Medigap Plan F and Medigap Plan G stand out as the most comprehensive options in Medicare Supplement Insurance.
While Plan F provides extensive coverage, its availability is limited.
In contrast, Plan G covers nearly as much and is accessible to all Medicare members.
Additionally, both Plans F and G offer a high-deductible Medigap plan in select states.
Due to its broader coverage, Plan F comes with a higher cost compared to Plan G.
If eligible for Medigap Plan F, individuals should weigh whether the additional coverage justifies the associated increase in price.
Understanding the distinctions between Medigap Plan F and Medigap Plan G is crucial in making an informed decision about which plan aligns best with individual needs and preferences.
Who is eligible for Medicare Supplement Plan F enrollment?
Medigap Plan F and Plan G differ in eligibility, with Plan G accessible to any Medicare beneficiary.
However, Plan F is restricted to those who became eligible for Medicare before January 1, 2020, and is not an option for new Medicare beneficiaries.
If you qualified for Medicare before 2020 and enrolled in Plan F, you are allowed to retain the plan.
Individuals eligible for Medicare before 2020 but did not enroll at that time, possibly due to employer coverage, may have the option to purchase Plan F upon Medicare enrollment.
Coverage comparison between Plan F and Plan G:
Medigap Plan F and Plan G provide nearly identical coverage, differing only in the coverage of the Medicare Part B deductible.
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Common benefits covered by the plans
- Part A coinsurance and hospital costs for an additional 365 days after exhausting Medicare benefits.
- Part A deductible.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Part B excess charges (if permitted by the provider).
- Blood transfusion for the first three pints.
- Skilled nursing facility care coinsurance.
- Medically necessary emergency health care service for the initial 60 days while traveling outside the U.S. (deductible and limitations apply).
In addition to the shared benefits, Medigap Plan F covers the Medicare Part B deductible, which is $240 in 2024.
Plan G, however, does not cover this deductible, and no Medigap plan available for those eligible for Medicare on or after January 1, 2020, covers the Part B deductible.
The primary distinction in coverage suggests minimal variations in price.
While the price difference can be modest, ranging from $10 to $20 more per month for Plan F, there are instances where the gap may be more substantial.
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Is Medigap Plan F worthwhile?
The decision to opt for Medigap Plan F over Plan G hinges on whether the additional cost for coverage of the Part B deductible is justifiable.
If the annual difference in premiums between the two plans is less than the Part B deductible (currently $240 in 2024), choosing Plan F might be financially prudent.
Otherwise, switching plans may be a consideration.
When does Plan F make sense?
If the monthly cost of Plan F is less than $20 more than Plan G, and the Medicare Part B deductible is $20 per month or less when divided over 12 months, then opting for Plan F could potentially result in cost savings in 2024.
Should I switch from Plan F to Plan G?
If the monthly premium for Plan F is $20 or more expensive than Plan G, transitioning to Plan G becomes the more cost-effective choice.
Ronald Mandela
CURRENTLY
Content Writer, Insurance Insights
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