Medicare Plan F is a Medigap policy that covers most of the costs Medicare Part A and Part B don't pay

Medicare Plan F is a supplemental insurance policy sold by private insurers. It works alongside Original Medicare (Part A and Part B) to cover the gaps — the deductibles, copayments, and coinsurance that Medicare leaves you responsible for. Plan F is one of the most comprehensive Medigap options available, which is why it has historically been popular with people who want predictable, low out-of-pocket costs.

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 became may be able to access before that date, you can still enroll in or switch to Plan F. If you became may be able to access after that date, Plan G is the most comprehensive option available to you instead.

Key Takeaways

  • Plan F covers Medicare Part A deductibles, Part B deductibles, copayments, and coinsurance for hospital and doctor visits.
  • Plan F does not cover dental, vision, hearing aids, or long-term care — those require separate coverage or out-of-pocket payment.
  • You must have both Original Medicare (Part A and Part B) and Plan F to use the coverage; Plan F does not work with Medicare Advantage.
  • Plan F premiums, deductibles, and coverage vary by insurance company and by state, so comparing quotes from multiple insurers is important.
  • If you became may be able to access for Medicare after January 1, 2020, you cannot enroll in Plan F; Plan G is the comparable alternative.

What Plan F Actually Covers

Plan F covers the Part A deductible — the amount you pay before Medicare hospital insurance kicks in. It also covers Part B coinsurance, which is the percentage of doctor visit costs you would normally pay after you meet your Part B deductible. If you need a hospital stay, Plan F covers the daily copayment amounts for days 61 through 90 of your hospital stay, and for an additional 60 "lifetime reserve days" that Medicare provides.

Plan F also covers skilled nursing facility coinsurance — the copayment for days 21 through 100 of a stay in a nursing home after a hospital stay. It covers the Part B deductible, which is the amount you must pay out of pocket before Part B coverage begins. Additionally, Plan F covers excess charges, which are amounts that some doctors charge above what Medicare allows. This protection is valuable if you see doctors who do not accept Medicare's approved amount as payment in full.

Plan F does not cover dental work, vision care, hearing aids, or long-term care. It also does not cover prescription drugs — you need Medicare Part D (a separate prescription drug plan) for that coverage.

How Plan F Works With Original Medicare

Plan F is a supplement to Original Medicare, not a replacement. You must be enrolled in both Medicare Part A and Part B to use Plan F. When you see a doctor or go to the hospital, Medicare processes the claim first and pays its share. Then Plan F processes the same claim and pays the portion that Medicare did not cover, up to the limits of your Plan F coverage.

You pay a monthly premium to both Medicare (for Part B) and to the private insurance company that sells your Plan F policy. The insurance company sets the Plan F premium, so the cost varies widely depending on which company you choose and which state you live in. Some insurers use age-based pricing, meaning your premium increases as you get older. Others use community rating, meaning everyone in your state pays the same premium regardless of age.

Plan F cannot be combined with Medicare Advantage (Part C). If you have a Medicare Advantage plan, you cannot also have Plan F. You would need to switch back to Original Medicare first.

Plan F vs. Plan G: Which One Is Available to You

Plan G covers nearly everything Plan F does, with one important difference: Plan G does not cover the Part B deductible. Instead, you pay that deductible out of pocket. For people who became may be able to access for Medicare before January 1, 2020, Plan F is still an option. For people who became may be able to access on or after that date, Plan G is the most comprehensive Medigap choice available.

In practice, the choice between Plan F and Plan G often comes down to premium cost. Plan F premiums are sometimes lower than Plan G premiums, but not always — it depends on the insurance company and your state. Some people find that the lower Plan F premium makes up for the lack of Part B deductible coverage in Plan G. Others find that Plan G's premium is worth paying to avoid the Part B deductible. Comparing quotes from multiple insurers for both plans will show you which makes more financial sense for your situation.

