Medicare Supplement Plan F

By: Agnus Smith
Published: Thursday, July 26 2018
Last Updated: 4 years ago

Medicare supplement plan F covers other medical costs that Medicare Parts A and B do not cover. According to the Association for Medicare Supplemental Insurance, as of 2017, nearly 14 million people in the U.S. owned a Medicare Supplemental Insurance plan. Of that number, nearly 40% had Medicare Supplement Plan F.

What Is Medicare Plan F?

Medicare Supplement Plan F is known also as the Medigap plan F. This is a supplemental private insurance which can be purchased through most insurance companies. Of the 10 Medigap plans that are offered, Medigap plan F is one of the most popular supplemental insurances because it allows an individual more vigorous choices when there is a need for covering any out-of-pocket expenses.

Medigap plan F specifically covers the gaps in coverage of Original Medicare Parts A and B. This allows a person to have the ability to complete their medical care without incurring any additional costs in most cases.

What Does Medicare Supplemental Plan F Cover?

As a supplement to Medicare Parts A and B, Medicare supplemental plan F will cover the 20% of additional medical expenses that a person incurs that are not approved through Original Medicare. This means that if a doctor submits a bill to Medicare, and the charges are considered to be beyond the scope of the Medicare guidelines for Parts A and B, then under Medicare Supplement Plan F, the unapproved expenses will be paid.

This can include extended hospital stays that require a patient be moved to a rehabilitation facility or skilled nursing care. The Medicare Plan F even covers emergency care overseas. All of the excess cost associated with these types of circumstances are covered for the first 100 days of care by Medicare Plan F. The following are just some of the specific charges covered by Medicare supplemental plan F:

  • Hospitalization deductibles
  • Hospice care copays
  • Initial three pints of blood during hospitalization
  • Semi-private hospital room
  • Hospital and outpatient service general supplies (including medical equipment)
  • Physical therapy (including speech therapy)
  • Diagnostic testing
  • Additional costs for doctor visits

What Doesn’t Medicare Plan F Cover?

The Medicare supplement Plan F does not give prescription coverage. This is offered through Medicare Advantage or Medicare Part D.

It also does not cover the monthly cost of premiums for Medicare plans A and B if you did not work at least 10 years prior to Medicare enrollment which would qualify you for premium-free Medicare under Parts A and B. This is not considered an out-of-pocket expense under the Medicare plan F coverage.

How Much Does Medicare Supplemental Plan F Cost?

The premium for Medicare Plan F varies by state as well as the zip code and county that you reside in. The private insurance company that you choose to purchase your Medicare supplemental plan F through will also qualify an individual’s rate based on whether you are a smoker.

Each insurance company will also look at the annual number of medical claims for the person based on specific medical procedures and compare them to the increases in the cost of those procedures over that period of time. That cost increase is then factored into the Medicare Plan F’s comprehensive structure and an annual premium is created based on these factors.

If you are someone who can afford to pay for some out-of-pocket expenses, a Medicare Plan F with a higher deductible (an HDF) is available which will offer a lower monthly premium rate.

As of 2018, the higher deductible that needs to be met before the Medicare plan F begins to pay for additional medical costs is $2,240. Once this is met, the basic benefits of Medicare Plan F begin and do not vary with each insurance company. The deductible and premium with an HDF can go up over time, so this must be considered when choosing between the HDF plan and the traditional Medigap plan F.

Who Should Consider Medicare Plan F Coverage?

Enrollment in Original Medicare automatically creates an Open Enrollment Period for Medigap plan F on the very first day of Medicare coverage. Anyone who is considering the Medicare plan F coverage should take their current health status into consideration. This means realistically assessing what kind of medical issues could occur that will result in needing coverage for additional medical costs.

Ask yourself if you have any pre-existing conditions that are controllable for an extended period of time. If the answer is that you may need to consider some long-term care in the near future, then you should consider the Medicare plan F coverage for those costs.