Plan F covers every gap Original Medicare leaves. It's no longer available to anyone newly eligible after January 1, 2020 (MACRA). Many existing F holders are comparing rate increases against switching to Plan G.
Best for
- Existing Plan F holders weighing renewal vs. switching
Watch out for
Closed to new enrollees. Premium increases steeper than Plan G in many regions.
What Plan F covers
- Part A coinsurance & 365 extra hospital daysCovered in full
- Part B coinsurance or copaymentCovered in full
- Blood (first 3 pints)Covered in full
- Part A hospice coinsurance / copayCovered in full
- Skilled nursing facility coinsuranceCovered in full
- Part A deductibleCovered in full
- Part B deductibleCovered in full
- Part B excess chargesCovered in full
- Foreign travel emergency (up to plan limits)Covered in full
Compare to other Medigap plans
- Plan AThe minimum-coverage Medigap plan - basic benefits only.
- Plan BPlan A plus the Part A deductible.
- Plan CComprehensive coverage - closed to anyone newly eligible after Jan 1, 2020.
- Plan DPlan G minus Part B excess. Modest savings, modest reduction in benefit.
- Plan GToday's most popular Medigap plan - comprehensive coverage minus only Part B deductible.
- Plan KLower premium, partial coverage with out-of-pocket cap.
- Plan LLike Plan K but covers more - 75% of most cost-sharing.
- Plan MSplits the Part A deductible 50/50 between you and the plan.
- Plan NLower premium than Plan G in exchange for office and ER copays.
What Does Medigap Plan F Cover?
Plan F is the only letter that leaves nothing on the table. It covers all nine benefits on the standardized Medigap chart. Members see a doctor, hand over the card, and pay nothing for covered services.
- Benefits on the standardized Medigap chart
- 9Benefits on the standardized Medigap chart
- Benefits Plan F covers in full
- 9Benefits Plan F covers in full
- Gaps left for you to pay
- 0Gaps left for you to pay
- Part A hospital coinsurance, plus 365 extra hospital days for life
- The Part A hospital deductible, paid in full each benefit period
- Part B coinsurance and copays, and the yearly Part B deductible
- Skilled nursing coinsurance after a qualifying hospital stay
- Part B excess charges when a provider bills above the approved amount
- Blood, hospice coinsurance, and foreign travel emergency care
A high deductible version also exists
High deductible Plan F charges a much lower premium. You pay covered costs yourself until you reach a yearly deductible set by Medicare. After that the plan behaves like standard Plan F.
Why Can't New Enrollees Buy Plan F?
A federal law stopped new Medigap plans from covering the Part B deductible. It took effect on January 1, 2020. Plan F and Plan C both pay that deductible, so both closed to newly eligible members.
Where you stand today
You already have Plan F
Keep it as long as you pay the premium. The law changed who can buy the plan, not what your policy covers.
Eligible for Medicare before January 1, 2020
You may still be able to buy Plan F, even if you delayed enrolling. Ask which carriers still offer it.
You became eligible after that date
Plan F is not an option. Plan G covers the same ground except the Part B deductible.
Closed does not mean canceled
Your benefits are guaranteed renewable and cannot be reduced. What changes is the pool. No new members join, the group ages together, and rate increases often outpace open letters.
Is Your Plan F Still Worth the Premium?
Plan F was the right answer for many years, and for some people it still is. The question is not loyalty. It is whether your rate has drifted past what the extra benefit is worth.
Reasons to stay
Holding Plan F still makes sense if:
- Your rate remains close to Plan G quotes in your county.
- You see providers who do not accept Medicare assignment.
- You want every covered service handled with no bill to sort out.
- Your carrier's increases have been mild for several years running.
Reasons to shop
It is time to compare if:
- Your renewal has climbed sharply two years in a row.
- Plan G quotes in Orange County sit well below what you pay.
- You are healthy and your birthday window is coming up soon.
- You have never had your supplement reviewed against the full market.
The only benefit Plan F adds over Plan G is the yearly Part B deductible. If the premium gap is larger than that deductible, you are paying more to receive less.
Plan F or Plan G: Which Should You Hold?
This is the comparison nearly every Plan F member should run once a year. The benefit difference is a single line on the chart.
Plan F vs Plan G
Medigap Plan F
Complete coverage, closed to newly eligible members.
- Open to new enrollees
- No, closed since January 1, 2020
- Part A coinsurance and 365 extra days
- Covered in full
- Part A hospital deductible
- Covered in full
- Skilled nursing coinsurance
- Covered in full
- Part B deductible
- Covered in full
- Part B excess charges
- Covered in full
- Foreign travel emergency
- Covered up to plan limits
- Typical premium
- Among the highest of any letter
- Membership trend
- A closed group that grows older each year
Medigap Plan G
The same coverage except the Part B deductible, and still open.
- Open to new enrollees
- Yes
- Part A coinsurance and 365 extra days
- Covered in full
- Part A hospital deductible
- Covered in full
- Skilled nursing coinsurance
- Covered in full
- Part B deductible
- You pay it each year
- Part B excess charges
- Covered in full
- Foreign travel emergency
- Covered up to plan limits
- Typical premium
- Lower than Plan F in most counties
- Membership trend
- Growing, with new members joining
Some members prefer a bigger premium cut and accept small copays instead. That is Plan N, which drops excess coverage and charges a little at office and emergency visits.
How Does the Birthday Rule Let You Switch Without Health Questions?
This rule was practically written for Plan F members. Because Plan F sits at the top of the chart, every other letter counts as equal or lesser benefits.
Moving from Plan F during your birthday window
- 01
Mark the window on your calendar
It opens 30 days before your birthday and runs 60 days in total. It closes 30 days after your birthday.
- 02
Shop the full market first
Start comparing a month or two early. Waiting until the window opens leaves little room to decide.
- 03
Apply with no health questions
Move to Plan G, Plan N, or another Plan F with a different carrier. Your health history cannot be used against you.
- 04
Cancel only after approval
Your current policy stays in force until the new one is issued with a written effective date.
Trial rights are a separate door
Joined a Medicare Advantage plan when you first turned 65? You have twelve months to leave it and buy any supplement sold in California.
Dropped a supplement to try Advantage for the first time? You have twelve months to go back. Plan F is on that guaranteed list only if you were eligible for Medicare before January 1, 2020.
What If You Miss the Window and Have to Underwrite?
Then a carrier reviews your health before it accepts you. This is exactly why we recommend planning the move well before your birthday arrives.
- A health questionnaire covering recent treatment, testing, and surgery
- A prescription history check through a pharmacy database
- Questions about anything unresolved, such as a pending biopsy or a scheduled surgery
- Use of oxygen, dialysis, insulin, a walker, or in home care
- Height and weight compared against the carrier's published limits
Your Plan F is your safety net
Never cancel a policy on the strength of an application. If a carrier declines you, your Plan F continues untouched. We hold the timing so you are never without coverage for a single day.
How Do You Run the Numbers Before Your Birthday?
A Plan F review is quick because the benefits are already settled. We are looking at price, rate history, and your qualifying window. Nothing else changes the answer.
What we bring to the table
Quotes from every carrier licensed in your county
We are independent, so no company gets preference in the comparison.
Your renewal history, read closely
Two or three years of notices show the trend better than one bill ever could.
A clear read on your window
Birthday rule, trial right, or underwriting. That answer shapes what is actually possible.
Your drug plan reviewed at the same time
Plan F covers no prescriptions. We check your Part D plan against your current medication list.
Book an annual review before your birthday month. We meet at 2135 N Pami Circle in Orange, by video, or by phone. Call (714) 922-0043 or reach out here at no cost to you.