One of the most important things to know about Medicare is that Medicare Part B only covers 80% of approved services. The rest falls to you. Fortunately, you can sign up for a Medicare Supplement plan, also known as a Medigap, to help cover the remaining 20%.
There are ten Medigap plans to choose from with varying levels of coverage. Two of the most popular plans are Plan G and Plan F. So, how is Medicare Plan G different from Plan F?
The Differences Between Medicare Plan G & Plan F
Medigap Plan G and Plan F are similar to one another. However, there are some key differences to know. Let’s take a closer look.
The most significant difference between Plan G and Plan F is that Plan F covers more than Plan G, also making Plan G more budget-friendly for some. Learn more about how to save with Plan G at https://boomerbenefits.com/medicare-supplement-g-two-ways-to-save/
There are nine different “gaps” in Medicare coverage that you are responsible for paying. These gaps include the Part A coinsurance and hospital costs, Part B excess charges, the Part B deductible, and more.
Each of the ten Medigap plans covers these gaps at different levels. Plan G and Plan F offer the most comprehensive coverage out of all the Medigap plans. The greatest difference between the two is that Plan F covers the Part B deductible, but Plan G does not. The Part B deductible is $226 in 2023.
Your Plan G benefits will not kick in until you meet the Part B deductible for the year. However, with Plan F, you do not need to meet the Part B deductible first. Your Plan F benefits kick in immediately.
Another notable difference between these two plans is that Plan F is not available to all Medicare beneficiaries. Whether you can enroll in Plan F depends on when you became eligible for Medicare.
If you became eligible before January 1st, 2020, you could still apply for Medigap Plan F. However, if you become eligible for Medicare on or after January 1st, 2020, you cannot apply for Plan F.
The monthly premiums associated with the two plans also differ. As mentioned earlier, Plan F covers more than Plan G. Because of this, Plan F tends to have higher monthly premiums than Plan G. So, if you’re eligible for Plan F, know that you will likely pay more each month.
Your exact cost for a Medigap plan depends on various factors, including your age, zip code, gender, tobacco use, and more.
About Medicare Supplement Plans
All ten Medigap plans share some of the same characteristics as well. Knowing how all the plans work will assist you in understanding the differences between Plan F and Plan G.
As mentioned earlier, Medigap plans help cover some or all of your 20%. But, these plans are secondary to Medicare, meaning Medicare pays first for approved services, and your Medigap pays second. If Medicare does not pay for a service, neither will your Medigap plan.
Another characteristic of Medigap plans is that they are all standardized. Each type of plan will offer the same benefits no matter which private insurance carrier you purchase it through. For example, a Medigap Plan F with UnitedHealthcare will have the same benefits as a Plan F with Blue Cross Blue Shield.
Medigap plans do not have network restrictions. Suppose you have Original Medicare (Medicare benefits through the federal government) and a Medigap plan. In this case, you can see any provider in the United States as long as they accept Medicare insurance.
Limited Enrollment Periods
Everyone qualifies for a 6-month Medigap Open Enrollment period based on their Part B effective date. During this period, you can enroll in a Medigap plan without answering health questions, commonly known as underwriting. This means insurance carriers cannot deny your application based on your health.
Once this enrollment period is over, you can still apply for a Medigap plan, but you will likely have to pass underwriting. This means an insurance carrier can deny your application based on your health.
Some states have more flexible underwriting rules, though, so it does depend on where you live.
People often ask which one is better, Plan F or Plan G. In the end, the right decision comes down to your budget and personal preferences. However, some people find that Plan G is economical in the long run, even with the Part B deductible, because Plan F premiums are usually high.