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:
Service | Who pays what? |
---|---|
First 60 days | Medicare pays: All cost but $1,632 Plan pays[1]: $1,632 Member pays[2]: Nothing |
61st thru 90th day | Medicare 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 days | Medicare pays: Nothing Plan pays[1]: 100% of Medicare-eligible expenses Member pays[2]: Nothing |
Beyond the additional 365 days | Medicare pays: Nothing
Plan pays[1]: Nothing Member pays[2]: All cost |
Service | Who pays what? |
---|---|
Part B Deductible | Medicare pays: Nothing Plan pays[1]: $240 Member pays[2]: Nothing |
Part B Coinsurance | Medicare 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 |
Service | Who pays what? |
---|---|
First three pints | Medicare 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 amounts | Medicare pays: 80% Plan pays[1]: 20% Member pays[2]: Nothing |
Service | Who 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 day | Medicare pays: 80% Plan pays[1]: 20% Member pays[2]: Nothing |
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.
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.
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