Medigap Plan F is the most common and comprehensive Medigap plan.
Some 
people even refer to Plan F as the “Cadillac” of Medicare Supplement plans. Over 40% of the Medicare-eligible beneficiaries who have a Medigap plan use Plan F. It pays everything that Medicare A & B do not cover at the doctor and hospital so that you do not have any out of pocket expenses for Medicare-covered services.
Of course, because it is the most comprehensive plan, Medigap Plan F is also the most expensive plan of the 10 standardized Medigap plans. It can be as much as $25-30/month more than Medigap Plan G, which is the plan most commonly sold by insurance companies as the middle-tier plan.
How Does Medigap Plan F Work?
First and foremost, you should understand that all Medigap plans, whether it is Plan F or another plan and regardless of which company sells you the plan, work the same way. There are no networks that you are required to stay within – you can go to any doctor or hospital that takes Medicare nationwide. You also are not required to get any kind of referrals to use a Medigap plan or see a specialist.
Additionally, claims are paid through the Medicare “crossover” system, regardless of what company you have for your Medigap coverage. Your company does not receive claims, look over them and decide whether they are going to pay them, as is the common impression with many other types of insurance. On the contrary, Medigap plans are paid automatically and electronically through the Medicare “crossover” system. This streamlined and straight-forward process further adds to the standardization among Medigap companies.
The MACRA legislation means that Plan F is not available to everyone. Starting January 1, 2020, Medigap plans sold to people new to Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people who are new to Medicare on or after January 1, 2020.
If you already have either of these two plans (or the high deductible version of Plan F) or are covered by one of these plans prior to January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020 but not yet enrolled, you may be able to buy one of these plans.
People new to Medicare are those who turn 65 on or after January 1, 2020, and those who get Medicare Part A (Hospital Insurance) on or after January 1, 2020.
Receive an Email with the List of Plan F's Available in Your Zip Code
Where should we email the list of plans?
Is Medigap Plan F Right For Me?
First and foremost, everyone is not eligible for a Plan F. Starting January 1, 2020, Medigap plans sold to people new to Medicare were no longer allowed to cover the Part B deductible. Because of this, Plan F is no longer available to people who are new to Medicare (after 1/1/2020). If you already have either of these two plans (or the high deductible version of Plan F) or were covered by one of these plans prior to 1/1/2020, you can keep your plan. People new to Medicare are those who turn 65 on or after January 1, 2020 or those who get Medicare Part A after that date.
Even if you are eligible for Medigap Plan F, Plan F is definitely not always the best “value”. It is the most comprehensive plan, but it is also the most expensive as compared to lower-cost options like Medigap Plan G and Medigap Plan N. Still, it may be right for you.
Some Medicare beneficiaries prefer to have very limited “exposure” to out of pocket costs. Plan F certainly takes care of that. It is easy to use and there is no surprise billing later.
Also, if you have health problems, it may make sense to go ahead and sign up for Medigap Plan F when you are first eligible. Outside of your initial enrollment period, you do have to qualify medically to get a plan. So if you think that may be difficult for you, due to some pre-existing health conditions, it may make sense to get Plan F when you can. This way, you can be locked in (you cannot be cancelled off of a Medigap plan – they are “guaranteed renewable”) to the top level of coverage without having to worry about whether you will be eligible for it.
If you have questions about Medigap Plan F or any of the other Medigap plans or how they work, please feel free to give us a call at 877.506.3378. You can also contact us online to get a comparison of Plan F quotes.
