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Each question links to a section on this page about Medigap Plan F;
- What is Medigap Plan F?
- Why is Medigap Plan F going away in 2020?
- What does Medigap Plan F cover?
- What does a Medigap Plan F not cover?
- How do I compare Medigap Plans?
- Is Medigap Plan F worth buying?
- How much does Medigap Plan F cost?
- How do I enroll in Medigap Plan F?
- How does Medigap Plan F compare with Part C Medicare Advantage (MA)?
- How does Medigap Plan F work with Medicare Part D Prescription drug coverage?
- How does Dental, Vision & Hearing Insurance (DVH) work with Medigap Plan F?
- How does Medigap Plan F work with a Critical Illness Insurance for cancer, heart-attack & stroke (CHAS)?
- How does Medigap Plan F work with a Long Term Care Insurance (LTC)?
- How does Plan F work with a Health Savings Account (HSA)?
Maybe you’ve heard some information about Medigap Plan F from friends & family but what exactly are Plan F anyway & how does it fit within Medicare Insurance benefits? We consolidated & simplified all the important details for you by answering common questions to help save you time, money & energy!
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| Benefits | Amount |
|---|---|
| ✔ Part A Co-Insurance (ie: Co-Ins.) | 100% |
| ✔ Part B Co-Ins. | 100% |
| ✔ Blood (First 3 Pints) | 100% |
| ✔ Hospice Care Co-Ins. | 100% |
| ✔ Skilled Nursing Co-Ins. | 100% |
| ✔ Part A Deductible | 100% |
| ✔ Part B Deductible | 100% |
| ✔ Part B Excess Charges | 100% |
| ✔ Foreign Travel Emergency | 80% |
What is Medigap Plan F?
Plan F is one of the most popular, if not thee most popular Medigap Plan on the senior health insurance market because it covers the maximum amount of benefits offered by Insurance Carriers. Known as the Cadillac plan, Plan F is known for first-dollar coverage for Original Medicare Part B but only if you are lucky enough to enroll before the discontinued cut-off date of January, 1 2020. This means if you enrolled in Medicare Part B before year 2020, you still actually have the option to enroll in Plan F via the grandfathered clause. According to Investopedia, first dollar coverage, ‘…is an insurance policy feature that provides full coverage for the entire value of a loss without a deductible’ (Investopedia, First Dollar). Basically, Plan F pays for 100% of the Part B Deductible of Original Medicare Insurance.
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Why is Medigap Plan F going away in 2020?
Plan F is going away because congress noticed an issue with both patient care providers and patients ‘misusing’ the government based insurance. As one could imagine, an unrestricted use of medical care without cost to patients increases its unnecessary usage while incentivising doctors to bill Medicare for more services rendered. Furthermore, congress issued, H.R.2 – Medicare Access and CHIP Reauthorization Act of 2015 to curb the expense. That is the basic explanation why Plan F is phased out in 2020.
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What does Medigap Plan F cover?
Plan F covers;
- 100% Medicare Part A Coinsurance.
- 100% Medicare Part B Coinsurance.
- 100% First Three (3) Pints of Blood.
- 100% Part A Hospice Coinsurance.
- 100% Skilled Nursing Facility Care Coinsurance.
- 100% Part A Deductible.
- 100% Part B Deductible.
- 100% Part B Excess Charges.
- 80% Foreign Travel Emergency Insurance.
The National Association of Insurance Commissioners (NAIC), standardized all Medigap Plans which must adhere to the following guidelines;
- Must cover costs for both Original Medicare Part A & Part B.
- Must reflect statutory changes in Medicare.
- Cannot deny preexisting conditions after a policy has been active for 6-months.
- Must include a 30-day look back period.
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What does Medigap Plan F not cover?
There is nothing Plan F doesn’t cover. Supplement Plan F covers all the Medicare Supplement benefits for policy holders who have enrolled in Medicare Part B before January 1, 2020. For people who enroll in Medicare after Jan. 1, 2020, Plan F will no longer be available.
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How do I compare Medigap Plan F?
Comparing Medigap policies can be confusing and time consuming when vetting multiple carriers. It takes more than reading a 2019 Medigap PDF Guide to get the answers. Simplify the process by speaking with a Bridge Agent who can answer your questions and run all your Medigap comparisons for Medigap Plan F – at no cost.
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Is Medigap Plan F worth buying?
Plan F is a great option for seniors clients who want the most comprehensive senior health coverage plan available on the market. However, if you are enrolling in Medicare after Jan. 1 2020, due to this plan’s discontinued status. For people enrolled in Medicare after said date, Plan G may be the next viable option for the most coverage. When deciding between Plan F or Plan G can be time consuming! Knowing the difference in coverage and pricing for Plan F vs. Plan G can save lots of money. We recommend speaking with a Bridge Agent to review your Medicare Options and get a comparison quote to fit your needs.
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How much does Medigap Plan F cost?
As with all Medigap Plans, since they are federally standardized the only differentiating factor is based on the price you pay. Since Medigap plans vary in price, availability and carrier. Contact a Bridge Agent for a hassle-free quote!
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How do I enroll in Medigap Plan F?
Enrolling in Plan F is pretty straightforward. Once you have enrolled in Original Medicare (especially Part B), you can contact a Bridge Agent to find plans in your service area.
