Medicare Plan F covers most of what Original Medicare leaves you to pay

Medicare Plan F is a Medigap policy sold by private insurance companies. It pays most of the costs that Original Medicare (Part A and Part B) does not cover — copayments, coinsurance, and deductibles. Plan F is the most comprehensive Medigap option available, which is why it typically costs more than other plans.

Plan F is no longer sold to people who became may be able to access for Medicare on or after January 1, 2020. If you enrolled in Plan F before that date, you can keep it. If you are newly may be able to access, Plan G is the most comprehensive option available to you.

This guide explains what Plan F covers, what you still pay, and how it works alongside Original Medicare.

Key Takeaways

  • Plan F covers the Part A deductible, Part B deductible, copayments for hospital stays and doctor visits, and coinsurance for skilled nursing facilities.
  • You still pay Plan F premiums to the insurance company every month, separate from your Medicare Part B premium.
  • Plan F does not cover dental, vision, hearing aids, or long-term care — those require separate coverage or out-of-pocket payment.
  • Plan F only works with Original Medicare; you cannot use it with Medicare Advantage plans.
  • If you became may be able to access for Medicare after January 1, 2020, you cannot purchase Plan F; Plan G is the next most comprehensive option.

What Plan F pays for you

Plan F covers the Part A deductible, which is the amount you pay before Original Medicare starts covering inpatient hospital care. In 2024, that deductible is $1,632 per benefit period. Plan F pays this in full.

Plan F also covers the Part B deductible, the amount you pay before Medicare covers doctor visits and outpatient services. In 2024, that deductible is $240. Again, Plan F pays this entirely.

For hospital stays, Plan F covers copayments for days 1 through 60 of a hospital stay in each benefit period, and coinsurance for days 61 through 90. It also covers the cost of up to 365 additional hospital days after you have used your lifetime reserve days under Medicare.

Plan F covers copayments for doctor visits and other Part B services. It also pays coinsurance for skilled nursing facility care — the amount you owe after Medicare covers the first 20 days of a stay.

Plan F covers blood transfusions (the first three pints per year) and hospice care copayments. It also covers foreign travel emergency care up to a limit of $250 per year if you are traveling outside the United States.

What Plan F does not cover

Plan F does not cover dental work, vision care, or hearing aids. Original Medicare does not cover these services, and Medigap plans cannot fill that gap. If you need dental or vision coverage, you must purchase a separate dental or vision plan.

Plan F does not cover long-term care — nursing home stays, assisted living, or home health aides for non-medical reasons. It also does not cover prescription drugs. You need a separate Part D plan for prescription coverage.

Plan F does not cover services that Original Medicare does not cover, such as routine foot care, cosmetic surgery, or acupuncture (with rare exceptions). It also does not cover care received outside the United States, except for the limited foreign travel emergency benefit mentioned above.

How Plan F premiums work

Plan F premiums are separate from your Medicare Part B premium. You pay your Part B premium to Medicare, and you pay your Plan F premium to the private insurance company that sells the plan. Premiums vary by insurance company, by your age, by your location, and sometimes by your health status at the time you enroll.

Premiums can increase each year. Some insurance companies use community rating, meaning everyone in your area pays the same premium regardless of age. Others use age-based rating, meaning your premium increases as you get older. A few use issue-age rating, meaning your premium is based on your age when you first enroll and does not increase with age, only with inflation and claims experience.

You can compare Plan F premiums from different insurance companies in your area. Rates change annually, so it is worth shopping each year during the annual enrollment period (October 15 to December 7) to see if a different company offers better value.

How Plan F works with Original Medicare

When you have Plan F, you continue to use Original Medicare for all your care. You show your Medicare card to your doctor or hospital, and Original Medicare pays its share first. Then Plan F pays what Original Medicare does not cover, up to the limits of the plan.

You cannot use Plan F with Medicare Advantage (Part C). If you are enrolled in a Medicare Advantage plan and want to switch to Original Medicare with Plan F, you must disenroll from the Advantage plan first. Open enrollment periods and special circumstances may allow you to make this switch.

Plan F works the same way whether you are receiving care in a hospital, a doctor's office, an urgent care center, or a skilled nursing facility — as long as the provider accepts Medicare, Plan F will cover its portion of the bill.

Plan F enrollment and timing

If you became may be able to access for Medicare before January 1, 2020, you can enroll in Plan F during your initial enrollment period (the six-month window around your 65th birthday) or during the annual enrollment period. You can also enroll during a special enrollment period if you lose other coverage.

Some insurance companies will not enroll you in Plan F if you have certain pre-existing conditions, depending on your state's rules. However, if you enroll during your initial enrollment period, insurance companies cannot deny you or charge you more based on health status.

If you miss your initial enrollment period and enroll later, you may face a higher premium or denial of coverage in some states. Timing matters, so contact an insurance company or your State Health Insurance information Program (SHIP) for guidance on your specific situation.

Plan F versus Plan G

Plan G is nearly identical to Plan F, with one key difference: Plan G does not cover the Part B deductible. In 2024, that deductible is $240. If you became may be able to access for Medicare after January 1, 2020, Plan G is the most comprehensive Medigap option you can purchase.

For people who became may be able to access before that date, the choice between Plan F and Plan G depends on the premium difference in your area. If Plan F premiums are only slightly higher than Plan G, Plan F may be better value because it covers the Part B deductible. If Plan G premiums are much lower, Plan G may save you money overall, even accounting for the $240 deductible you will pay each year.

Both plans cover the same hospital and skilled nursing facility costs. The main trade-off is the Part B deductible.

Frequently Asked Questions

Does Plan F cover my prescription medications?

No. Plan F does not cover prescription drugs. You need a separate Medicare Part D plan for prescription coverage. You can enroll in Part D when you first become may be able to access for Medicare, or during the annual enrollment period. If you delay enrolling in Part D without other creditable coverage, you may face a penalty.

Can I use Plan F with Medicare Advantage?

No. Plan F is a Medigap policy that works only with Original Medicare. If you are enrolled in a Medicare Advantage plan, you cannot use Plan F. You would need to disenroll from the Advantage plan and switch to Original Medicare first.

What happens if I move to a different state?

Medigap policies are regulated by state, so your Plan F may not be available in your new state, or the coverage may differ slightly. You will need to contact insurance companies in your new state to see what plans they offer. You may be able to switch plans during a move without penalty, depending on your state's rules.

Will my Plan F premium go up every year?

Most likely, yes. Premiums typically increase annually due to inflation and claims experience. The amount of the increase varies by insurance company and rating method. You can shop for a new Plan F from a different company each year if a competitor offers a lower rate.

Does Plan F cover care outside the United States?

Plan F includes a limited foreign travel emergency benefit that covers up to $250 per year for emergency care received outside the United States. This is not comprehensive international coverage. If you travel frequently outside the U.S., ask your insurance company about additional options.