What Is Medicare Plan F?

Medicare Plan F, also known as Medicare Part F or Medicare Supplement Plan F, offers the most comprehensive benefits of all lettered Medigap plans, including gap coverage for deductibles, copays, and coinsurance. Medicare Plan F is offered through private insurers but is no longer available to enrollees who became eligible for Medicare after Dec. 31, 2019.

Understanding Medigap

Medicare Supplement Plans (Medigap) help cover the gaps in coverage provided by Medicare Parts A and B. Original Medicare (Parts A and B) cover hospital, preventive, and outpatient care, respectively. However, some beneficiaries struggle to pay out-of-pocket expenses. Therefore, there are up to ten (lettered A through F) different Medigap plan options to help pay for these costs, depending on where you live.

How Does Medicare Plan F Work?

Medigap works alongside Medicare to supplement out-of-pocket costs, including deductibles, copayments, and coinsurance. You can purchase Medigap upon initial enrollment in Medicare, when you first receive Part B benefits or add it later to your Original Medicare coverage. Medigap provides financial, not medical, benefits. Keep in mind that you cannot hold Medicare Advantage and Medigap plans at the same time.

Eligibility

New enrollees (after Dec. 31, 2019) cannot get Plan F. People who enrolled in Medicare Plan F before this date may keep their coverage purchased through a private insurer for an additional cost. The Medigap open enrollment period occurs during the first six months of Part B benefits.

You may still be eligible to purchase Medicare Part F if you turned 65 before Dec. 31, 2019, but never enrolled in Medicare. In this case, you would need to enroll in Medicare Part B during the annual enrollment period and then potentially purchase Plan F during the Medigap open enrollment period, if it is available in your state, once Part B benefits kick in.

Coverages

Medicare Supplement Plan F is especially popular for its comprehensive coverage, which pays for more out-of-pocket costs than any other Medigap plan. Part F includes the following benefits:

Part A coinsurance and hospitalization of up to 365 days after exhaustion of Medicare benefits
Part A deductible
Part A hospice care coinsurance and copays
Part B deductible
Part B coinsurance and copays
Part B excess charges
Skilled nursing facility coinsurance
Up to 3 pints of blood

What Medicare Plan F Does Not Cover

While Medicare Plan F is the most inclusive Medigap plan, it does not extend medical services beyond Original Medicare, such as dental, hearing, or vision care. The following benefits are excluded from Plan F:

Prescription drugs
Routine or preventive vision care
Routine or preventive dental care
Cosmetic (non-medically-necessary) surgery
Routine hearing services, including hearing tests and hearing aids

How Much Does Medicare Part F Cost?

While Medicare Part F offers the same benefits wherever you live, costs may vary by location. Other factors affecting Medigap’s cost include your age, health, gender, and smoking habits. You must pay monthly Medigap premiums and annual deductibles and maintain Part B premiums to enjoy the benefits of your Medicare supplement plan.

The cost of monthly premiums for Medicare Part F averaged $187 in 2022, though prices vary by provider. Some insurers require underwriting to assess Plan F eligibility.

Are Medicare Part F Premiums Tax-Deductible?

Yes, Medicare Part F premiums can be deducted from your federal income taxes. Generally, you may deduct out-of-pocket costs, including Medicare premiums, deductibles, and copays, provided these expenses exceed 7.5% of your adjusted gross income. You must itemize the out-of-pocket expenses according to the necessary schedule sheets on your taxes to qualify for a deduction.

Should You Get Medicare Plan F?

New enrollees cannot purchase Medicare Plan F, but you can still enroll if you became eligible for Medicare before 2020.

Consider Getting Medicare Plan F If…

You turned 65 or otherwise became eligible for Medicare before Dec. 31, 2019
You plan to use Original Medicare for frequent outpatient and routine medical care (Part B) and inpatient care (Part A) over the next year
You prefer a plan with comprehensive benefits, including coinsurance for hospice and nursing facility care
You may need coverage while traveling to a foreign country
You need a plan to pay your Part B deductible
You live in a state that allows providers to assign excess charges for Part B services

Advantages

Medicare Plan F offers the most widespread coverage of any Medigap plan. The following are among the many standout advantages of Part F:

Coverage for all out-of-pocket expenses
One of only two Medigap plans to cover excess Part B charges
It offers a special initial Medigap enrollment period after you start receiving Part B benefits

Disadvantages

Despite its many benefits, Medicare Plan F availability is minimal for existing Medicare beneficiaries and closed to new enrollees. Part F comes with the following disadvantages:

