It’s usually one of the first questions we get asked: “Which Medicare supplement will give me the most coverage?” If you’ve been learning about Medicare before reading this article, you know just about every question regarding Medicare coverage gets answered with, “It depends.”
This time, we’re going to give you a straight answer. The most comprehensive coverage you can find on the market today is Medigap Plan F.
What does this plan cover?
When paired with Original Medicare, Plan F leaves its members with virtually no out-of-pocket costs for Medicare-covered services. Plan F covers:
● Part A coinsurance
● An additional year of hospital costs once Part A benefits have been exhausted
● Part B coinsurance and copayment
● Up to 3 pints of blood
● Part A hospice coinsurance and copayment
● Skilled nursing facility coinsurance
● Part A deductible
● Part B deductible
● Part B excess charges
● 80% foreign travel exchange
Medicare supplements, also called Medigap plans, are standardized by the federal government. That means that regardless of which private insurance company you choose to purchase one from, the coverage will remain the same. The only thing the carrier is allowed to decide is how much they want to charge for the monthly premium.
How much does this plan cost?
As you may have guessed, since Medigap Plan F is the most comprehensive, it is also the most costly. Your premium will be based on where you live, your current health condition, your age and gender, and the carrier you choose to purchase the plan from.
For the average 65-year-old, Plan F ranges in price from $120 to $140 each month. Premiums can and do increase each year.
How to Enroll in Medigap Plan F
You are eligible to enroll in Medigap Plan F as soon as you have obtained coverage in Original Medicare – Part A and Part B. You are first eligible to apply for Original Medicare three months before your 65th birthday and have until three months after your 65th birthday to complete your annulment. This is called your Initial Election Period. You may apply for Medigap Plan F at any point after applying for Parts A and B. The deadline to enroll in a Medigap policy without medical underwriting is six months after your Medicare Part B effective date.
Enrolling outside of that six-month window means that you no longer have the benefit of a guaranteed issuance. That six-month window is nearly the only time that you can apply for a Medigap plan and is guaranteed acceptance by any carrier, no matter your medical condition. The carrier is also not allowed to charge you more based on your medical history.
There are a handful of other times that the guaranteed issuance applies. These instances relate to the Special Enrollment Period and if you live in a state with unique rules regarding Medigap policies. These instances are not common.
You’ve got several options in how you enroll in Medigap Plan F. The best way is to enroll through an independent agent. Independent agents are contracted with many insurance carriers, not just one. This means that they can compare rates across companies and check their history of rate increases. (After all, if Medigap plans are standardized across companies, why pay more than you need to?) Independent agents and brokers are not bound to one carrier, so their opinion is unbiased.
Otherwise, you can choose to call a carrier directly or go to the carrier’s website to enroll.
What’s the catch?
There are two important things to know if you are considering Medigap Plan F.
First, it is no longer available to those who turned (or are turning) 65 on January 1, 2020, or after. Changes were made to the Medicare program that no longer allows any plan to pay for the Part B deductible. Any Medicare beneficiary who was already enrolled in Medigap Plan F prior to January 2020 may still keep their plan. Those who delayed enrollment in Medigap may also purchase Medigap Plan F if their 65th birthday was prior to January 1, 2020.
Second, if you do fall into the group that can still purchase Plan F, you may still consider another plan. Here’s why. When Medigap plans get discontinued, enrollment drops. Fewer members in the plan mean there are fewer members to split costs. For this reason, discontinued plans will frequently raise their premiums, and usually at an accelerated rate. Since Plan F is already the most expensive on the market, it could quickly become unaffordable to its members.
Alternatives to Medigap Plan F
Medigap Plan G is the closest alternative to Medigap Plan F. It offers the same exact coverage, except it does not pay the Part B deductible.
If you are looking for comprehensive coverage but would like a lower premium, there is also a high-deductible version of both Plans F and G. Coverage in these are the same as their lower deductible counterparts but have a high deductible that members must meet before the plan helps pay for services. The high deductible does allow the plan to have lower premiums.
We said that the answer to the question posed at the beginning of this article was straightforward. It is. Plan F does offer the most comprehensive coverage. However, individuals must take into account their unique set of circumstances to decide if it is the best plan for them.