Medicare Part F

 Medicare Part F is a type of Medicare Supplement Insurance (Medigap) plan. Medigap policies are designed to help cover some of the costs that Original Medicare (Parts A and B) doesn’t cover, such as copayments, coinsurance, and deductibles. Here’s an overview of Medicare Part F:

Medicare Part F Overview

• Coverage: Medicare Part F is one of several standardized Medigap plans available through private insurance companies. It offers comprehensive coverage by filling in many of the gaps left by Original Medicare. Specifically, Medicare Part F covers:
  • Part A Coinsurance and Hospital Costs: Covers coinsurance and hospital costs for days 61-150 in a hospital stay, as well as 365 days after Medicare benefits are exhausted.
  • Part B Coinsurance or Copayments: Covers the 20% coinsurance or copayments for outpatient services.
  • Blood: Covers the cost of the first three pints of blood needed for a transfusion.
  • Part A Deductible: Covers the deductible for inpatient hospital stays.
  • Part B Deductible: Covers the deductible for outpatient services (note: this is a feature only available in the Plan F policy, and starting January 1, 2020, new enrollees are not able to enroll in this plan due to changes in Medicare rules).
  • Part B Excess Charges: Covers the cost of any charges that exceed the Medicare-approved amount for certain services.
  • Foreign Travel Emergency: Covers 80% of emergency foreign travel expenses (up to plan limits).

Eligibility and Enrollment

• Eligibility: Medicare Part F is available to individuals who are enrolled in Medicare Parts A and B. However, new Medicare beneficiaries who become eligible on or after January 1, 2020, are not able to purchase Medicare Part F due to changes in Medicare regulations. Instead, these individuals can consider other Medigap plans like Plan G or Plan N, which offer similar coverage without the Part B deductible benefit.

• Enrollment: If you were eligible for Medicare before January 1, 2020, you may still be able to purchase a Medicare Part F policy, provided you can find a plan through a private insurance company. The best time to enroll in Medigap is during your Medigap Open Enrollment Period, which begins the month you turn 65 and are enrolled in Part B and lasts for six months.

Costs

• Premiums: The cost of Medicare Part F varies by insurance company and geographic location. Premiums can be higher than for other Medigap plans due to the comprehensive coverage it provides.

• No Copayments or Coinsurance: Medicare Part F covers most out-of-pocket costs, which means you typically won’t have any copayments or coinsurance for covered services.

Alternative Medigap Plans

For those who are newly eligible for Medicare on or after January 1, 2020, and cannot enroll in Medicare Part F, other Medigap plans like Plan G and Plan N offer similar coverage, with a few differences:

• Plan G: Covers everything that Part F covers, except the Part B deductible.
• Plan N: Covers most of the same benefits as Plan F but may require copayments for some doctor visits and emergency room visits.

Choosing the right Medigap plan depends on your health needs and financial situation. It’s often helpful to compare the benefits and costs of different plans before making a decision.