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Medicare Supplement Plan F vs Plan G: How to Choose

4 mins read
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Choosing the right Medicare Supplement plan, also known as a Medigap plan, is crucial for comprehensive healthcare coverage in your golden years. With many options available, it’s easy to get overwhelmed. 

Two plans that are often in direct comparison are Medigap Plan F and Medigap Plan G. They are among the most comprehensive Medigap plans, but each comes with its own set of considerations. 

In this article, we delve into the key differences between these plans, Medicare Plan F vs. Plan G, to help you make an informed decision tailored to your healthcare needs.

Understand Medicare Supplement Plans

Medicare Supplement plans, commonly known as Medigap plans, complement the coverage provided by Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance). Although Original Medicare provides comprehensive coverage, it doesn’t cover all possible healthcare costs. For example, you’ll still face out-of-pocket expenses like deductibles under Part A and a 20% coinsurance for most services under Part B. Medigap plans fill these coverage gaps and take care of additional costs, offering you a more comprehensive healthcare package.

The industry standardizes these supplement plans across the board, so one insurance company’s Plan F offers the same basic benefits as another company’s. This standardization makes it easy to compare plans based solely on cost. In total, there are ten standardized Medigap plans, labeled A through N, each with different covered costs and benefits. Plans F and G stand out for their expansive coverage and are particularly popular choices among beneficiaries.

What to Know About Medicare Plan F

When it comes to comprehensive coverage, Medicare Supplement Plan F takes the lead. It’s the most robust of all Medigap plans, covering nearly all out-of-pocket costs associated with Original Medicare. 

One of the standout features of Plan F is its coverage of both Part A and Part B deductibles. This means that hospital stays under Part A and medical services under Part B come without the burden of an upfront deductible, allowing you to access healthcare without immediate financial concern.

If you’re someone with frequent healthcare needs, the benefits of Plan F could be highly advantageous. Whether it’s frequent doctor visits, ongoing treatments, or hospital stays, Plan F has you covered with minimal to no out-of-pocket costs. All you’re responsible for is the monthly premium.

Plan F also covers Medicare Part B excess charges. These are the additional costs that can arise if a healthcare provider charges more than the Medicare-approved amount for a service. This feature of Plan F offers you full peace of mind and eliminates worry about unexpected expenses.

What to Know About Medicare Plan G

Plan G covers many of the same benefits as Plan F, including the Part A deductible and coinsurance amounts for hospital stays. The key distinction with it is that it does not cover the Medicare Part B deductible. That means you’ll be responsible for paying this amount out-of-pocket before your Plan G benefits kick in for Part B services.

Despite this coverage gap, Plan G compensates by covering Medicare Part B excess charges, just like Plan F. If a healthcare provider charges more than what Medicare has approved for a particular service or item, Plan G will pay for the difference.

The cost-sharing structure of Plan G often makes it a more economical option for many beneficiaries. Monthly premiums are typically lower than those for Plan F, which can result in significant annual savings. This cost difference can more than offset the out-of-pocket Part B deductible that you would be responsible for paying.

Pros and Cons Plan G and Plan F

When comparing Medigap Plan F and Plan G, each offers its own set of trade-offs. 

Plan F is preferred for its comprehensive coverage, essentially offering a “zero out-of-pocket” experience for all services covered by Original Medicare. While this makes healthcare costs more predictable, it comes at the cost of a higher monthly premium. 

Most importantly, Plan F is now only available to beneficiaries who were eligible for Medicare before January 1, 2020. Plan G is available to all new Medicare enrollees, making it a versatile option if you’re newly eligible.

Plan G, on the other hand, offers slightly less coverage as it does not cover the Medicare Part B deductible. It generally comes with lower monthly premiums, however, potentially offering a more cost-effective solution.

Both plans cover Part B excess charges, providing you peace of mind in case a healthcare provider charges more than Medicare’s approved amounts. 

Here are the considerations Medicare beneficiaries weighing the two options must focus on:

  • Premium stability: Investigate the insurer’s pricing method to gauge how your premiums might increase over time.
  • Future policy changes: Keep abreast of potential changes in Medicare that could influence your plan’s benefits or costs.
  • Personal healthcare needs: If you frequently visit healthcare providers or have ongoing medical treatments, evaluate whether the higher premium for more comprehensive coverage will be offset by reduced out-of-pocket expenses.

In summary, your choice between Plan F and Plan G should hinge on your healthcare needs, financial situation, and long-term planning considerations.

At CoverRight, we’re here to help you navigate the complexities of Medicare. Contact us today to find the Medigap plan that best fits your healthcare needs and budget.

Frequently Asked Questions

Can I switch from Plan F to Plan G?

Switching from Plan F to Plan G is possible but comes with certain conditions. Federal law generally does not give you the right to switch Medigap policies unless you’re within your 6-month Medigap open enrollment period or you qualify under a specific situation or guaranteed issue right. If you’re considering a switch, note that you may have a 30-day free look period for your new Medigap policy. During this time, you can revert to your original Plan F without penalties, but you’ll need to pay premiums for both plans for that month.

Are there any network restrictions?

Medigap plans, including Plan F and Plan G, generally don’t have network restrictions when you’re using healthcare providers that accept Medicare. This gives you the flexibility to choose healthcare providers and facilities that accept Medicare patients.

Will my coverage change if I switch plans?

Yes. For instance, if you switch from Plan F to Plan G, you’ll lose coverage for the Medicare Part B deductible, but you’ll likely pay a lower premium. You may also have to wait for the new plan to cover any pre-existing conditions if you’ve had your current Medigap policy for less than six months.

Richard Chan

Richard is the Founder of CoverRight and based in New York. He is passionate about empowering consumers to take control of their health and finances. Prior to starting CoverRight, Richard had extensive experience working in financial services with over 8 years' experience in consumer lending and investment banking.

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