Some medical costs are not covered under original Medicare. As a result, people may buy supplemental plans such as Plan F to cover these payment gaps. The cost and availability of these plans, commonly called Medigap coverage, vary by state and by the insurance provider. People covered under a Medicare Advantage Plan like a Health Maintenance Organization cannot use Medigap plans.
Plan F Coverage
Anyone eligible for Medicare who has both parts A and B is eligible to buy Plan F as his Medigap coverage. The plan covers the same basic items no matter which insurance company is selling it. Basic coverage includes: Part A coinsurance and hospital costs for 365 days after Medicare benefits have run out; Part B copayment; three pints of blood; hospice care copayment for Part A; skilled nursing care coinsurance; deductibles and excess charges over and above other parts A and B limits. Coverage is somewhat different in Massachusetts, Wisconsin and Minnesota.
Cost of Coverage
Plan F comes in two forms: standard deductible and high deductible. Cost of the high-deductible policy is lower, but you must pay your annual deductible before Plan F starts paying. In 2015, that means you’ll pay $2,180 out of your pocket before your coverage begins. Either way, the cost of Plan F varies depending on which insurance company is selling it.
Availability of Plan F
The availability of Plan F varies by insurance carrier. It is generally up to the insurer as to whether or not to offer any plan, including Plan F. According to the publication Choosing a Medigap Policy, availability of plans will vary by state, so Plan F may or may not be available where you live. Insurance companies that sell Medigap coverage must offer Plan A, and if they offer more than Plan A then Plan C or Plan F must also be available.
Medigap coverage is priced several different ways. Your plan might be “community rated,” where everyone pays the same rate; “issue age rated,” where your rate depends on your age at the time of purchase will remain the same thereafter; or “attained age rated,” where your premium increases as you get older. The Medicare.gov site recommends that you buy a Medigap coverage plan when you first become eligible for Medicare, as you may find the price is much higher or that insurers will refuse to sell to you entirely if you delay.
- Centers for Medicare and Medicaid Services: What is a Medicare Advantage Plan?
- Centers for Medicare and Medicaid Services: Choosing a Medigap Policy -- A Guide to Health Insurance for People with Medicare
- Medicare.gov: Costs of Medigap Policies
- Medicare.gov: Medicare Supplement Insurance
- Medicare.gov: How to Compare Medigap Policies
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