What to Know Before Medigap Plan F Goes Away
Is Medicare Supplement Plan F going away?
Yes, but not for everyone. People who were eligible for Medicare before January 1, 2020, can still purchase Plan F or Plan C. Additionally, anyone enrolled in Plan F or C prior to 2020 will be able to keep their plan. The same goes for high deductible Plan F.
Anyone who becomes eligible for Medicare on January 1, 2020, or later won’t be able to purchase Plan F (and high deductible Plan F) or Plan C.
Congress passed this decision as part of The Medicare Access and CHIP Reauthorization Act of 2015.2 To control the rising costs of Medicare, the law restricts any Medigap plan from covering the Part B deductible. In essence, Congress believes that if more people have to pay the Part B deductible before they see a doctor, it will limit unnecessary visits and help lower costs.
Should I get Plan F if I still can?
Maybe, maybe not. Following the new changes, enrollment in Plan F will decrease over time, and the risk pool will slowly decrease. With fewer people in the risk pool, premiums may rise (although nobody knows for sure). But if that Part B deductible coverage appeals to you, Plan F may still be a good option.
Alternatively, Plan G provides all the same benefits as Plan F, apart from the Part B deductible, so it could be a good alternative. Sometimes, Plan G premiums are low enough that they compensate for the Part B deductible waived by Plan F, but premiums depend on company, location, and whether you have guaranteed issue rights (see more on these rights below).
What is a Medicare Supplement plan?
A Medicare Supplement plan is insurance you can purchase to supplement your Original Medicare coverage. These plans are also known as Medigap plans because they help bridge some of the “gaps” that Medicare doesn’t cover, like coinsurance, copayments, or deductibles.
Currently, there are ten Medigap plans to choose from: A, B, C, D, F, G, K, L, M, and N. Soon, two of these plans will be off the table for certain people—more on that in a bit.
What is Medicare Supplement Plan F?
By far the most popular Medicare Supplement plan is Plan F, accounting for over half of all Medigap plans sold.1 It’s easy to understand why: When compared to the other plans, Plan F has the most comprehensive coverage, including payment of the Part B deductible.
Medicare Supplement plan benefits
|1. Part A coinsurance/hospital costs||Yes||Yes||Yes||Yees||Yes||Yes||Yes||Yes||Yes||Yes|
|2. Part B coinsurance/copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|3. Blood (first 3 pints)||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|4. Part A hospice care coinsurance||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|5. Skilled nursing facility care coinsurance||No||No||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|6. Part A deductible||No||Yes||Yes||Yes||Yes||Yes||50%||75%||50%||Yes|
|7. Part B deductible||No||No||Yes||No||Yes||No||No||No||No||No|
|8. Part B excess charge||No||No||No||No||Yes||Yes||No||No||No||No|
|9. Foreign travel coverage||No||No||80%||80%||80%||80%||No||No||80%||80%|
|10. Out-of-pocket limit||No||No||No||No||No||No||$5,560||$2,780||No||–|
Chart based on information from Medicare.gov and is for illustration purposes only. Data effective 12/12/2019.
The bottom line
Specifically, Plan F provides first dollar coverage for doctor visits by taking care of the Part B deductible. First dollar coverage means you’re immediately covered for a doctor visit without paying any deductibles. Plan C also covers the Part B deductible.
However, because Plans F and C cover the Part B deductible, they are both being phased out.
I’m currently on Plan F. Should I switch to another plan?
It depends. If you don’t currently have guaranteed issue rights (or don’t live in a state that has Medigap protections), you may be subject to medical underwriting if you try to switch to another plan. Medical underwriting means that insurance companies can use your health information to charge more for coverage, enforce a waiting period before a policy goes into effect, or even deny you a policy. You can learn more about guaranteed issue rights and medical underwriting here.
So, for instance, if you bought Plan F but have medical issues, it may be best for you to stay on your current plan to avoid medical underwriting. But in light of Plan F being phased out, your state may have passed laws giving increased protections to those who switch Medigap plans. To find out if these protections apply to you, contact your State Health Insurance Assistance Program (SHIP).
It’s impossible to give absolute recommendations without knowing everything about your situation—where you live, whether you have a condition that may be considered pre-existing, etc. To get personalized help and answers specific to you, call an experienced agent today.
- Kaiser Family Foundation, “Medigap Enrollment and Consumer Protections Vary across States”
- Congress, “Medicare Access and CHIP Reauthorization Act of 2015 (see section 401)”
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