As we make our ranks through the various Medicare supplement insurance plans available, it only fits that we spend more time on the most popular plan available…the F Medigap plan. Not only is it the most popular Medicare supplement plan by far (estimated around 80% of Medicare supplement subscribers) but we highly endorse it for some very important reasons. Let’s take a look at the benefits of the F plan and find out why it’s such a strong candidate.
Before we jump in, there are a few key concerns or “gaps” in traditional Medicare coverage. We’ll look at each segment in detail but the F plan is the only Medigap plan to cover all the important gaps in coverage. Let’s start with the biggest gaps in coverage and see how the F plan will deal with them.
When you think of traditional health care costs, you’ll find yourself contemplating the usual suspects..hospitals, doctors, and labs. Hospital and facility care is by far the most expensive part of the equation. This is where the liability of not having a Medicare supplement plan can runs 10’s of thousands dollars pretty quickly. We’ll break down the core pieces first. These expenses are broken up into two main pieces: hospital and facility based care which falls under the Part A of Medicare umbrella and physician costs (including associated labs, x-rays, etc) which fall under Part B. Medicare deals with both of these sections with items familiar to most people who have had health insurance during their lives. First you have a deductible for either Part A or Part B. This is an amount (indexed to go every year) you must pay before getting help with medical expenses. The Part A deductible for hospital is much higher than for Part B which correctly reflects the underlying costs both must cover. After the deductible is met, you will pay 20% of the remaining calendar year expenses. This is called co-insurance. The F plan covers both deductibles and both co-insurances in total. Many of the other Medicare supplement plans will cover some but not all of these four separate pieces. The F plan will cover all four which is a baseline of coverage needed when looking for a plan. Let’s look at the other main items with traditional gaps within Medicare.
The F plan, again, covers all the main gaps in Medicare. Following Part A and B, the most critical of these is Excess which reflects an additional amount that Medicare providers can charge. That means you could pay the 15% above what Medicare allows and there is ceiling to this amount. F plan covers this potential 15%. We’ll continue on down the line starting with the more significant benefits. Next in line would be Skilled Nursing facility care and Hospice care. Both are critical since they can involve facility based health care expenses and as we mentioned, that where’s the real costs can be. The F plan will cover both items in terms of filling in the gaps for these items.
The plan also covers the remaining gaps in traditional Medicare coverage. This includes the first 4 pints of blood, foreign emergency travel insurance, and of course, preventative coverage. This rounds out the main gaps that Medicare supplemental plans are created to fill in. Keep in mind that Medicare ultimately dictates if something is covered or not and a Medicare supplemental insurance plan will only fill in gaps for medical bills that Medicare has made eligible and paid their portion of. A Medigap plan will not pay above beyond benefits of what Medicare allows.
This is the deal. To cover 100% of the gaps in Medicare with the F plan, you will pay 10’s of dollars per month depending on your age and the plan we’re comparing it against. The potential financial risk is not worth a few bucks per month. As you get older, the difference in cost goes up but so does the chance actually using the expenses. The trade-off continues to make sense as you get older. It’s hard to argue against the F plan versus other Medicare supplement insurance plans but we’re happy to walk through the differences with you as it pertains to your particular situation.