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 out-of-pocket Medicare expenses.
This article discusses Medigap coverage and compares Plan F with Plan G. It then looks at eligibility, enrollment, and costs.
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.
A person can get a Medigap plan, which is optional health insurance, from health insurance companies. More than 25% of people enrolled in Medicare had a Medigap plan in 2015, according to the Kaiser Family Foundation (KFF).
There are 10 Medigap policies, labeled 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 health care if a person needs treatment while they are away from the United States.
Each plan must each offer the same benefits, although premiums may be different. In addition, Medigap policies do not cover:
- dental or vision care, including eyeglasses
- long-term care
- hearing aids
- private-duty nursing
Prescription drug coverage
In general, Medigap policies do not cover prescription drugs. If a person wants such coverage, they can enroll in Medicare Part D.
Although the government standardizes Medigap policies, there are three states with different standardization, namely Massachusetts, Minnesota, and Wisconsin.
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 not covered by original Medicare.
However, eligibility rules changed in January 2020, and Plan F is no longer available to a new enrollee in Medicare.
If someone was eligible for Medicare Part A before 2019 but did not enroll, then they may still be eligible to enroll in Plan F. A person can check the start date on their Medicare card. Also, if a person already has Plan F, they can keep it.
There is a high-deductible Plan F, and in 2021, the deductible is $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 not covered by original Medicare. However, Plan G does not cover the Medicare Part B deductible..
Medigap Plan G’s 2021 high-deductible plan 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 |
|Medicare Part A deductible||100%||100%|
|Medicare Part B coinsurance |
|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%|
In some states, both plans offer a high-deductible plan. A person in 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, although Minnesota, Massachusetts and Wisconsin standardize Medigap policies differently. The standardization means 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 the Medigap policies are paid to the private insurance companies.
A deductible may be applied by Plan F and Plan G to cover foreign travel emergency services, and a usual lifetime limit is $50,000. The healthcare must begin during the first 60 days of a person’s trip, and must not be covered by any other Medicare benefit.
People who choose the standard Plan G pay a monthly premium that varies between 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, and their age
- marital status
- whether or not they smoke
In addition, premiums may vary depending on if a person chooses a standard or a high-deductible policy.
The U.S. government’s Medigap policy finder tool can help a person compare the costs for Medigap plans, and find a policy online. The search tool is based on a person’s zip code to show plans in their area.
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 (SHIP) can offer advice on various plans and costs.
Medigap plans are renewable, which means the company offering the plan cannot cancel a person’s Medigap policy as long as the person pays the premiums, even if the person has health problems.
Medigap plans F and G are supplemental health insurance plans that work in conjunction with original Medicare and are offered by private insurance companies. Plans F and G have similar coverage, although Plan G does not cover the Medicare Part B deductible.
Premiums for Medigap plans depend on several factors including age, gender, marital status, where a person lives, and if they smoke.
We will update the 2021 costs as soon as possible after the Centers for Medicare and Medicaid Services (CMS) have released them.
We last updated the costs on this page on October 8, 2020.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.