Medicare Supplement
High-Deductible Plan F


Medigap High Deductible Plan F is a specific variation of Medigap Plan F that has a higher deductible compared to the standard Plan F. This plan is designed for individuals who are looking for lower monthly premiums but are willing to pay a higher deductible before their coverage begins.

With High Deductible Plan F, you will need to pay a certain amount out-of-pocket as a deductible ($2,800 for 2024) before the plan starts covering your Medicare costs. Once you have reached the deductible, the plan will provide coverage for the same benefits as the standard Plan F. The key advantage of High Deductible Plan F is its lower monthly premium compared to the standard Plan F. This can be particularly beneficial for individuals who are generally healthy and do not anticipate frequent medical expenses but still want the comprehensive coverage provided by Plan F when needed.

It's important to note that High Deductible Plan F is also not available for new Medicare beneficiaries who became eligible on or after January 1, 2020. Only those who were eligible for Medicare before this date can enroll in or switch to High Deductible Plan F.

If you choose High Deductible Plan F, it's essential to consider your healthcare needs and financial situation. You will be responsible for paying the deductible amount out-of-pocket before the plan covers your expenses, so make sure you can comfortably afford the deductible before selecting this plan.

Below is a comprehensive list of the covered services provided by Medicare Supplement High-Deductible Plan F, which include benefits under Medicare Part A, Medicare Part B, and other areas:

MEDICARE PART A - HOSPITAL SERVICES - PER BENEFIT PERIOD


HOSPITALIZATION
Semi-private room & board, general nursing and miscellaneous services and supplies

ServiceWho pays what?

First 60 daysMedicare pays: All cost but $1,632
Plan pays[1]: $1,632
Member pays[2]: Nothing
61st thru 90th dayMedicare pays: All cost but $408/day
Plan pays[1]: $408/day
Member pays[2]: Nothing
91st day and after (While using 60 lifetime reserve days)Medicare pays: All cost but $816day
Plan pays[1]: $816/day
Member pays[2]: Nothing
Once lifetime reserve days are used; additional 365 daysMedicare pays: Nothing
Plan pays[1]: 100% of Medicare-eligible expenses
Member pays[2]: Nothing
Beyond the additional 365 daysMedicare pays: Nothing
Plan pays[1]: Nothing
Member pays[2]: All cost


SKILLED NURSING FACILITY CARE
You must meet Medicare’s requirements, including having been in a hospital for at least three days, and enter a Medicare approved facility within 30 days after leaving the hospital.

ServiceWho pays what?
First 20 daysMedicare pays: All cost
Plan pays[1]: Nothing
Member pays[2]: Nothing
21st thru 100th dayMedicare pays: All but $204/day
Plan pays[1]: Up to $204/day
Member pays[2]: Nothing
101st day and afterMedicare pays: Nothing
Plan pays[1]: Nothing
Member pays[2]: All cost


BLOOD

ServiceWho pays what?
First three pintsMedicare pays: Nothing
Plan pays[1]: All cost
Member pays[2]: Nothing
Additional amountMedicare pays: All cost
Plan pays[1]: Nothing
Member pays[2]: Nothing


HOSPICE CARE
You must meet Medicare's requirements, including a doctor's certification of terminal illness.

ServiceWho pays what?
Hospice CareMedicare pays: All but very limited
copayment/ coinsurance for outpatient
drugs and inpatient respite care
Plan pays[1]: Medicare copayment and
coinsurance
Member pays[2]: Nothing

MEDICARE PART B - MEDICAL SERVICES - PER CALENDAR YEAR


MEDICAL EXPENSES
In or out of the hospital and outpatient hospital treatment, such as physician's services, inpatient and outpatient medical services and surgical services, physical and speech therapy, diagnostic tests, durable medical equipment.

ServiceWho pays what?
Part B DeductibleMedicare pays: Nothing
Plan pays[1]: $240
Member pays[2]: Nothing
Part B CoinsuranceMedicare pays: 80%
Plan pays[1]: 20%
Member pays[2]: Nothing
Part B Excess Charges
(above Medicare approved
amounts)
Medicare pays: Nothing
Plan pays[1]: All cost
Member pays[2]: Nothing


CLINICAL LABORATORY SERVICES

ServiceWho pays what?
Test for diagnostic lab services  Medicare pays: All cost
Plan pays[1]: Nothing
Member pays[2]: Nothing


BLOOD

ServiceWho pays what?
First three pintsMedicare pays: All cost
Plan pays[1]: Nothing
Member pays[2]: Nothing
Additional amount (First $226 of
Medicare approved amounts)
Medicare pays: Nothing
Plan pays[1]: $240 (Part B deductible)
Member pays[2]: Nothing
Remainder of Medicare approved amountsMedicare pays: 80%
Plan pays[1]: 20%
Member pays[2]: Nothing

MEDICARE PARTS A & B - MEDICAL SERVICES - PER CALENDAR YEAR


HOME HEALTH CARE
Medicare approved services

ServiceWho pays what?
Medically necessary skilled care
services and medical supplies/
Durable medical equipment
(First $226 of Medicare approved amounts)
Medicare pays: Nothing
Plan pays[1]: $240 (Part B deductible)
Member pays[2]: Nothing
61st thru 90th dayMedicare pays: 80%
Plan pays[1]: 20%
Member pays[2]: Nothing

OTHER BENEFITS


FOREIGN TRAVEL
Medically necessary emergency care services beginning during the first 60 days of each trip outside the United States

ServiceWho pays what?
First $250 each calendar year/Remainder of chargesMedicare pays: Nothing (except under limited circumstances)
Plan pays[1]: $0/80% to a lifetime maximum of $50,000
Member pays[2]: $250/20% and amounts over the $50,000 lifetime maximum

Can I enroll in Medicare Supplement High-Deductible Plan F if I am new to Medicare?

No, only individuals who became eligible for Medicare before January 1, 2020, can apply for High-Deductible Plan F. The enactment of the Medicare Access and CHIP Reauthorization (MACRA) legislation in 2015 prohibits the sale of Medicare Supplement plans that cover Medicare's Part B deductible. The objective of this legislation is to phase out these plans, including Plans C, Plan F, and High-Deductible Plan F, and ensure that all Medicare beneficiaries have some out-of-pocket expenses when receiving healthcare services.

Can I keep my Medicare Supplement High-Deductible Plan F if I already have one?

Absolutely! If you have enrolled in Medicare Supplement High-Deductible Plan F before January 1, 2022, you can continue to maintain your coverage without any changes.

Other Medicare Supplement Plans

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