Choosing the Right Medicare Supplement Plan F or G for You

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Medicare Supplement Plan F is often considered the most comprehensive plan, covering 100% of Medicare-approved costs, including deductibles, copays, and coinsurance.

Plan F is a popular choice, but it's essential to consider your budget and medical needs.

Plan G, on the other hand, has a lower premium compared to Plan F but still covers many of the same costs.

Plan G has a $2,190 deductible, which can be a significant out-of-pocket expense for some individuals.

Medicare Supplement Plan F/G Basics

Plan F and Plan G are two popular Medicare Supplement plans that can help cover out-of-pocket costs not covered by Original Medicare.

Plan F has been around for a while, but it's no longer available to new Medicare recipients.

Plan G, on the other hand, is a more recent addition and has become the replacement for Plan F.

Plan G and Plan F both have a high deductible option, which works similarly and has the same deductible amount of $2,800 in 2024.

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High Deductible Plan F is only available to those who were new to Medicare before January 1, 2020.

High Deductible Plan G, however, is available to individuals new to Medicare on or after January 1, 2020.

Plan F covers the Part B deductible of $240, but Plan G does not.

There are two types of Medigap Plan G, with differences in out-of-pocket costs, availability, and coverage.

Plan Benefits and Coverage

Most Medicare Supplement Plans, including Plan F and Plan G, are designed to help pay out-of-pocket costs associated with Original Medicare. Plan F and Plan G are two of the most popular options, offering broad coverage for some of the most significant costs.

Plan F covers the Part B deductible of $240, which is a significant expense for many Medicare recipients. Plan G, on the other hand, does not cover this deductible, but it does offer the same high deductible option as Plan F with a $2,800 deductible in 2024.

Cover Out-of-Pocket Costs

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To cover out-of-pocket costs, you can add a Medicare Supplement Plan to Original Medicare. This can help pay for expenses that aren't covered by Medicare.

Plan G offers the broadest coverage for some, making it a popular choice. It's available to individuals new to Medicare on or after January 1, 2020.

Plan F and Plan G both have a high deductible option with a $2,800 deductible in 2024. However, High Deductible Plan F is only available to those who were not new to Medicare before January 1, 2020.

Plan G does not cover the Part B deductible of $240, unlike Plan F which does cover it.

What Does Medicare Cover?

Medicare covers a wide range of healthcare services, including doctor visits and hospital stays.

Original Medicare has two parts: Part A and Part B. Part A covers inpatient hospital care, skilled nursing facility care, and hospice care.

Medicare also covers outpatient care, including lab tests, X-rays, and other diagnostic services.

Medicare Part B covers doctor services, including office visits, surgery, and other medical procedures.

Medicare covers prescription drugs under Part D, which is offered by private insurance companies.

Insurance Options and Providers

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Medicare Supplement plans are offered by private insurance companies like Anthem, and are standardized by the federal government with each plan named with a letter, like A, F, G, and N.

To sign up for Medicare Supplement, you must have Original Medicare Parts A and B, and you'll pay a monthly premium, which can range from $102 to $226.

Most people choose Plan F, G, or N, but the best plan for you may not be the most popular one - it's the one that provides the benefits that meet your needs, with a monthly premium that works with your budget.

You can go to any doctor or hospital that accepts Medicare patients with a Medicare Supplement plan, giving you peace of mind knowing that your benefits are guaranteed as long as you pay your premiums.

Medicare Supplement plans do not include prescription drug, dental, and vision coverage, but stand-alone plans for these benefits can be purchased for an additional premium.

Anthem plans offer value-added programs like SilverSneakers fitness memberships, ScriptSave/WellRx, a prescription savings program, and SpecialOffers, which provides discounts on vitamins and weight loss programs.

Enrollment and Eligibility

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You can enroll in a Medicare Supplement plan anytime if you already have Original Medicare Part A and Part B. The best time to enroll is during the Medigap Open Enrollment Period, starting the first month you have Medicare Part B and you’re 65 or older.

