Medicare and Plan F – What You Need to Know

What is going on with Medicare Plan F?

Medicare Plan FWhere Medigap coverage is concerned, provisions of the 2015 Medicare Access and CHIP Reauthorization Act, or MACRA, have raised a number of questions. Much uncertainty now revolves around the future of the popular Medigap Plan F. Will seniors lose this valued coverage? If someone doesn’t have it yet, will that someone be out of luck?

Depending on where any one person stands with respect to Medicare eligibility, these fears may or may not be legitimate.

The Glories of Medicare Plan F

Of the 10 Medicare supplement policies available in the United States today, Plan F offers recipients of Original Medicare the greatest number of benefits. This most-comprehensive Medigap policy offers so-called “first-dollar” coverage, often paying most if not all costs remaining after Medicare Parts A and B and rewarding its beneficiaries with little to no out-of-pocket medical or hospital expenses. Many people feel that its extensive range of coverage more than justifies its higher premium cost.

Plan F is a heavy favorite with the nation’s baby boomers, and although those who already have this coverage will find themselves in luck, the MACRA provisions are giving others legitimate cause for concern.

Plan F, 2020 and You

Anyone concerned about obtaining coverage under Medicare Plan F needs to keep an eye on January 1, 2020. That is the cut-off date upon which those who do not already have Medicare Supplement Plan F or are not yet eligible for Medicare Part A will no longer have the chance to purchase this popular Medigap plan. In short, this MACRA prohibition will affect those who:

  • Have failed to obtain or apply for Plan F coverage by midnight of December 31, 2019.
  • Do not become Medicare-eligible until January 1, 2020, or any date thereafter.

For everyone else, Plan F is not going anywhere. If you’re already enrolled in this supplemental coverage, there’s nothing you need to do. You will not lose this benefit under MACRA. In addition, if you become eligible for Medicare Part A either on or before December 31, 2019, Plan F will remain available for your purchase both now and in the future.

Purchasing Medicare Supplement Plan F

All forms of Medicare supplement coverage are available only from private insurers, and the law requires none of them to offer the full range of Medigap plans. However, those who do offer Medigap at all must include Plan A, and many will also offer Plan F.

After your regular Medicare benefits run out, you can count on Medicare Plan F to cover:

  • Your Part A deductible.
  • Any hospice copay and coinsurance.
  • An extra 356 days’ worth of Part A hospital and coinsurance expenses.
  • Your Part B deductible, coinsurance and excess charges.
  • Coinsurance payments for care at skilled nursing facilities.
  • Emergency foreign-travel medical needs.
  • Up to three pints of blood each year when needed during sanctioned medical procedures.

Despite the similarities in coverage, Plan F premiums themselves will often vary between insurers and in different areas of your state. In addition, a Plan F variation does afford lower premiums in exchange for a higher deductible. The covered benefits, however, remain the same.

While most Medicare beneficiaries do have access to less-expensive Medigap plans, those with extensive medical needs entailing frequent doctor visits or hospitalizations appreciate the ability of Plan F coverage to minimize or eliminate excessive out-of-pocket expenditures.

The benefits of Plan F will not always extend to each of your Original Medicare costs. You will still be responsible for meeting your Part B premiums, and unless you qualify for premium-free Part A, you must continue to pay for that as well.

Medicare Supplement Plan G

As a Medigap alternative to Plan F, the comparable Plan G could soon become one of Medicare’s more popular supplement plans. With the exception of the Part B deductible, it provides coverage similar to that currently available through Plan F. For seniors adversely affected by MACRA Medigap coverage restrictions, this should come as extremely good news.

Getting the Medigap coverage you need at the most attractive price entails comparing prices between the various plans and insurance carriers to find which ones offer the savings and benefits you want. At All Kinds of Insurance, we do the heavy lifting for you, using our extensive acquaintance with numerous insurers to find you the coverage that suits you best.

Don’t let MACRA’s prohibitions leave you in the cold. If you’re currently eligible for Medicare Part B, you’re still in the running for Medigap Plan F. Call All Kinds of Insurance today at 702-534-4697 let us help you get this valuable coverage while you still can.