Certain Medicare Supplement plans, also known as Medigap, will no longer be offered to newly eligible enrollees after January 1, 2020. This change specifically impacts plans that pay for the Medicare Part B deductible, like Medicare Supplement Plan F.
What Does Plan F Cover?
Like most Medigap plans, Plan F covers many of the out-of-pocket expenses associated with your Original Medicare benefits:
- 100% coverage of Part A coinsurance and costs while staying in the hospital, for up to 365-day once Medicare benefits are exhausted
- 100% coverage of Part B outpatient coinsurances and copayments
- 100% coverage of the first 3 pints of blood for a transfusion.
- 100% coverage of Part A’s coinsurance or copayment for hospice care.
- 100% coverage of the coinsurance at a skilled nursing facility.
- 100% coverage of the Part A deductible
- 100% coverage of the Part B deductible
- 100% coverage of excess charges with Part B
- 80% coverage of medical care during a foreign travel emergency
Plan F does cap out-of-pocket expense limits like some other plans do. Medigap plans offered by private insurers may have a high-deductible version of Plan F alongside traditional Plan F coverage.
What Changes for Plan F in 2020?
Although Medigap Plan F is being discontinued at the beginning of 2020, this does not mean current enrollees in Plan F will lose their coverage with that plan. The change impacts newly eligible enrollees, which means anyone who turns 65 and first becomes eligible for Medicare in 2020.
Medicare recipients who already have Medigap Plan F or who turned 65 prior to 2020 can use this plan. While open enrollment for Medigap plans is limited to the 6 months when you first become eligible for Medicare itself, starting the month you turn 65, there are certain life events that can offer you a guaranteed issue right. These prevent Medigap plans from denying you or delaying your coverage for pre-existing conditions or charging higher premiums.
Even if a Medigap plan has been discontinued for newly eligible enrollees, Medicare recipients who satisfy the special circumstances that grant them guaranteed issue rights and who were 65 before the date a plan is discontinued may still be able to enroll in that plan if it’s offered in their area.
It’s important to note that the premiums for discontinued plans like Plan F can rise once new Medicare beneficiaries can no longer enroll in it. Current enrollees may find the cost of their Plan F’s premium too high when compared to other Medigap plans on the market. However, there are some important factors to keep in mind before changing to a different Medigap plan.
Can Plan F Enrollees Change Their Coverage?
Loss of coverage can open up penalty-free enrollment rules for other Medigap plans, but this does not apply to plans that are still being offered even though they have been discontinued for new enrollees. An existing Plan F recipient may not be able to switch to another Medigap plan if the plan denies them coverage due to a pre-existing condition. Recipients may also find they are charged a higher premium for attempting to switch plans past their initial enrollment period.
If a recipient is still within their 6-month open enrollment period when they choose Plan F, they may switch to a different Medigap plan without these issues factoring in. In addition to that, Medigap plans offer recipients a 30-day grace period where they can return to their former plan if they don’t find the new one to their liking. Premiums for both plans must be paid in this period, however.
Recipients can choose to change to a Medicare Advantage plan or Original Medicare benefits at any time, but they may not be able to change back to Plan F or any other Medigap plan after the switch.
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