Not available to people who became eligible for Medicare after Dec. 31, 2019
May require underwriting for eligible enrollees who delayed signing up for Medicare
Not available in all states
May require higher costs, especially through insurers with no high-deductible option

How to Get Medicare Part F

Research Medicare Part F availability in your state. If you were eligible for Medicare before 2020 but never enrolled in Original Medicare and/or Medigap, you may be able to purchase Plan F coverage if it is available in your state. Use the Medicare.gov search tool or contact your preferred private insurance company to compare rates for Plan F.
Prepare for the Medigap enrollment period. If you already have Medicare but not Medigap, you can add or change Medigap coverage anytime throughout the year. If you were eligible for Medicare before Dec. 31, 2019, but have yet to sign up, you can enroll in Original Medicare during open enrollment. You have six months after activating Part B benefits to enroll in Part F.
Enroll in your preferred Part F plan. Once you choose the right Plan F coverage, you may enroll in person, by phone, by mail, or online, depending on your insurer’s individual enrollment options. Consider consulting with a Medicare agent or insurance representative before closing the deal.

Alternatives to Medicare Plan F

While access to Medicare Plan F is limited to pre-2020 enrollees, there are several comparable alternatives for newer Medicare beneficiaries.

High-Deductible Plan F

High-Deductible Plan F is an option for those eligible for Medigap before 2020. A high-deductible plan typically includes lower monthly premiums than the standard Plan F but requires beneficiaries to pay all out-of-pocket expenses up front toward meeting the deductible. The standard Plan F and High-Deductible Plan F offer the same essential benefits.

Medicare Plan G

Medicare Plan G is the most similar to Medicare Plan F. Plan G offers all of the same benefits as Part F, except for covering the Part B deductible. The exclusion of this popular benefit generally means lower monthly premiums for Plan G than Medicare Plan F. Most states carry Plan G as an alternative to Plan F.

Plan G is the only Medigap plan besides Part F to cover Part B excess charges. You may be responsible for excess charges if your provider charges more for Part B medical services than Medicare will cover, which providers are legally allowed to do in some states. If you live in a state that permits excess charges, Medicare Plan G can provide a sensible Plan F alternative.

Other Medicare Supplement Plans

You can choose from various Medigap plans if you do not qualify for Plan F. Popular alternatives include Plan N, which offers Part A deductible coverage, and Plan G, which covers excess Part B charges, comparable to a Part F plan. You might start by verifying whether either or both plans are available in your state to understand your options.

A few states — Massachusetts, Minnesota, and Wisconsin — operate independently and offer their own Medigap plans with non-standard regulations. In all other states, Medigap standardizes its lettered plans, which means the coverage remains the same regardless of where you live; however, your location does affect the cost and availability of Medigap plans.

Putting It All Together

Medicare Supplement Plan F offers the most comprehensive coverage of all ten Medigap plans; however, it is only available to people who became eligible for Medicare before 2020. New enrollees can enjoy similar benefits through alternatives such as Plan G or N.

Plan F is especially popular for its extensive coverage of out-of-pocket costs, including the Part B deductible. While the cost of such coverage can be expensive, Medigap offers a high-deductible Plan F to help lower monthly premium costs for those who qualify. Check Medicare.gov or contact your insurance agent for available Medigap plans in your state.

Frequently Asked Questions

You may keep your Plan F coverage and switch providers at any time, but remember that your new provider may require you to undergo an underwriting process when you apply for a new plan.

Yes, however, the enrollment process may not be as smooth and seamless as signing up back then. Enrolling in Plan F when you were first eligible is the only way to avoid a potential underwriting requirement.

You may have Medicare and employer coverage simultaneously, but this scenario requires your insurers to establish a primary and secondary payer system. Typically, Medicare pays first if your employer has 100 or fewer employees, and your employer pays first if it is larger than 100 employees. Employers may reimburse you for Medigap premiums if they have a Section 105 plan in place. You can also have Medicare and VA benefits simultaneously, though each will only pay for services provided at an approved Medicare or VA facility, respectively.

Yes, suppose you became eligible but did not enroll in Medigap until after the initial enrollment period or decide to switch plans. In that case, you are subject to underwriting for new health conditions, which enables insurers to deny or charge more for coverage at their discretion.

You can only enroll in Plan F if you turned 65 or were otherwise eligible for Medicare before Dec. 31, 2019, but did not buy a Medigap plan during the initial enrollment period. No special circumstances allow new enrollees to join Plan F or High-Deductible Plan F.

Understanding Medicare Plan F