Health & Wellness / Medicare

Medicare Supplements: Plan F or Plan G ?

medicare-slider-no-wordsBy – Christopher Shyide

Shopping for Medicare Supplements is no simple task. With 11 different supplements[i] that each fill in the gaps Medicare leaves you responsible for, it can all seem very overwhelming. Agents often start with Plan F or Plan G. These two plans look very similar and trying to choose one over the other can cause indecision.  What is the difference? Why Choose Plan F over Plan G, or Plan G over Plan F?

Let’s start with Plan F. Plan F is the most comprehensive of the Medicare supplements. It is the only plan that is designed to cover the full 20% Medicare leaves you responsible for; providing it is a Medicare covered service. The gaps that Medicare leaves you responsible for can be broken down into 9 Categories and Plan F is the plan that covers them all.

  1. Part A Coinsurance and Hospital Costs- After your first 60 days in a hospital Part A leaves you responsible for $322 per day for days 60-90. For Days 91-150 (Your Life time reserve days) you pay $644 per day. After day 150 you are responsible for 100% of the cost. Plan F will pay your cost from day 60 to day 150 and cover you at 100% for an additional 365 days.
  2. Part B Coinsurance or Copayment- Medicare generally covers 80% leaving you responsible for 20%. Plan F will pay that 20%.
  3. First 3 Pints of Blood– Medicare covers anything over 3 pints, but you would pay the full cost for the first 3- Plan F will cover those first pints.
  4. Part A Hospice Care Coinsurance or Copayment- Medicare will cover all costs except a very limited copayment/coinsurance for outpatient drugs and inpatient respite care. Plan F will pay the Medicare copayment/coinsurance.
  5. Skilled Nursing Facility Care- Medicare pays for the first 20 days in skilled nursing facility when you have met Medicare’s requirements. Days 21-100 Medicare makes you pay $161 per day. Days 101 and on you would be responsible for the full cost. Plan F will cover your $161 per day, for days 21-100.
  6. Part A Deductible- This year the deductible per benefit period is $1,288 for the first 60 days. Plan F pays your deductible.
  7. Part B Deductible- This year the deductible is $166. This is an annual deductible on Part B Medical Expenses. Plan F will cover your $166.
  8. Part B Excess charges- An Excess charge is an amount over what Medicare pays a doctor that a doctor can charge you. If you go to a doctor who does not accept Medicare payment in full, they may charge you up to 15% over what Medicare pays them. Plan F will cover this.
  9. Foreign Travel Emergency- Medicare does not cover you out of the country except for limited circumstance near the U.S. Border. Plan F will cover you in the event of an emergency. You will have a $250 deductible and be responsible for 20% up to a lifetime limit of $50,000.

Plan G covers everything Plan F covers except for one thing, The Part B Deductible. This means in a Plan G you will be responsible for the first $166 of Part B Expenses. That is the one and only difference, everything else is the same.

Why take Plan F over Plan G?

People take Plan F over Plan G for many reasons. The biggest reason would be knowing that you are fully covered. As long as you are seeing a doctor for a Medicare approved service you would have no out of pocket expenses. This makes budgeting monthly easier because you don’t have to worry about out of control medical bills.

Why Plan G over Plan F?

Taking Plan G over Plan F often comes down to cost. Depending on where you live there can be a large difference between Plan F and Plan G. It may make paying the deductible the smarter of the two options. While it is important to know that the deductible can change every year, this year being $166. This means that unless the difference is less than $14 you may be paying more than $166 a year to cover the deductible.

In the end both Plans are good and will help fill in your 20%. What’s most important is deciding what you want and what coverage will fit your needs best.

[i] MA, MN and WI have separate state guidelines. Please call AMAC’s licensed Agents for information on these states.

If you have any questions please call AMAC’s Medicare Department to speak to one of our Trusted, Licensed Insurance Agents

Call
1-800-334-9330
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source: medicare.gov

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LWri
2 years ago

This article is very out of date, and should be replace with Eileen MacNalish article “Which is Best for Me? Don’t you think?

dan
2 years ago

plan F is being discontinued Jan 1, 2020. for new enrollments

Jan Moore
2 years ago

Does your plan have silver sneakers?

Gerry Bradley
3 years ago

What about Plan F – High deductible?

