There are two parts of Original Medicare; Parts A and B. Part hospital insurance covers inpatient care, hospice care, skilled nursing facility, home healthcare, skilled nursing facility, and laboratory tests. Part B covers majorly doctor’s services and outpatient care. It also covers some preventive services and tests, and few durable equipment. As you age, you begin to realize that Original Medicare covers only a fraction of your medical needs. You need more coverage to stay healthy and remain financially stable.
What Original Medicare Doesn’t Cover
At first glance, the benefits of Original Medicare Parts A and B may seem enough. But there are vital healthcare needs that neither Part A nor B cover. If you have only Original Medicare coverage, you have to cover these out-of-pocket costs on your own.
Original Medicare out-of-pocket costs include:
- Up to $1,408 worth of Part A deductible
- Up to $198 Part B deductible
- 20% of doctor’s services and other medical needs
- Copayment if you stay in a hospital for more than 60 days
- Copayment if you stay in a skilled nursing facility for more than 20 days
To cover these costs, you have to enroll in a Medicare insurance policy sold by private insurance companies. You may enroll for a Medicare Advantage, Medicare Supplement, or a Prescription Drug plan.
Many people enroll in a Medicare Supplement plan, called Medigap. This is because Medigap offers you more freedom. It covers most of your copayments, coinsurance, and deductibles. You can get a doctor’s service anywhere in the country. You don’t need a referral from a primary care provider. And you get emergency care in a foreign country. Mutual of Omaha, AARP, and Blue Cross are just a few options on where you can get high quality Medicare Supplement plans.
Why Medicare Supplement Plan F
Medigap offers up to 12 plans lettered A to N and depending on where you live medicare supplement plan f rates may vary. All the plans are standardized in up to 50 states. Each Medigap plan offers a different range of benefits.
Medicare Supplement Plan F is the most complete and comprehensive Medigap plan. It is also the most popular plan. The list of Plan F benefits include:
- Part A deductible: If you have to stay in the hospital, you need to pay the Part A deductible. This is payable every benefit period and the cost is up to $1,408. Some Medigap plans may cover up to 50% or 75% of this cost but Plan F covers 100%.
- Part B deductible: Every year, you have to pay a $198 deductible before you get your Part B Medicare coverage. Medicare Supplement Plan F covers 100% of this cost. Only Plan F and Plan C cover this cost.
- Part B coinsurance: For every Part B coverage you get from Medicare, there is a 20% out-of-pocket copayment. Plan F covers all of the copayment for your Part B Medicare services.
- Part B excess charges: Some doctors don’t accept Medicare-approved payment as their full payment. They may charge up to 15% more. You have to bear this excess charge yourself. But with a Medicare Supplement Plan F, you get 100% coverage for excess charges.
- Foreign Travel Medical costs: Plan F covers up to 80% of your travel medical cost if you have an emergency in a foreign country.
Additional Medicare Supplement Plan F Benefits
Alongside these benefits, Plan F covers 100% your Part A copayments and coinsurance. This includes hospice care copayment and expense for 365 days after your Medicare coverage stops. You also get a 100% skilled nursing facility copayment benefit.
If you visit the hospital frequently due to a medical condition, Plan F may be the best for you. It may also be the best if you take foreign travels a lot or you usually have to pay excess charges.
In 2015, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed. The law stopped Medigap policies from giving Part B Medicare deductible benefits. This affects new policyholders enrolling from January 2020. It doesn’t affect a previous Plan F policyholder.
The Best Plan for You
Medicare Supplement Plan F could be the best Medigap option for you. Every seniors situation is unique so it’s important to find a customized plan that fits your needs. However, we are confident that Plan F can provide you quality heath care benefits you deserve. If you have any questions about Medigap plans or which plan may be best for you, we’d love to help. Feel free to contact us at 855-249-0191!