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Medigap Plan F

Plan F provides the broadest coverage of the 10 standard Medigap plans and is the most popular of the plans with 50% of covered lives.1 Costs such as the deductibles for Medicare hospitalization (Part A) and medical services (Part B) are covered by Plan F. The table below summarizes the key benefits of Plan F.

Plan F Coverage
Medicare Part A Deductible100% coverage
Medicare Part B Deductible100% coverage
Medicare Part B “Excess Charges”*100% coverage
Copayment or Co-Insurance Fee for Medicare Part B services100% coverage
Part A Co-Insurance Fees & Hospital Costs for up to 365 days after Original Medicare Benefits are Exhausted100% coverage
Cost of first 3 Pints of Blood100% coverage
Copayment or Co-Insurance Fee for Medicare Part A Hospice Care100% coverage
Co-Insurance Fees for Skilled Nursing Facility Care100% coverage
Foreign Travel Medical Emergency Coverage (up to plan limits)Yes
Annual Limit on Enrollee Out-of-Pocket Expenses?Not applicable

An “Excess charge” is the amount a healthcare provider is legally allowed to charge you above the Medicare-approved amount for a covered medical service.

Only Medigap plans F and G cover excess charges.

No Medigap plan currently available for purchase includes prescription drug coverage. In order for a Medigap enrollee to obtain drug coverage, he or she would need to buy a Medicare Part D plan.

Medigap Plan F - High Deductible

There is an alternative version of Plan F known as “high deductible Plan F.” In this option, the enrollee pays all Medicare out-of-pocket costs until the Plan F deductible is satisfied. After the deductible is satisfied, the Plan F policy will pay all of the out-of-pocket costs described in the table from the previous section.

However, enrollees in high deductible Plan F must also pay a separate deductible ($250 per year) for any emergency medical services they used while traveling in a foreign country.

The Plan F deductible amount in 2014 is $2,140. In 2012 less than 3% of Plan F enrollees chose the high-deductible version of Plan F.2

1 The 50% statistic is based on 2012 data. See http://www.markfarrah.com/healthcare-business-strategy/Med-Supp-Enrollment-Tops-10-Million.aspx.
2 Ibid.

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