Dennis Swanson
3 years ago

Be careful about joining Plan F. After 2020, the plan can no longer be sold. That means each year after that the pool will get smaller and that means the prices will go up much faster than Plan G. Going to Plan F will cost you much more after 2020 in additional premiums that will far exceed the Part B deductible.

Dorothea Lander
3 years ago
Reply to  Dennis Swanson

Dennis, are you able to point me to where you found that Plan F can no longer be sold after 2020? Thanks.

Donna Jacks
1 year ago

Dorothea, actually Plan F cannot be sold to new enrollees after Dec 31, 2019. Those already enrolled can continue their coverage in 2020 and are grandfathered in. Plan G will be the best plan availability in 2020. It is identical to Plan F with one exception, and that is that the Part B Deductible will not be covered (currently $184.50) and must be paid by the Plan G policyholders. Plan G premiums will be lower than Plan F premiums.

Bob
4 years ago

Number 7, Part B Deductible above says “Plan F will cover your $166”. I believe this information is incorrect as Plan F does NOT cover the $166 deductible.

Anthony M
4 years ago
Reply to  Bob

Plan F most definitely covers the part B deductible, the G does not …… if you want to double check what is covered by which of the several supplement plans i would suggest doing a google search and view the “choosing a medigap policy” adobe doc that comes up for medicare.gov ……….. also the deductibles are going up for both A and B ……. A-$1316 and B-$183 for 2017

Jim H
4 years ago

If you are on a medicare advantage plan that is accepted by your doctor and want to switch to a supplemental plan BE CAREFUL. To subscribe to a supplemental plan your primary plan MUST be Medicare and not all doctors accept Medicare. If you switch first and then find out that your doctor doesn’t take medicare you will have to find a new doctor who not only takes Medicare patients but also accepts the insurance plan you switched to, or if you want to keep your doctor you will have to go back to your advantage plan.

Anthony M
4 years ago
Reply to  Jim H

if the provider does not accept medicare then they surely will not accept the medicare advantage plan, since the provider MUST accept medicare to contract for or accept the medicare advantage plan ………

Mike Bouley
4 years ago
Reply to  Jim H

More doctors actually accept Original Medicare than do Medicare Advantage as Original Medicare pays more for services. If someone can afford and/or qualify for a Medigap Supplement, it will certainly provide broader and more expanded coverage. Regardless of whom your Supplement is with, you are able to see any doctor that accepts Original Medicare. Folks that travel will also see the value in the flexibility.

Les
5 years ago

I’ll be continuing my FEHB, Blue Cross Blue Shield into retirement. The federal retirement seminars all tell me that once I have Medicare I should select part B and BCBS will waive copays etc. But if this plan F pays for everything else that Part A doesn’t why should I even keep the BCBS? Other than for the fact that my experience with parents and grandparents has shown that people with additional private insurance are treated more promptly and courteously than medicare only folks?

Candy
5 years ago
Reply to  Les

I have part B and FEHB Blue Cross Blue Shield. BCBS is not waiving my copays. I have met my $350 and am still paying lots and lots of out of pocket.

Chures Ragan
5 years ago

One correction, medicare pays 78.+% of what they allow the provider to charge medicare patients; the law changed in 2014, from 80% to 78.+%. I called them, because my portion of my bills seemed to be more than 20%.
I have a supplement, I chose plan F, and have a deductible of $2600, it will end in 3 years. I pray nothing happens between now and then.
I don’t think medicare is good. Not too many doctors will take new medicare patients. If you need to see a specialist you will need a referral from your pcp. I am talking about dermatologist. And then you either wait for weeks even months to see the md or you are referred to a pa.
Oh, and the first thing you are asked is if you are on medicare.
Then when you are finally at the office you are given a stack of forms including dnr order and will and last testament to complete.

Stuart
5 years ago
Reply to  Chures Ragan

I lived in the Medicare system as a provider for many years in Florida. While there has obviously been an incredible mismanagement of Medicare funds by our government, most people have ignored the personal responsibility portion of the benefit.

For instance, why do you think that Medicare now requires a referral from your primary provider? Because Medicare recipients would get a twinge in their chest and go directly to a cardiologist who might run thousands of dollars of tests only to determine that the patient had indigestion which could have been treated for 1/10th of the cost by a primary provider. At the first twinge of knee pain the recipient went directly to the rheumatologist or orthopedist. I could go on and on.

