
x
x
50%
75%
50%
x
Part B Deductible ($198 for 2020)    
x
 
x
         
Part B Excess Charges (additional 15% for providers not accepting Medicare assignment)        
x
x
       
Foreign Travel Emergency    
x
x
x
x
   
x
x
Out-of-Pocket Maximum            
$5,880
$2,940
   

* Plan N requires up to a $20 co-payment for an office visit and up to a $50 co-payment for an emergency room visit
** There is also a high-deductible Plan F ($2,340 in 2020)

** High Deductible Plan G is available to people who are new to Medicare on or after 1/1/2020.

 

 

 

Medicare Supplement Plans by State
Alabama Idaho Maine Nevada Oklahoma Texas
Arizona Illinois Maryland New Hampshire Oregon Utah
Arkansas Indiana Michigan New Jersey Pennsylvania Vermont
California Iowa Mississippi New York Rhode Island Virginia
Colorado Kansas Missouri North Carolina South Carolina Washington
Florida Kentucky Montana North Dakota South Dakota West Virginia
Georgia Louisiana Nebraska Ohio Tennessee Wyoming

 

 

 

Site Map

Plan A | Plan B | Plan C | Plan D | Plan F | Plan High Deductible F | Plan G | Plan K | Plan L | Plan M | Plan N

 

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