You can't be denied coverage during this time, even if you have pre-existing health problems.

Insurance companies must offer a policy at the best available rate, regardless of your health status. This means you can't be charged more because of a pre-existing condition.

Medigap plans are renewable, which means the company offering them can't cancel your policy as long as you pay the premiums. This gives you peace of mind and financial security.

You may still be able to get Plan G even if you missed the Open Enrollment Window. This is because most states allow insurers to consider your health for the application, as long as you don't have serious pre-existing conditions.

Plan Costs and Variations

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Plan costs and variations can be a bit confusing, but let's break it down. Medigap plan premiums vary depending on the insurance company providing the policies.

You'll pay the Part B premiums to Medicare and the premiums for Medigap policies to the private insurance company administering the plan. This can add up, but it's worth it for the extra coverage.

A $250 annual deductible may apply to Plan F and Plan G to cover foreign travel emergency services, with a lifetime limit generally set at $50,000.

Costs

You'll pay Part B premiums to Medicare and the premiums for Medigap policies to the private insurance company administering the plan.

Medigap plan premiums vary depending on the insurance company, so you'll need to shop around to find the best deal.

A $250 annual deductible may apply to Plan F and Plan G to cover foreign travel emergency services.

Variations

Plan costs and variations can be a bit confusing, but let's break it down.

People who choose Medigap Plan G will pay a monthly premium that varies among states.

This cost does not include the Part B premium.

In some cases, premiums may vary depending on whether a person chooses a standard or a high deductible policy.

High-Deduct Plan

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High-Deductible Plan G can be a good fit if you don’t think you’ll have higher health expenses during an average year.

The deductible for High-Deductible Plan G is $2,800 in 2024, which is the same as High Deductible Plan F.

You must first pay expenses out of pocket until you reach the plan deductible, then your plan begins to pay for costs.

The High-Deductible Plan G counts your Part B deductible payment toward meeting the plan’s overall deductible.

You’ll also pay a separate $250 per year deductible for foreign travel emergencies.

High-Deductible Plan G typically charges lower premiums, but it can be harder to find, with only six insurers in New York State offering a High-Deductible Plan G, for example.

Monthly premiums for High-Deductible Plan G in New York State range between $52.53 and $103.10, depending on location.

Plan Comparison and Evaluation

Medigap plans F and G offer similar coverage, but Plan G doesn't cover the Medicare Part B deductible.

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Plan G is the second most popular Medigap plan, and it covers more costs than most other Medigap plans, including the entire Part A deductible and 100% of doctor charges Medicare doesn't pay.

Plan G has two types: Regular and High-Deductible Plan G. High-Deductible Plan G charges some of the lowest monthly premiums available.

Plan G provides some coverage for emergency foreign care, addressing at least one coverage gap. It also covers excess costs a physician may charge if you don't live in one of the eight states prohibiting excess charges.

Here's a comparison of Plan F and Plan G:

Plan G tends to offer the most cost coverage combined with lower out-of-pocket expenses among the Medicare Supplement options. With Plan G, you can choose between a regular plan and a high-deductible plan, and you can use the plan anywhere in the U.S. with any physician accepting Medicare.

A person with Plan G must pay the Medicare-eligible costs amounting to $2,870 in 2025 before the plan coverage starts.

Plan Details and Requirements

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Plan G and Plan F have a high deductible option with a $2,800 deductible in 2024, but High Deductible Plan F is only available to those who were not new to Medicare before Jan. 1, 2020.

To qualify for Plan G, you must typically be turning 65 on or after Jan. 1, 2020, and enrolled in Original Medicare Parts A and B.

You'll need to be in the initial enrollment period for Medicare at age 65, and in 33 states, people who qualify for Medicare due to a disability can potentially be eligible for Plan G or other Medicare supplement policies.

