Medicare supplemental health insurance plans, also called Medigap, work with original Medicare. Medigap Plan F provides many of the same benefits as Plan G, with some differences.
Medigap plans help a person pay their out-of-pocket Medicare expenses. A person can get a Medigap plan, which is optional health insurance, from private health insurance companies.
Around 25% of people enrolled in Medicare had a Medigap plan in 2015, according to the Kaiser Family Foundation.
There are 10 Medigap policies: A, B, C, D, F, G, K, L, M, and N. The plans offer standardized benefits to Medicare recipients and help pay coinsurance, deductibles, and copays that original Medicare may not cover.
Medigap plans may also cover emergency healthcare if a person needs treatment while they are away from the United States.
However, the policies do not cover dental or vision care, including eyeglasses, long-term care, hearing aids, or private-duty nursing.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Each Medigap plan must offer the same benefits as all other plans with the same letter, though plan premiums may be different.
However, eligibility rules changed in January 2020, and Plan F is no longer available to new enrollees in Medicare. Plan G coverage is similar to that of Plan F but does not cover the Medicare Part B deductible.
Both plans F and G offer a high deductible version of their plans.
Prescription drug coverage
In general, Medigap policies do not cover prescription drugs. If a person wants such coverage, they can choose to enroll in Medicare Part D.
Exceptions
Although the government standardizes Medigap policies, Massachusetts, Minnesota, and Wisconsin standardize their plans in a different way.
In addition, if a person is enrolled in a Medicare Advantage plan, they cannot also have a Medigap plan.
Medigap Plan F provides a person with coverage for some parts of healthcare that original Medicare does not cover.
However, there are some restrictions on enrollment:
- A person newly enrolled in Medicare can no longer get Plan F.
- If someone was eligible for Medicare Part A before 2019 but did not enroll, they may still be eligible to enroll in Plan F. A person can check the start date on their Medicare card.
- If a person already has Plan F, they can keep it.
In addition to the basic Plan F, there is a high deductible version of Plan F available. In 2021, this has a deductible of $2,370. A person must reach the deductible before the plan starts to cover costs.
Medigap Plan G provides a person with coverage for some parts of healthcare that original Medicare does not cover. However, Plan G does not cover the Medicare Part B deductible, which is $148.50 in 2021.
In 2021, the high deductible version of Plan G has a $2,370 deductible before the plan will start coverage.
Medigap plans F and G offer similar coverage. However, Plan G does not cover the Medicare Part B deductible.
| Medigap Plan F | Medigap Plan G | |
|---|---|---|
| Medicare Part A coinsurance and copays | 100% | 100% |
| Medicare Part A deductible | 100% | 100% |
| Medicare Part B coinsurance and copays | 100% | 100% |
| Medicare Part B deductible | 100% | No |
| Skilled nursing facility care coinsurance | 100% | 100% |
| First 3 pints of blood | 100% | 100% |
| Foreign travel exchange | 80% | 80% |
| Prescription drugs | No | No |
| Out-of-pocket limit | N/A | N/A |
In some states, both plans offer a high deductible version. A person with such a plan must pay the Medicare-covered costs amounting to $2,370 before the plan coverage starts.
Each Medigap policy is standardized by the federal government, though Minnesota, Massachusetts, and Wisconsin standardize their Medigap policies differently. This standardization means that each plan must offer the same basic benefits.
However, individual Medigap plan premiums vary depending on the insurance company providing the policies.
In general, the premiums for Part B are paid to Medicare, and the premiums for Medigap policies are paid to the private insurance companies.
A $250 annual deductible may be applied by Plan F and Plan G to cover foreign travel emergency services, with a lifetime limit generally set at $50,000. The healthcare must begin during the first 60 days of a person’s trip, and no other Medicare benefit may cover it.
Variations
People who choose the standard Plan G pay a monthly premium that varies among states. This cost does not include the Part B premium.
The premiums of Medigap plans depend on several factors, such as:
- where a person lives
- their gender
- their age
- their marital status
- whether or not they smoke
In addition, premiums may vary depending on whether a person chooses a standard or a high deductible policy.
This Medigap policy finder tool can help a person compare the costs of Medigap plans and find a policy online. The search tool is based on a person’s ZIP code to show plans in their area.
Eligibility
Insurance companies must offer a policy at the best available rate, regardless of the person’s health status. An online tool offered by the State Health Insurance Assistance Program can provide advice on various plans and costs.
Medigap plans are renewable, which means that the company offering them cannot cancel a person’s Medigap policy as long as they pay the premiums — even if they have health problems.
Medigap plans F and G are supplemental health insurance plans that work in conjunction with original Medicare. Private insurance companies offer them.
Plans F and G have similar coverage, though Plan G does not cover the Medicare Part B deductible.
Premiums for Medigap plans depend on several factors, including a person’s age, gender, marital status, location, and smoking status.