Medicare Supplement Plan F fills all the gaps in Original Medicare. It covers Medicare Part A and B coinsurance amounts. Plan F also covers the Part A Deductible, Part B Deductible, and Skilled Nursing Facilities. In other words, you pay $0 for these services. In addition, Plan F also pays for Part B Excess Charges, and Foreign Travel Emergency. Providers that don’t accept Medicare assignment are allowed to charge an additional 15%. Most importantly, Plan F will pay for those excess charges.
Plan F is considered the best Medicare Supplement plan available for purchase. According to the National Association of Insurance Commissioners (NAIC), about 54% of Medicare Supplement policy holders are enrolled in Plan F. As a result, Plan F is the most expensive Medigap plan.
There’s new legislation affecting Plan F and Plan 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.
Part A Hospital Coinsurance
- Plan F pays 100% of the Part A co-insurance and hospital costs.
Additional Part A Hospital Benefits
- An extra 365 days of inpatient hospital care after you use your Original Medicare hospital benefits.
Part B Coinsurance
- Plan F pays for the 20% Part B coinsurance from day one.
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
- Plan F pays only after you meet 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.
Enrollment by State
The following data is provided by Ahip.org and it is as of December 31, 2018:
Plan F (281,215 – 555,187 Enrollees)
- Florida leads all states with the most enrollees in Plan F. In other words there were 555,187 people in Florida that had Plan F.
- Illinois had 506,283 people enrolled in Plan F. That is to say, only Florida had more enrollees.
- Texas had 477,558 enrollees in Plan F. That is to say, more than 50% were in Plan F.
- California had 396,195 enrollees in Medigap Plan F. In other words, 67% of enrollees were in Plan F
- North Carolina had 296,027 enrollees in Plan F. Above all, only Florida, Illinois, California and Texas had more enrollees.
- Ohio had 281,215 people enrolled in Plan F. In other words, 48% of enrollees had Plan F
Plan F (199,510 – 270,533 Enrollees)
- New York had 270,533 people enrolled in Plan F. Only Florida, Illinois, and also North Carolina had more enrollees.
- Pennsylvania had 268,334 enrollees in Medigap Plan F. It had more than double of Plan G’s enrollment.
- Virginia had 259,370 people enrolled in Plan F. In short, Plan F had the most enrollees by far.
- Iowa had 234,772 people enrolled in Plan F. In other words, more than 90% of enrollees had Plan F.
- Indiana had 201,604 people enrolled in Plan F. That is to say, more than 50% of enrollees were in Plan F.
- Georgia had 199,510 of enrollees in Plan F. In other words, 54% of enrollees had Plan F.
Plan F (139,085 – 195,282 Enrollees)
- Arizona had 195,282 of people enrolled in Plan F. In short, 60% of enrollees were in Plan F.
- New Jersey had 193,882 people enrolled in Plan F. That is to say, 40% had Plan F.
- Missouri had 186,122 people enrolled in Plan F. In other words, 57% were in Plan F.
- Washington had 179,803 enrollees in Plan F. In short, 60% of enrollees were in Plan F.
- Tennessee had 175,561 people enrolled in Plan F. In other words 57% of enrollees had Plan F.
- Kansas had 156,260 enrollees in Plan F. That is to say, 63% of enrollees were in Plan F.
- Michigan had 139,085 people enrolled in Plan F. In short, only 32% had Plan F.