Visits to medical care providers are an activity for many seniors and I watched many spend 2-3 days a week attending office visits. Besides fixing process, we need to fix the attitude of seniors on Medicare as to appropriate use of the health care system to avoid waste and ensure that there will still be funds available to run the program.

And, by the way, if you are 65 and have not thought about and acted upon developing advanced directives (DNR, Health Care Power of Attorney, Living Will) you are not doing yourself any favors and may be punishing those loved ones that service you.

Nancy Powell
5 years ago

The question is “what is the difference between all the F plans of various insurance companiec? that is where one can save money…i.e.: Is Blue Cross/Blue Shield ‘s F plan better than the various other companies? There is a salesman who tells me the coverage is the same if I switch and can save $500 a year. I’m leary about changing coverage…any thoughts?

CJeanne Deutsch-Schmidt
5 years ago
Reply to  Nancy Powell

The answer is easy…. ALL PLAN Fs, from any company MUST cover exactly the same as is covered in other Plan Fs!!!! If you are trying to decide if you want Plan F from BC/BS or from AETNA, or any other company…… ALL PLAN Fs MUST cover the same. The ONLY difference is what your monthly premium is!!!
The same holds true for ALL Plan Gs, Plan Ls, Plan Ns, etc.

The government requires that all the points of coverage are EXACTLY the same for each Plan, regardless of which company is offering it! The ONLY difference can be is what any specific insurance company charges for the monthly premiums.

In addition, ask your agent which companies rank in the top 10 insurance companies of new insurers. The most trustworthy may have a little higher premium at beginning, compared to monthly premium of a less “rated” company. However, I learned very quickly that those insurance companies who market about REALLY LOW premiums pay a lot later. They are cheaper up front, but then add huge increases in premiums each of next years…

For example my friend listed to Mutual of Ohama and another to Bankers Life as their premiums were “most reasonable”. My agent explained that their rates would esculate each year…..and they clearly did, from $80/month to now 3 years later, exceeding $145/month!
I selected AETNA, one of top 3 Medicare Supplements, and I started first year at $98/month and now 3 years later cost has only moved to $112/month!

Hope you can benefit from my learnings!

Freddie Seaboch
5 years ago
Reply to  Nancy Powell

All F plans and other plans are the same no matter which company you chose

Anthony M
4 years ago
Reply to  Nancy Powell

i would also suggest asking if there are any additional benefits, such as a gym membership through the silver sneakers program or welldine (meals sent after a hospitalization) ……… otherwise all plans in 47 states are the same ….. MA, WI and MN have different options all together ….. sometimes it may be a better option to go with some of the lower cost plans as the premiums on the F and G get very expensive in the later years and most people dont go to the doctor all that often, most just for preventive and the majority of preventive screenings are covered 100% by medicare, I work a lot with the high deductible F since most can put away $2200 for their portion of the out of pocket expenses if they have a bad year, but most people do not have a lot of bad years back to back and if they do they will have saved well over the out of pocket max (deductible) to pay for it. Why pay for a high premium supplement plan when you will rarely ever use it to justify that high of a premium. I tend to use the High Deductible F or the N, and sometimes the K or L. Its best to do a cost analysis and see how much risk you are comfortable with each year, and stop paying those high premiums on the F plan or the G.

PaulO
5 years ago

I selected plan F because the insurance company I wanted to go with doesn’t offer Plan G. Otherwise I would have preferred Plan G as it was more cost effective for me.

Why I chose the insurance company I did was because they are community-rated (also called Not-Age-Rated) which means premiums might go up because of inflation and other factors but do not increase because you’re getting older every year.

Freddie Seaboch
5 years ago
Reply to  PaulO

What’s the name of your company and can anyone on Medicare join

Mike Bouley
4 years ago
Reply to  PaulO

Paul, what State do you reside in, if I may ask? I see that you are in a Community Rated State. If you reside in Massachusetts, New York, Vermont or Connecticut, you have Guaranteed Issue rights that will allow you to change your plan without having to answer health questions. California and Oregon also have laws that allow folks to shop and change their plan, on an annual basis, during the time around their birthday without having to answer health questions.

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