What Seniors Are Choosing If They Can't Access Medigap Plan F
Before 2020, Medicare Supplement (Medigap) Plan F was by far the most popular option for Medigap beneficiaries.
That was because Plan F was the most generous of all the Medigap plans available on the market. It essentially covered all the gaps in Original Medicare, providing "first dollar" coverage for all services covered under Medicare.
Plan F was popular because you could have a doctor visit, diagnostic tests run, X-rays, an MRI, or even an extended hospital stay, and everything would be covered. With Plan F, you would pay nothing out of pocket.
But as generous as Plan F is, it was perhaps too good to last. Beginning in 2020, federal officials closed Plan F and the similar Plan C to new enrollees. Anyone who becomes eligible for Medicare during or after the year 2020 will need to find another solution.
(Note: Medigap providers in Massachusetts, Wisconsin and Minnesota standardize their plans differently than the rest of the country.)
New enrollees
If you are not already enrolled in Plan F, but you still want the broadest coverage available, consider Medicare Supplement Plans G or N. Both these plans provide similar benefits to Plan F, though at a lower premium.
Plan G vs. Plan F The key differences between Plan F and Plan G are these:
- Plan G does not cover the Part B deductible, which is $203 as of 2021. You must pay the first $203 of any covered services under Part B before your Medigap Plan G will pay benefits.
- If your doctor charges more than the Medicare-authorized reimbursement rate, Medigap Plan F covers these excess charges. But under Medicare Plan G, you'll have to pay them yourself.
- Some states offer a high-deductible Plan G. With this option, you must pay for Medicare-covered costs (coinsurance, copayments and deductibles) up to $2,370 (in 2021) before your policy begins to pay benefits. However, your monthly premiums will be lower.
Plan N This plan also provides a broad set of protections similar to Plan F. There are important differences, however:
- Like Plan F, Plan N does not cover your Part B deductible or "excess charges" from physicians.
- Plan N covers your 20% coinsurance under Plan B. However, you would still have a $50 deductible for emergency room visits that don't result in hospital admission.
- You may have to cover an out-of-pocket copay for doctor's visits of up to $20.
Current Plan F Enrollees
Existing enrollees are grandfathered in. That means if you were already enrolled in Plan F before 2020, you can keep it. As long as you pay premiums, you'll remain enrolled in Plan F until you choose to change your coverage.
However, you should monitor your premiums as they are reset every year. Since younger enrollees are now being blocked from the plan, the average age of your risk pool rises.
Premiums may start to increase to reflect higher health care costs. Call us for more information.
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