When you look over the Medigap coverage chart, which shows the standardized Medigap plans, you may notice an asterisk beside the Plan F. Most people never pay much attention to this or read the fine print below the chart to understand exactly what this signifies. Is Plan F a Viable Medicare Supplement Option?
Actually, this notation represents an entirely separate Medigap plan called the High Deductible Plan F (often referred to in shorthand as HDF).
High Deductible Plan F is a unique Medigap plan that has a large deductible of $2,200 (for 2017) that must be met before any plan benefits begin. After that deductible is satisfied, the HDF plan works like a “regular” Plan F, paying everything that Medicare does not cover at the doctor and hospital.
The HDF plan works like any standard Medigap plan in that you can go to any doctor or hospital. There are no networks on any Medigap plan, including HDF.
If you have this plan, Medicare is still your primary coverage. Medicare pays its portion of your medical bills, then you pay the remainder of the charges until you have paid out the $2,200 deductible amount. After that amount is satisfied, Medicare plus the HDF would cover your medical bills in their entirety.
Also, like with other Medigap plans, claims payments are handled automatically through the Medicare crossover system. You are not responsible for paying at the time of service. The doctor’s office or hospital would bill Medicare first and then bill you the remainder after Medicare has paid its portion.
Obviously, High Deductible Plan F is best suited for someone who is in relatively good health with minimal known doctor visits or recurring or chronic medical conditions.
It does allow you to plan for your medical costs on a predictable basis because you can figure in the premium for HDF, plus the $2,200 deductible to come up with a maximum out of pocket cost that you would have in a calendar year.
While the premiums are lower on HDF, you are responsible for a significantly higher amount of out-of-pocket costs, so that is one downside of this plan. You are responsible for anything Medicare does not cover until you’ve met the annual deductible.
Also, you should keep in mind, if you are considering this plan, that you do have to qualify medically to change Medigap plans in most cases. So, although you may be in good health now, if that changes and you want to change plans, you may not be able to do so.
Lastly, the deductible amount, which is currently $2,200, does change annually. Whereas other Medigap plans expand to fill the Medicare “gaps” as they change, your out-of-pocket costs under the High Deductible Plan F do change over time as the deductible itself changes.
Overall, the HDF is a viable option if you are in good health and just looking to keep your premiums down. However, you should certainly take the time to understand the long-term implications of this plan or any other plan you are considering. Is Plan F a Viable Medicare Supplement Option?
Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option? Is Plan F a Viable Medicare Supplement Option?
Garrett is the founder/President of Secure Medicare Solutions, a leading, independent Medicare insurance agency. Since 2007, Garrett has worked with tens of thousands of people turning 65 or already on Medicare to understand, compare and choose Medicare insurance that fits their specific needs and situation.
His latest project is 65Medicare.org, an online hub for people just starting with Medicare, which is focused on distilling difficult Medicare questions into easy-to-understand resources.
Garrett resides in North Carolina with his lovely wife, Celeste, and three spirited children.View All Articles