Here are the typical requirements for Plan G:

  • Turning 65 on or after Jan. 1, 2020
  • Enrolled in Original Medicare (not Medicare Advantage) Parts A and B
  • In the initial enrollment period for Medicare at age 65
  • In 33 states, people who qualify for Medicare due to a disability can potentially be eligible for Plan G or other Medicare supplement policies

You'll pay monthly premiums to the insurance company you bought the plan from, and generally, you can expect an increase in the plan premium every year.

Plan Requirements

To qualify for Plan G, you must typically be turning 65 on or after Jan. 1, 2020. You'll also need to be enrolled in Original Medicare (not Medicare Advantage) Parts A and B.

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During the initial enrollment period, insurers can't turn you away for preexisting health conditions or charge more based on your health history. This six-month period is a great time to shop around and compare options.

In some states, Medigap enrollment is extended or occurs at other times beyond the initial six-month period. This is something to keep in mind when planning your Medicare strategy.

To be eligible for Plan G, you must be in the initial enrollment period for Medicare at age 65. This is a one-time window, so it's essential to be prepared.

Here are the key requirements for Plan G:

  • Turning 65 on or after Jan. 1, 2020
  • Enrolled in Original Medicare (not Medicare Advantage) Parts A and B
  • In the initial enrollment period for Medicare at age 65
  • In 33 states, people who qualify for Medicare due to a disability can potentially be eligible for Plan G or other Medicare supplement policies

If you qualify for Plan G and purchase a plan, you'll pay monthly premiums to the insurance company. These premiums can increase every year.

Is Discontinued?

Medicare Plan F is no longer available to newly enrolled individuals, but those already enrolled can keep it.

People who were eligible for Medicare before January 1, 2020, but didn't enroll in a plan, or those under 65 with Part A starting before that date, may be able to buy Plan F if they live in a state that offers it.

There is a high deductible version of Plan F, which has a deductible of $2,870 in 2025.

In some states, both the basic and high deductible Plan F options have a high deductible version.

Glossary of Terms

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Out-of-pocket costs, deductibles, coinsurance, and copayments are all important terms to understand when selecting the best insurance plan.

An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.

A deductible is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.

Coinsurance is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.

A copayment is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.

Here's a quick summary of these key terms:

  • Out-of-pocket costs: Deductibles, coinsurance, copayments, and premiums
  • Deductible: Annual amount to be spent out of pocket before coverage begins
  • Coinsurance: 20% of treatment costs for Medicare Part B
  • Copayment: Fixed dollar amount paid for certain treatments

Exceptions

There are some exceptions to the standardization of Medigap policies. The federal government standardizes each plan to offer the same basic benefits, but some states have their own way of standardizing their plans.

Credit: youtube.com, 086 05 Exception Plan

Massachusetts, Minnesota, and Wisconsin are among the states that standardize their Medigap policies differently. This means that if you live in one of these states, you may have different options for Medigap coverage.

A person enrolled in a Medicare Advantage plan cannot also have a Medigap plan. This is a requirement that applies to everyone, regardless of where you live.

Frequently Asked Questions

Why is Medicare Plan F discontinued?

Medicare Plan F is discontinued because the Centers for Medicare and Medicaid Services (CMS) wants to eliminate plans with no out-of-pocket cost sharing, known as "first dollar coverage". This change took effect for those turning 65 after January 1, 2020.

What is the disadvantage of Plan G?

The main disadvantage of Medicare Plan G is that it doesn't cover the Part B deductible, dental, vision, or prescriptions, leaving you with out-of-pocket expenses for these essential services. This means you'll need to budget for these costs separately.

Felicia Koss

Junior Writer

Felicia Koss is a rising star in the world of finance writing, with a keen eye for detail and a knack for breaking down complex topics into accessible, engaging pieces. Her articles have covered a range of topics, from retirement account loans to other financial matters that affect everyday people. With a focus on clarity and concision, Felicia's writing has helped readers make informed decisions about their financial futures.

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