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How does Medigap Plan F compare with Part C Medicare Advantage (MA)?
Plan F may offer more comprehensive coverage when paired with Original Medicare & a Part D drug plan. In comparison, Plan F is only a supplemental health insurance plan unlike Medicare Advantage (Part C) which is an “all encompassing health plan”. For example, Part C may contain a drug plan within it called MA-PD vs. PDPwhich is a stand alone drug plan. Comparing Medigap vs Medicare Advantage Plans can be difficult going at it alone. After all, they are similar in that both are considered private health plans but you cannot be enrolled in both Original Medicare and a Medicare Advantage at the same time. Read about comparing Original Medicare vs Medicare Advantage
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But wait…although, Medicare Advantage Plans are appealing based on price, they can also come with a few Medicare pitfalls that may have you reconsider the real ‘advantage’. For example;
- Prices have been historically unstable.
- Your coverage will change annually.
- You could be locked-in without the future option for a Medigap Plan
- You’re responsible for out-of-network, Physician costs.
- No coverage beyond your service area.
- Must use in-network providers.
- No travel coverage.
- May need a referral to see a specilist.
Additionally, If you have a MA plan and diagnosed with a critical illness such as cancer, heart attack or stroke, costs for treatment if the hospital is out-of-network may not be covered in your plan. The max out-of-pocket only applies to covered services and could require a specialist referral. People with MA plans, think they have more coverage than they actually do unlike Medigap plans, which is considered more comprehensive senior health coverage plan.
How does Medigap Plan F work with Medicare Part D prescription drug coverage?
Since Plan F is compatible with Original Medicare, enrollees who choose this plan will also need to enroll separately in a Part D drug plan. Enrollees have a guaranteed eligibility for a Part D plan when they enroll in Plan D (on-time). It’s best to avoid the Part D Enrollment Penalty by enrolling during your initial enrollment period (also known as, IEP). Did you know that drugs administered in a Hospital setting are generally covered under your Medicare Part A? For more information on enrollments, visit the Medicare Enrollment Periods page.
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How does Dental, Vision & Hearing Insurance (DVH) work with Medigap Plan F?
Good news! Plan F is compatible with DVH plans however since they are considered standalone plans, DVH’s would need to be purchased separately. By working with a Bridge Agent, we can help you find an affordable DVH insurance plan to fit your needs.
?️ Get a DVH Plan with your Medigap Policy. Ask Bridge!
How does Medigap Plan F work with a Critical Illness Insurance for cancer, heart-attack & stroke coverage (CHAS)?
Plan F is compatible with CHAS insurance / cancer plans however since they are considered standalone plans, they would need to be purchased separately. By working with a Bridge Agent, we can help you find an CHAS and/or affordable critical illness insurance plans to fit your needs.
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How does Medigap Plan F work with a Long Term Care Insurance (LTC)?
Medigap Plan F is compatible with LTC plans however, since they are considered standalone plans, they would need to be purchased separately. There is talk about developing a new Medigap plan to include LTC coverage. By working with a Bridge Agent, we can help you find an affordable LTC insurance plan to fit your needs(LTC).
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How does Plan F work with a Health Savings Account (HSA)?
As with all Medigap Plans, Medigap Plan F is not considered a qualified expense to pay out of your Health Savings Account (HSA). However, your HSA can pay for Medicare Parts A, B, C & D. Once enrolled in Medicare, enrollees are no longer able to contribute to their Health Savings Account. However, the funds can be used to pay for qualified Medicare costs stated above. If one postpones Medicare enrollment they may still contribute to their Health Savings but enrolling late will also be subject to a Medicare Late Enrollment Penalty which is a percentage increase of costs per year. Speak with your Financial Advisor to determine what works best for you!
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Additional FAQs
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How is Medicare paid for?
Every employed or self-employed American pays for Medicare in the form of payroll taxes called the Federal Insurance Contributions Act (FICA). FICA Infographic.
In Conclusion
Plan F is only available to Medicare enrollees who have enrolled prior to January 1, 2020 due to a grandfather clause. Plan F is one of the most popular Medigap plans because it offers the most coverage including; Part B, first-dollar coverage, foreign travel and skilled nursing care coverage which is give beneficiaries the most expansive coverage anywhere. The cost of Plan F is dependent upon carrier & availability. All carriers who sell Plan F must adhere to standardized federal guidelines. Plan F is private Medicare insurance that “supplements” Original Medicare. The cost of Plan F is dependent upon carrier and availability. All carriers who sell Plan F must adhere to standardized federal guidelines. Comparing Medigap Policies can be confusing and time consuming! If you would like to speak with a licensed Bridge Agent about Plan F options, please contact us today for a free, no-obligation, comparison quote today!
Medigap Plans Previously Reviewed
Page Sources
- FL225 – Health & life (including annuities & variable contracts) Study Manual Florida 32nd Edition – 2017
- cms.gov
- medicare.gov
- offical social security
- mymedicare.gov
- US Medicare Wiki
- Medicare Wiki
- Medigap Wiki
- Medicare Advanatage Wiki
- CMS Wiki
- medicare.com
- medicare interactive
- NAIC
- FINRA
- AHIP
- SHIP
- WhiteHouse.gov
- Medicaid.gov
Checkpoint
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