Medicare is important to seniors. However, it can be confusing when there are so many supplemental plans to choose from. Not only do you have Medicare Supplement Plan F. You also have Plan G and Plan N. So, what is the difference between the three?
Medigap Plan F
Medigap Plan F is a supplement insurance policy offered by private insurance companies. Plan F covers any gaps that Medicare does not pay for. Medigap Plan F was discontinued in 2020 to new Medicare enrollees. Because of this, Medigap Plan F is no longer available for purchase to new enrollees. However, those who enrolled in Plan F before its discontinuation continue to receive coverage under Medigap Plan F.
Plan F picks up costs, such as copayments, deductibles, and coinsurance. Plan F offers the most comprehensive coverage of any Medigap plan. If you enrolled in Plan F by December 31, 2019, you can keep it. After January 1, 2020, new policies are not allowed to pay for the Medicare Part B deductible.
While Plan F is most likely the best Medigap plan, Plan F is more expensive than its counterparts. As a result, you may spend more on the extra coverage you receive.
If you are not eligible to purchase Medigap Plan F, you have several options that may be just as good and cover almost as much. Medicare pays 80 percent of your medical costs, while supplement Plan F picks up the remaining costs. There’s just one catch. You may need to pay significantly more for Plan F than other Medigap plans.
But what exactly does Plan F cover? According to experts, Plan F offers coverage for Medicare Part A and Part B deductibles. It also covers international medical coverage and skilled nursing facility care. Plan F covers costs that are above the amount Medicare will cover, and you may not have out-of-pocket costs for doctor visits and hospital stays.
Under this plan, hospital stays that last for an additional 365 days are covered after Medicare benefits “end,” experts say. Plan F also covers additional expenses, such as Part B coinsurance, copayments, approved medical expenses, and outpatient services rendered in a hospital setting.
In addition, Plan F pays for the first three pints of blood for a blood transfusion each year. It also covers hospice care, Medicare Part B excess charges, your Part A deductible for hospital stays, and your Part B deductible for outpatient and inpatient medical expenses. However, be advised that Plan F has a “high deductible option.”
If you select the high deductible option, you will pay a high price. In 2023, the deductible amount for the high deductible option was $2,700. However, that amount is likely to increase each year. Premiums for high deductible policies are generally lower, but your out-of-pocket costs are higher.
Plan F is a good option for people who don’t want to deal with strict doctor networks. These can be limiting. If you don’t want to deal with doctor networks, Plan F is probably a good option for you. This plan covers international travel emergencies for the first 60 days of your travel outside the country.
However, Plan F does not cover prescription drugs, long-term care, vision care, and dental care.
Medigap Plan G
Medigap Plan G offers several benefits. Like other Medigap plans, Plan G fills in the gaps that Original Medicare does not cover and picks up costs that remain after Medicare pays its share. Plan G covers more expenses for new enrollees than any other plan. Plan G is essentially a replacement for Plan F for new members. Plan C is no longer available, as well.
According to experts, Plan G covers the cost of hospital stays that extend to an additional 365 days after all Medicare benefits are exhausted. Plan G also covers your Part A deductible and Part A hospice care copayment or coinsurance. Your Plan B coinsurance or copayment are also covered, as are any Part B excess charges you accrue.
Plan G also covers your medical expenses for emergencies when you travel overseas. This coverage is active up to the first 60 days of overseas travel. However, there may be limitations. In some cases, a deductible will need to be paid.
It is important to note that Plan G does not cover prescription medications, dental care, vision care, private-duty nursing care, or long-term care that you would find in a nursing home setting.
However, the cost of care is a huge consideration, especially for those with other expenses.
The cost of Medigap Plan G will vary depending on a number of factors. Prices for Plan G are generally determined by private health insurance companies, even though the government regulates these plans. Price will also depend upon one’s age, gender location, smoking status, and a multitude of other factors.
A smoker who is 65 years of age could pay between $101 and $343 for a monthly premium. You can get a high-deductible Plan G in many states. This high-deductible plan offers “the same benefits” after you meet a deductible of $2,700. The $226 Part B deductible does not count towards the $2,700. Monthly premiums for a nonsmoker over the age of 65 range from $39 to $61 per month.
But when is the best time to buy a Medigap plan G? Open enrollment is the best time to sign up for a Medigap Plan. The Medigap open enrollment period lasts for six months. Open enrollment only happens once. It happens the moment you turn 65, enrolled in Part B and ends after six months.
If you are 65, still working, and have a plan through your employer, your six-month open enrollment window opens after you leave your place of employment and enroll in part B. Medigap policies are the easiest to get during your open enrollment period. This is because insurance companies are not permitted to factor your medical history and health status into the price they quote you.
Once your open enrollment window closes, insurance companies may deny you coverage based upon your health, and prices go up depending on your situation.
Medigap Plan N
According to Nerd Wallet, Medigap Plan N is a supplemental insurance plan that pays for out-of-pocket medical expenses that are not covered by Original Medicare, which is also called Medicare Parts A and B. If you don’t go to the doctor or medical facilities very often, Plan N might be the right Medigap plan for you.
It is more cost-effective. Plan N’s premiums are lower when compared to other Medigap plans. However, you will be required to pay many small copays. The cost of these adds up, and in some cases, places an undue hardship on Medicare beneficiaries. Companies keep these costs low by offering “reduced coverage” for some benefits. Instead of paying for the total cost of your Part B copayment, your insurance company holds you responsible for the copayment under Plan N.
You must pay $20 for certain office visits. Emergency room visits cost you $50 as long as you are not admitted into a facility for inpatient care. Once you pay for these costs, Plan B covers any other coinsurance or copayments you are required to pay. Much like Medigap Plans F and G, Plan N pays for an extra year of hospitalization after Medicare has paid its share.
It also covers the Part A deductible, a hospice care coinsurance or copayment, and coinsurance for skilled nursing facility care.
It also pays for the first three pints of blood for a blood transfusion and any service deemed medically necessary in the first 60 weeks of international travel. But like Plan G, there may also be limitations and the potential for deductibles.
What exactly does Plan N not cover? Plan N does not cover Plan B excess charges. Plan N also does not cover the Plan B deductible. However, some individuals who have older plans may have these costs covered. It’s important to note that these plans are similar, but there are distinct differences.
Plan F is by far the most comprehensive Medigap option, but since it is no longer available, seniors enrolled in Plan F before discontinuation continue to enjoy its benefits. Because Plan F’s benefits are costly, it may be unattainable to some people who obtained coverage.
New Medigap enrollees enjoy tremendous benefits through Plan G. Plan N, on the other hand, is more beneficial to a different demographic. Although those with Plan N have lower premiums, the cost of copays adds up. You need to factor your health status & budget in deciding.
In the end, it is important to evaluate your situation and decide which plan will best meet your lifestyle and financial situation. If Plan N does not suit your needs, but you want the benefits of Plan F, Plan G may be your best option.
It is important to consider other factors, such as your monthly income and whether you are on a fixed income. The right plan for you may also depend upon your health. Many of these plans are similar, but their differences can determine which one will better suit you.
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