If you currently use Medicare benefits, you may or may not realize that Medigap Plan F will no longer be an option in January 2020. Medigap insurance is offered to retired persons age 65 and older to supplement their Medicare benefits. Medigap Plan F has been a popular choice, as it provides coverage for care not met by Original Medicare alone. While new Medicare enrollees will no longer be able to choose Plan F, there are other options available. Since Medicare coverage can be confusing, the following is a brief overview.
8. Original Medicare
Medicare coverage can vary widely depending on where you live. According to the U.S. Government Site for Medicare, both federal and state laws dictate your specific coverage. Original Medicare consists of two parts known as Part A and Part B. Part A covers inpatient hospital care, skilled nursing facility care, inpatient care in a skilled nursing facility, hospice care, and home health care. Part B of Original Medicare covers outpatient services such as clinical studies, ambulance services, medical equipment, mental health needs, and some outpatient prescription medications.
7. Things That Are Not Covered by Original Medicare
Original Medicare does not pay for any and every medical service a patient might need. Items not covered by Original Medicare may include long-term care, dental services, and eye exams for glasses. Furthermore, this coverage may exclude dentures, acupuncture, hearing aids and related exams, and cosmetic surgery. Moreover, the use of Original Medicare requires you to pay out-of-pocket for deductibles, coinsurance, and copayments.
6. Medicare Advantage Plans (Part C)
Since Original Medicare has many gaps in coverage, private health insurance companies offer Medicare health plans to help fill in the holes left by this coverage. By purchasing a Medicare Advantage Plan, an enrollee will have all of his or her Part A and Part B benefits in addition to additional coverage. This coverage can be provided by a health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS) plan, or special needs (SNP) plan.
5. Medicare Medical Savings Account (MSA) Plans
MSA plans allow an enrollee to take part in a Medicare Advantage Plan (Part C) in which the participant pays a high deductible each year for services. Once the enrollee meets this high deductible, the health care plan will begin paying out for costs. Along with this high deductible plan comes a medical savings account. Medicare places funds into this account, which the enrollee can then use to pay for medical care. Payments for services covered under Part A and Part B count toward the deductible. Some MSA plans may cover for items such as dental or vision care.
4. Medicare Supplement Plans
According to eHealth Medicare, there are ten different supplemental plans to choose from when looking to purchase coverage to supplement Original Medicare. Plans A, B, C, D, F, G, K, L, M, and N are available in most states, and their coverage varies depending on location and state regulations. An individual must first enroll in Original Medicare Parts A and B before adding a supplemental plan to the mix.
3. Medicare Plan F
According to Boomer Benefits, Medigap Plan F has been a popular plan among baby boomers. While this plan is more expensive than other types of coverage, it covers all Medicare deductibles, copays, and coinsurance premiums. This allows the enrollee to avoid any unexpected out-of-pocket expenses. This plan also includes the deductibles in Medicare Part B. However, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) dictates that as of January 2020, Medigap plans will not be allowed to cover the Part B deductible. This means that Plan F, and Plan C, which also covers the Part B deductible, will no longer be available to new enrollees.
2. Is It Wise to Continue With Plan F
Those who are currently utilizing Plan F will be able to continue with the same coverage. If you are presently using Plan F, you may be wondering if it is wise to stick with this option. Likewise, if you are looking to enroll in a supplemental plan before 2020 rolls around, you may question whether you should hurry and select this plan while it is still available. While that is certainly an option, once the change occurs, Plan F may not be a savvy option. As the population using Plan F ages and no new enrollees join, rates may increase.
1. Other Medigap Options
Those who are looking for coverage similar to that offered by Plan F may benefit from coverage under Plan G. Plan G covers many of the same items as Plan F. However, it does not include the Part B deductible that is no longer allowed. eHealth Medicare advises individuals living in Minnesota, Massachusetts, or Wisconsin to investigate the options available in those states. Each of these states maintains a state health insurance assistance program (SHIP).