Medicare Plan F Overview: Eligibility Criteria, Expenses, and Continuation
In a significant shift, **Medicare Plan F became unavailable to new Medicare beneficiaries** as of January 1, 2020[1][2][3][5]. This change means that if you became eligible for Medicare on or after this date, you cannot enroll in Plan F, but those who were eligible before then can still buy or keep it.
**Key changes to eligibility and coverage after January 1, 2020:**
- **Plan F and Plan C are no longer sold to new Medicare beneficiaries** who became eligible on or after January 1, 2020[1][2][3][4][5]. - People eligible on or after this date can instead enroll in **Plan G or Plan D**, which offer nearly identical coverage except they do not pay for the Part B deductible, which Plan F and C cover[1][3][4]. - Plan G covers all Medicare Part A and B out-of-pocket costs except the Part B deductible of $257 in 2025[3]. - Plan N is another option for new enrollees, covering most costs like Plan G but requires copayments for some office visits and emergency room visits and may not cover Part B excess charges depending on the state[3]. - Those already enrolled in Plan F before 2020 can keep it, but no new enrollments are allowed unless eligibility was prior to January 1, 2020[2][3].
The reason for this change is that Congress decided Plan F and C were too comprehensive and eliminated cost-sharing for Medicare beneficiaries, so the plans were closed to new enrollees to encourage some cost-sharing participation[3].
**Enrollment and Eligibility**
To enroll in Medicare Plan F, a person must determine their eligibility and whether it is available in their area. A person can enroll in Medicare during the Initial Enrollment Period, with delaying enrollment potentially leading to a penalty on the premium for Part B[6]. To be eligible, a person must also have enrolled in Medicare Part B[7].
**Costs and Coverage**
Medicare Plan F covers deductibles, copayments, and coinsurance for Medicare Part A and Part B. Together, Medicare Part A and Part B are called Original Medicare, with Part A covering hospital expenses and Part B covering other medical expenses[8].
People who have worked for 10 or more years do not need to pay for Medicare Part A. Those who have worked less than 10 years must pay a premium, with a premium of $252 per month for 7.5 to 10 years of work, and $458 per month for less than 7.5 years[9].
The standard benefits that all Medigap Plan F policies offer include Part A hospital costs for an additional 365 days, Part A coinsurance for an additional 365 days, Part A hospice coinsurance or copayments, Part A deductible, Part B coinsurance or copayments, Part B deductible, Part B excess charges, killed nursing facility coinsurance, blood (first 3 pints), foreign travel - 80% of expenses up to the plan limit[10].
It's important to note that Medigap policies are different in Minnesota, Wisconsin, and Massachusetts[11].
Everyone must pay a premium for Medicare Part B, with the base rate being $144.60 per month[12].
**Conclusion**
In summary, while Plan F coverage remains the most comprehensive, paying all deductibles and coinsurance for Part A and B benefits, after January 1, 2020, only those eligible before that date can enroll. New Medicare beneficiaries must choose other plans like Plan G or N, which exclude the Part B deductible coverage found in Plan F[1][2][3][4][5].
[1] https://www.medicare.gov/supplements-other-insurance/how-do-i-get-medigap/when-can-i-buy-medigap-insurance [2] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-changes/medigap-policy-changes-the-basics [3] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-changes/medigap-policy-changes-history [4] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-changes/medigap-policy-changes-what-happened-to-plans-c-and-f [5] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-changes/medigap-policy-changes-faqs [6] https://www.medicare.gov/sign-up-change-plans/get-started/when-can-i-join-a-health-or-drug-plan/part-b-initial-enrollment-period [7] https://www.medicare.gov/sign-up-change-plans/get-started/when-can-i-join-a-health-or-drug-plan/part-b-initial-enrollment-period [8] https://www.medicare.gov/what-medicare-covers/part-a/part-a-hospital-insurance [9] https://www.ssa.gov/planners/retire/costofmedicare.html [10] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-information/medigap-policy-information-plan-f [11] https://www.medicare.gov/supplements-other-insurance/medigap-policies/medigap-policy-information/medigap-policy-information-minnesota-wisconsin-and-massachusetts [12] https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/medicare-premiums-costs/medicare-premiums-costs.html
- Health organizations should provide information about alternative Medicare plans for new beneficiaries, such as Plan G or Plan N, since Plan F and Plan C are no longer available to them starting January 1, 2020.
- Medicare beneficiaries can still seek scientific evidence about the coverage and costs of different healthcare plans, like Plan G or Plan D, as these plans offer nearly identical coverage to Plan F and C except they do not pay for the Part B deductible.
- As part of overall health and wellness, individuals may need to plan for medical-conditions and consider the impact of Medicare plan changes on their future financial well-being, especially since Plan F is not available to new Medicare beneficiaries after January 1, 2020.
