What Medicare Part F Is
Medicare Part F is a Medigap (supplemental insurance) plan that covers many of the costs Medicare Part A and Part B do not pay. It is one of ten standardized Medigap plans available to people with Original Medicare. Part F picks up where Medicare leaves off — it pays your deductibles, copayments, and coinsurance for hospital and doctor visits.
Part F is the most comprehensive Medigap option available. It covers the Part A hospital deductible, the Part B doctor visit deductible, copayments for hospital stays and outpatient services, and coinsurance for blood transfusions. It also covers skilled nursing facility coinsurance and Part B excess charges (the amount doctors can bill above Medicare's approved amount).
You buy Part F from a private insurance company, not from Medicare. It works alongside your Original Medicare coverage. When you see a doctor or go to the hospital, Medicare pays its share first, then Part F pays its share of what remains.
Key Takeaways
- Part F is a Medigap plan sold by private insurers that covers deductibles, copayments, and coinsurance that Original Medicare does not pay.
- Part F is the most comprehensive Medigap option, but it is also typically the most expensive.
- You can only buy Part F during your initial enrollment period or during the annual Medigap open enrollment period in your state.
- Part F does not cover prescription drugs — you need a separate Part D plan for that coverage.
- If you enroll in Part F after your initial enrollment window, insurers may deny coverage or charge higher premiums based on your health history.
What Part F Covers
Part F covers the full Part A deductible for hospital stays. In 2024, that deductible is $1,632 per benefit period, but this amount changes each year. Without Part F, you would pay this amount out of pocket before Medicare hospital coverage begins.
Part F also covers the Part B deductible ($240 in 2024) and the 20% coinsurance you owe for doctor visits, outpatient surgery, and other Part B services after you meet the deductible. If your doctor charges more than Medicare allows, Part F covers those excess charges — up to 15% above the Medicare-approved amount in most states.
Part F covers coinsurance for skilled nursing facility stays after the first 100 days. It also covers the cost of blood transfusions and emergency care outside the United States (up to the plan limits). However, Part F does not cover routine dental, vision, hearing aids, or long-term care.
Part F vs. Other Medigap Plans
Medigap plans are labeled A through N, and each covers a different combination of costs. Part F is the most comprehensive — it covers nearly all out-of-pocket costs except prescription drugs. Plans G and N are less expensive but leave you responsible for some deductibles or copayments. Plan A is the least expensive but covers fewer costs.
The trade-off is straightforward: Part F has higher monthly premiums than other plans, but you pay less when you actually use healthcare. If you see doctors frequently or have hospital stays, Part F may save you money overall. If you rarely use healthcare, a less expensive plan might make more sense.
One important note: Part F is not available to people who first became may be able to access for Medicare on or after January 1, 2020. If that applies to you, Plan G is the most comprehensive option available to you.
How to Buy Part F and When You Can Enroll
You buy Part F directly from private insurance companies such as UnitedHealthcare, Humana, Aetna, or CIGNA. You do not buy it from Medicare. You can compare plans and prices on Medicare.gov or by calling 1-800-MEDICARE.
Timing matters. You have the best chance of being accepted and paying the lowest price if you enroll during your initial enrollment period — the six-month window that starts the month you turn 65 and enroll in Medicare Part B. During this window, insurers cannot deny you coverage or charge more based on your health.
After your initial enrollment period ends, you can still buy Part F during your state's annual Medigap open enrollment period, which typically runs for a set number of days each year. Outside these windows, insurers can refuse to sell you Part F or charge higher premiums based on your medical history. Rules vary by state, so contact your state insurance commissioner's office to learn your state's enrollment dates.
How Part F Works With Medicare
When you have Part F, you keep your Original Medicare coverage. You still have a Medicare card and use it at doctors' offices and hospitals. The billing process is automatic: the provider bills Medicare first, Medicare pays its share, then the claim goes to your Part F insurer, which pays its share.
You pay your Part F premium directly to the insurance company each month, separate from your Medicare Part B premium. You also continue to pay your Part B premium to Medicare. Some people also pay a Part D premium for prescription drug coverage.
Part F does not limit which doctors you can see or require you to use a network. You can see any doctor who accepts Medicare, anywhere in the country. This is different from Medicare Advantage plans, which have networks and geographic limits.
Part F Costs and Premiums
Part F premiums vary widely depending on the insurance company, your age, your location, and whether the company uses age-based pricing or community rating. In some states, a 65-year-old might pay $100 to $200 per month, while in others the same plan costs $250 or more. Premiums also increase as you age.
Insurance companies use different pricing methods. Some use community rating, meaning everyone in your state pays the same premium regardless of age. Others use age-based rating, meaning premiums increase as you get older. A few use issue-age rating, meaning your premium is based on your age when you first buy the plan and stays locked in at that rate.
To find current prices in your area, visit Medicare.gov and use the Medigap plan finder tool, or call 1-800-MEDICARE. Get quotes from at least three companies before you decide. Premiums can differ by hundreds of dollars per year for the same coverage.
What Part F Does Not Cover
Part F does not cover prescription medications. You need a separate Part D plan to cover drug costs. Part D is sold by private insurers and has its own enrollment periods and premiums.
Part F also does not cover routine dental care, vision exams, eyeglasses, hearing aids, or dentures. It does not cover long-term care, custodial care, or care in a nursing home beyond the skilled nursing facility coinsurance it covers. It does not cover private-duty nursing or homemaker services.
Part F covers emergency care outside the United States, but only up to plan limits — typically $250 per day for a maximum of 365 days per year. It does not cover routine care abroad.
Questions to Ask Your Doctor or Insurance Agent
Before you buy Part F, ask your insurance agent whether the plan uses community rating, age-based rating, or issue-age rating in your state. Ask what the premium will be in five years and ten years, if that information is available. Ask whether the company has a history of raising rates faster than competitors.
Ask your doctor whether they accept Medicare and whether they have any concerns about Medigap coverage. Ask whether your current medications are covered under Part D plans available in your area, since Part F does not cover drugs.
If you are considering Part F because you have a chronic condition, ask your insurance agent about the underwriting process if you enroll outside your initial enrollment period. Some companies may deny coverage or charge higher rates based on your health history.
Frequently Asked Questions
Can I switch from Part F to a different Medigap plan later?
Yes, but it depends on when you switch. If you switch within the first 12 months of buying Part F, most states allow you to switch to any other Medigap plan without medical underwriting. After 12 months, some states allow switches, but others require medical underwriting, which means the new insurer can deny you or charge more based on your health.
What happens if I do not buy Part F during my initial enrollment period?
You can still buy Part F later, but insurers can deny you coverage or charge higher premiums based on your health history. Some states have protections that limit how much more they can charge, but rules vary. It is usually cheaper and easier to buy during your initial enrollment period.
Can I have Part F and Medicare Advantage at the same time?
No. Part F is a supplement to Original Medicare, so you must have Original Medicare to use it. If you switch to a Medicare Advantage plan, you must drop Part F. If you later switch back to Original Medicare, you may be able to re-enroll in Part F, but only during certain enrollment periods.
Does Part F cover the Part D deductible?
No. Part F covers deductibles and coinsurance for Part A and Part B services only. Part D (prescription drug coverage) has its own deductible, and Medigap plans do not cover it. You pay the Part D deductible separately.
Will my Part F premium increase every year?
Yes, most Part F premiums increase annually. The amount varies by company and by state. Some companies raise rates faster than others. When you shop for Part F, ask the agent about the company's rate history and whether they can project future increases.