In the past, Medicare Supplement Plan F was the plan of choice for those seeking the fullest, most flexible coverage. In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA). This Act limits the ability of new Medicare beneficiaries to purchase plan F after January 1st, 2020. Medicare beneficiaries already with Plan F can keep that plan.
Medicare Supplement Plan F provides first dollar coverage. More specifically, Plan F pays the Medicare Part B annual deductible ($198 in 2020). This meant that when you went to the doctor, in most cases, you did not pay anything out-of-pocket. Congress wants Medicare beneficiaries to have skin in the game. Thus, they have decided to phase out Plan F for new Medicare beneficiaries.
Existing Plan F Medicare Supplements are grandfathered; you may keep your Plan F Medicare Supplement if your Medicare Entitlement date is prior to January 1st, 2020. Plan F is still a good plan, but in some areas Plan G can provide comparable coverage at a lower overall cost. The only difference between the plans is that Plan F covers the Medicare Part B deductible and Plan G does not. In 2020, the Medicare Plan B annual deductible was $198. The premium savings for Plan G generally was greater than the additional $198 benefit that Plan F provides.
What Does Plan F Cover?
Medicare Plan F covers Medicare Part A coinsurance and hospital costs (up to 365 days after Medicare benefits are used.) For example, if you are in the hospital for anywhere between one and 60 days as an inpatient, Medicare Part A will pay everything by the Medicare Part A deductible of $1,408. Plan F will cover the $1,408; therefore, you will have no out of pocket costs during the first 60 days as long as your care is medically nessiary, you are admitted as an inpatient and the hospital accepts Medicare.
After day 60 in the hospital, Medicare Part A will pay and plan F will pay the remaining.
Plan F will also help pay for the first 100 days of your care in a skilled nursing facility. Medicare Part A will pay for the first 20 as long as you initially spent three days in the hospital and were released into the skilled nursing facility. Days 21-100 Medicare Part A pay and Plan F pays.
In the doctor’s office, Plan F will pay the Medicare Part B deductile and then then the 20% coinsurance that Medicare Part B leaves. Medicare Part B pays 80% of medical services.
Some doctors that participate in Medicare charge more than what Medicare says certain services are worth. Medicare allows these doctors to charge up to 15% more than Medicare’s listed rates. These doctors are doctors that don’t accept assignment with Medicare. Plan F will cover this additional 15% if the doctor charges it.
Plan F also offers Foreign Emergency Care. Medicare Parts A and B only provide coverage within the United States. Plan F will provide up to $50,000 worth of lifetime maximum coverage paying at 80% of reasonable and customary charges after a $250 deductible for the first 60 days of your trip.
All Plan F’s are standardized by Medicare, meaning that every company must cover the same benefits. The only differences are the company’s premium, customer service, and financial stability. Recently a few companies have begun adding a fitness benefits SilverSneakers and others as an extra ancillary benefit to their Plan F’s.