Medicare Supplement Plan F pays for most of the costs that Original Medicare leaves you responsible for

Plan F is a Medigap policy sold by private insurance companies. It covers the coinsurance, copayments, and deductibles that Medicare Part A and Part B require you to pay out of pocket. Plan F also covers some care that Original Medicare does not pay for at all, like the first three pints of blood you need in a hospital stay.

Plan F is the most comprehensive Medigap option available, which means it covers the widest range of costs. If you enroll in Plan F, you pay a monthly premium to the insurance company, and then most of your Medicare-covered medical bills are handled between Medicare and your Medigap insurer — you typically pay little or nothing at the point of care.

Plan F is only available to people who first became may be able to access for Medicare before January 1, 2020. If you became may be able to access on or after that date, you cannot purchase Plan F; you would choose from Plan G, Plan N, or other options instead.

Key Takeaways

  • Plan F covers Medicare Part A deductibles, Part B deductibles, coinsurance, and copayments for most services.
  • Plan F is only sold to people who were may be able to access for Medicare before January 1, 2020.
  • You pay a monthly premium to the insurance company, and costs vary by insurer and location.
  • Plan F does not cover dental, vision, hearing aids, or long-term care — those require separate coverage or out-of-pocket payment.
  • Once you enroll in a Medigap plan, you can switch to a different plan, but you may face waiting periods or higher premiums depending on your health.

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 coinsurance for hospital stays that last more than 60 days. If you stay in the hospital for 61 to 90 days, Medicare pays most costs but you pay coinsurance; Plan F covers that coinsurance.

For Part B (doctor visits, outpatient care, medical equipment), Plan F covers the annual deductible and then covers 20 percent coinsurance on most services. When your doctor bills Medicare, Medicare pays 80 percent and you would normally owe 20 percent; Plan F pays that 20 percent.

Plan F also covers the blood deductible. If you need a blood transfusion, Medicare requires you to pay for the first three pints of blood; Plan F covers that cost. It also covers skilled nursing facility coinsurance — if you move to a nursing home after a hospital stay, you pay coinsurance for days 21 through 100, and Plan F covers it.

Additionally, Plan F covers some care that Original Medicare does not cover at all: foreign travel emergency care. If you travel outside the United States and need emergency medical care, Plan F covers 80 percent of the cost after you pay a deductible. This is the only Medigap benefit that extends outside the U.S.

What Plan F does not cover

Plan F does not cover dental work, vision care, or hearing aids. If you need dentures, glasses, contact lenses, or a hearing aid, you pay the full cost unless you have a separate dental or vision plan. Some Medicare Advantage plans include dental or vision coverage, but Original Medicare with Plan F does not.

Plan F does not cover long-term care — nursing home care, assisted living, or in-home care for non-medical reasons. It also does not cover prescription drugs. If you take medications, you need a separate Part D prescription drug plan, which you purchase from a private insurer just as you do with Medigap.

Plan F does not cover routine physical exams, most preventive care screenings, or care from providers who do not accept Medicare. It also does not cover care you receive outside the United States, except for the emergency travel coverage mentioned above.

How much Plan F costs

Plan F premiums vary widely depending on which insurance company sells the plan and where you live. Some states have higher average premiums than others, and the same plan costs different amounts from different insurers. You might pay anywhere from $100 to $300 or more per month, depending on these factors.

Insurance companies use three different methods to set premiums: community-rated (everyone in your state pays the same), issue-age-rated (your premium is based on your age when you enroll), or attained-age-rated (your premium increases as you get older). The method affects how much you pay now and how much your premium will rise in future years.

To find the actual cost in your area, you need to contact insurance companies directly or use the Medicare Plan Finder tool on Medicare.gov. Comparing quotes from at least three insurers is standard practice, because the same plan can cost significantly different amounts.

When you can enroll in Plan F

If you are already may be able to access for Medicare and have not yet enrolled in a Medigap plan, you have a six-month open enrollment period that starts the month you turn 65 and enroll in Medicare Part B. During this window, insurance companies cannot deny you coverage or charge you more based on your health history.

If you miss this window, you can still enroll in Plan F, but the insurance company may require you to answer health questions and can charge you a higher premium based on your medical history. Some states have additional protections that allow you to enroll without health screening, but this varies.

If you already have a different Medigap plan and want to switch to Plan F, you can do so, but again you may face health screening and higher premiums depending on how long it has been since you first enrolled in Medigap.

How Plan F works with Medicare

When you have Plan F, you keep your Medicare card and your Medigap card. You go to any doctor or hospital that accepts Medicare. The provider bills Medicare first, and Medicare pays its share. The provider then bills your Medigap insurer for the remaining cost that you would normally owe, and the insurer pays it.

In most cases, you do not handle the billing yourself. The provider submits the claim to Medicare, receives Medicare's payment and explanation of benefits, and then automatically submits the remaining balance to your Medigap insurer. You receive an explanation of benefits from both Medicare and your Medigap company, but you typically do not receive a bill.

If a provider does not accept Medicare, Plan F does not help. You would need to pay the full cost out of pocket or find a Medicare-accepting provider. Plan F also does not cover any charges above what Medicare allows, unless the provider has agreed to accept Medicare's payment as full payment.

Plan F versus Plan G and other options

Plan G is very similar to Plan F but does not cover the Part B deductible. This means you pay the Part B deductible (currently $240 per year, though this amount changes annually) out of pocket, and Plan G covers everything else that Plan F covers. For many people, Plan G has a lower monthly premium than Plan F, which can make up for the deductible you pay once a year.

Plan N is less comprehensive than both Plan F and Plan G. It does not cover the Part B deductible, and it requires you to pay copayments for some doctor visits and emergency room visits. However, Plan N premiums are often significantly lower than Plan F or Plan G.

If you became may be able to access for Medicare on or after January 1, 2020, Plan F is not available to you. You would compare Plan G, Plan N, and other options based on your expected medical needs and the premiums available in your area.

Frequently Asked Questions

Can I switch from Plan F to a different Medigap plan?

Yes, you can switch to another Medigap plan at any time. However, if you switch outside of your initial six-month enrollment period, the new insurance company may require health screening and can charge you a higher premium. Some states have rules that make switching easier, so check with your state insurance commissioner's office.

Does Plan F cover Medicare Advantage plans?

No. Plan F is a Medigap supplement to Original Medicare only. If you enroll in a Medicare Advantage plan instead of Original Medicare, you cannot use Medigap, including Plan F. You would stay in the Medicare Advantage plan or switch back to Original Medicare and then enroll in Medigap.

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

Your Plan F coverage continues, but you may want to shop for a new plan in your new state because premiums and available insurers differ by location. You can switch plans when you move without facing health screening, as long as you do so within a certain timeframe — typically 30 to 60 days. Contact your current insurer to ask about your state's rules.

Does Plan F cover preventive care like colonoscopies or mammograms?

Medicare covers many preventive services at no cost to you, and Plan F does not change that. You still pay nothing for covered preventive care. However, if a preventive test finds a problem and you need follow-up diagnostic care, Plan F covers your share of that diagnostic care.

Can I have Plan F and a Medicare Advantage plan at the same time?

No. You must choose either Original Medicare with Medigap (Plan F) or a Medicare Advantage plan. You cannot have both. If you want to switch from one to the other, you must disenroll from one before enrolling in the other.