How to Find and Compare Plan F Quotes

Plan F is sold by private insurance companies, not by Medicare directly. You can contact insurers in your state individually, or you can use Medicare's Plan Finder tool at Medicare.gov to see which companies offer Plan F in your area and compare their premiums side by side. The Plan Finder shows you the monthly cost for each plan option, but you will need to contact the insurance company directly to ask about any discounts (such as discounts for paying by automatic bank withdrawal or for not smoking).

You can enroll in Plan F during your Initial Enrollment Period, which is the seven-month window that begins three months before the month you turn 65. You can also enroll during the annual Open Enrollment Period for Medigap, which runs from October 15 to December 7 each year. Outside these windows, insurance companies can deny your process or charge you a higher premium based on your health history, so timing matters.

What Plan F Does Not Cover

Plan F covers gaps in Medicare, but it does not cover services that Medicare itself does not cover. Dental cleanings and fillings, routine vision exams and eyeglasses, and hearing aids are not covered by Medicare or by Plan F. If you need these services, you can purchase separate dental, vision, or hearing coverage, or pay out of pocket.

Plan F also does not cover long-term care — nursing home care, assisted living, or in-home care for non-medical reasons. If you think you may need long-term care in the future, you may want to explore long-term care insurance separately, though these policies have age and health restrictions and can be expensive.

Prescription drugs are not covered by Plan F. You must enroll in a separate Medicare Part D prescription drug plan. You can enroll in Part D during your Initial Enrollment Period or during the annual Open Enrollment Period. If you do not enroll when you are first may be able to access and do not have other creditable drug coverage, you may pay a penalty when you do enroll.

Plan F Premiums and Costs Vary Widely

Plan F premiums differ significantly by insurance company and by state. In some states, Plan F premiums are higher than Plan G premiums; in others, they are lower. Age, location, and the insurance company's pricing method all affect what you pay. Some insurers offer discounts for automatic bank withdrawal, non-smoker status, or household enrollment of multiple family members.

Because Plan F is no longer sold to new Medicare beneficiaries, some insurance companies have stopped offering it or are raising premiums on existing Plan F enrollees. If you have Plan F now, you can usually keep it, but you should review your premium each year during Open Enrollment to see if switching to Plan G or another Medigap plan would save you money.

Frequently Asked Questions

Can I switch from Plan F to another Medigap plan?

Yes. You can switch to another Medigap plan during the annual Open Enrollment Period (October 15 to December 7) without being denied or charged more based on your health. Outside this window, the insurance company can use your health history to decide whether to accept you and what to charge. If you are switching away from Plan F, the insurance company cannot deny you or charge more — but if you are switching to Plan F from another plan, they can.

If I have Plan F, do I still need to enroll in Part D for prescriptions?

Yes. Plan F covers gaps in Medicare, but it does not cover prescription drugs. You must enroll in a separate Medicare Part D plan. You can enroll during your Initial Enrollment Period or during the annual Open Enrollment Period. Delaying enrollment without other creditable drug coverage can result in a permanent penalty.

What happens to my Plan F if I move to a different state?

Your Plan F coverage ends when you move out of state. You will need to enroll in a new Medigap plan in your new state. Contact your current insurance company to find out when your coverage ends, then use Medicare's Plan Finder to see which plans are available in your new location. You have a may provide issue period (usually 30 to 60 days) to enroll in a new plan without being denied or charged more based on health.

Is Plan F the same as Medicare Part F?

No. Plan F is a Medigap supplemental policy sold by private insurance companies. There is no "Medicare Part F." Medicare has Part A (hospital), Part B (doctor), Part C (Medicare Advantage), and Part D (prescriptions). Plan F is a private product that works alongside Original Medicare.

Can I have both Plan F and Medicare Advantage?

No. Plan F is designed to work with Original Medicare (Part A and Part B). If you enroll in a Medicare Advantage plan, your Original Medicare coverage ends, and you cannot use Plan F. You would need to switch back to Original Medicare to use Plan F.