Medicare Supplement Plan F

Should you decide which you want to pick the higher deductible plan then you will be required to pay for all the out-of-pocket costs until you’ve reached a certain amount the original Medicare does not cover. But, by choosing the higher deductible plan you could end up paying a much lower monthly amount than with the standard Medigap Plan F.

Since Plan F does offer the largest amount of benefits, normally it’ll be the most expensive plan, however, in the event you shop around you can find a less expensive plan.

Open Enrollment for Texas Medicare Supplement Insurance is at age 65 for all consumers, including those already receiving Medicare due to disability. The Open Enrollment period is six months, beginning when you are both age 65 or older and enrolled in Medicare Part B, companies must sell you any Medicare supplement plan they offer. After this limited open enrollment period, companies can pick and choose whom they will cover and how much they will charge based on your health. If you have an individual or “bank group” insurance policy, becoming Medicare eligible does not require you to cancel it and purchase a Medicare supplement. Doing so may save premium costs but it is important to compare benefits before deciding which will work best.

If you are eligible for employer retirement insurance, review the plan carefully to understand what benefits are available and how it works with Medicare. Be aware that employer plans are not standardized and are not subject to the requirements governing standardized Medicare supplement policies. Also, it is important to remember, that if you leave an employer plan you may not be able to go back on it.

Medigap Plan F covers the basic set of benefits. These basic benefits include most Medicare Part A and B coinsurance amounts, blood, and additional hospital benefits not covered by Original Medicare. Plan F also covers the Part A Deductible, Part B Deductible, Skilled Nursing Facilities, Part B Excess Charges, Skilled Nursing Facilities, and Foreign Travel Emergency.

Part A Hospital Coinsurance

• Days 61-90 of a hospital stay in each Medicare benefit period.
• Days 91-150 of a hospital stay. Medicare will only pay for these 60 days once during your lifetime.

Additional Part A Hospital Benefits

• An extra 365 days of inpatient hospital care after you use your Original Medicare hospital benefits.

Part B Coinsurance

• Pays for the Part B coinsurance after you meet your annual deductible.

Part A and B Blood Coverage

• Pays for the first three pints of blood per calendar year.

Part A Hospice Coinsurance

• Pays for outpatient prescriptions drug and inpatient respite care coinsurance.

Part A Deductible

• In 2019, the Medicare Part A Deductible is $1,364. Medigap Plan F covers the deductible amount.

Part B Deductible

• In 2019, the Medicare Part B Deductible is $185.00. Medigap Plan F covers the deductible amount.

Skilled Nursing Facilities

• In 2019, the co-payment for skilled nursing is $170.50/day for days 21-100. Medigap Plan F covers the co-payment amount.

Part B Excess Charges

• If you go to a provider that does not accept Medicare assignment, that provider is allowed to charge an additional 15%. Plan F will cover that additional 15% charge at 100%.

Foreign Travel Emergency

• Pays only for emergency care
• Pays only after you first meet and pay a $250 deductible.
• Pays 80% of billed charges for Medicare-eligible expenses for medically necessary hospital, physician, and medical care received in a foreign country. You would be responsible for the other 20%.
• Has a $ 50,000-lifetime maximum benefit.

To see a list of all the Medicare supplements available – take a look at our Medigap supplement chart. This chart can be found in the booklet called “Choosing a Medigap,” which is published by Medicare itself. The chart details the benefits that are included in each Medicare supplement, which are labeled Plan A – Plan N.