You may be looking at Medigap Plans F and G and thinking, what’s the difference? At first glance, the two plans appear nearly identical. While Plan F has typically been the most popular plan on the market, covering all gaps in Medicare and giving you peace of mind, Plan G is fast gaining popularity. Let’s take a closer look at Medigap Plan F vs G so you can determine which one is best for you.
If you already know which plan you prefer, you can get a free price report to compare premiums in you area!
Some Context
As with all Medigap plans, plans F and G both cover the gaps that your Medicare plan leaves uncovered, saving you out of pocket expenses in exchange for a monthly premium. A variety of Medigap plans are available and offer differing levels of gap coverage.
Plans with lower monthly premiums tend cover fewer gaps, leaving you with more out of pocket expenses should you have a medical need. Plans with higher monthly premiums cover more gaps, giving you the added assurances that come with greater coverage. Plans F and G fall on the latter end of the spectrum, offering comprehensive coverage for higher monthly premiums.
Plan F vs Plan G Coverage
Our Medigap plans comparison gives a broad overview of coverage across all plans, but here’s a quick rundown on the differences between Plans F and G:
Plan F Covers
- Medicare Part A coinsurance and hospital costs
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part A deductible
- Medicare Part B coinsurance or copayment
- Medicare Part B deductible
- Medicare Part B excess charges
- First three pints of blood used in an approved medical procedure (annually)
- Foreign travel emergency care (up to 80%)
- Skilled Nursing Facility (SNF) coinsurance
- Coverage for any doctor in-network for Medicare (that’s more than 800,000 doctors nationwide).
Plan G Covers
- Medicare Part A coinsurance and hospital costs
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part A deductible
- Medicare Part B coinsurance or copayment
- Medicare Part B excess charges
- First three pints of blood used in an approved medical procedure (annually)
- Foreign travel emergency care (up to 80%)
- Skilled Nursing Facility (SNF) coinsurance
- Coverage for any doctor in-network for Medicare (that’s more than 800,000 doctors nationwide).
You’ll notice the only difference between the two is that Plan F pays the annual Medicare Part B deductible—which in 2021 is $203 annually—while Plan G does not. The Medicare Part B deductible covers general medical and outpatient care, and is one of the lower-costing expenses associated with Medicare.
While Plan F covers this deductible, Plan G allows a cost-sharing option, meaning that once that annual deductible is hit, Medicare will pay 80% of remaining outpatient costs and Plan G will pay the other 20%. Most importantly, Plans F and G both cover all Medicare Part A expenses, which include all hospital expenses and the hospital deductible, which alone can be over $1484.
Why choose Plan G if Plan F covers everything?
It really depends on what you value: more money in your pocket or the security of knowing you’re completely covered.
- Plan F has a higher monthly premium but covers that extra $203 deductible for general medical and outpatient care.
- Plan G has a lower monthly premium in exchange for a little bit of cost-sharing.
- Which should I choose? If you anticipate frequent medical and outpatient expenses, Plan F may be worth the extra monthly premium, but you’ll want to schedule an agent call for personalized assistance.
Changes to Plan F
Your eligibility for Plan F may also be impacted if you’re a new enrollee. After January 1, 2020, no Medigap policies covering the Medicare Part B deductible (Plans F and C) may be sold or issued to a newly eligible Medicare beneficiary. People who turn 65 on December 31, 2019 will be the last group eligible to enroll in Medigap Plans F and C. However everyone eligible and enrolled in Medicare PRIOR to 1/1/2020 will still have the right to switch from a Plan F or Plan C with one carrier to another OR purchase a new Plan F or C for the first time. If you’re directly affected by this law and are looking for the most comprehensive coverage, the decision is made for you already. Plan G offers the highest coverage unaffected by this change.
Additional Considerations
Medigap plans provide coverage for any doctor that’s in-network for Medicare, giving you options across more than 800,000 nationwide providers. With Medigap plans, you’re able to see any Medicare specialist, with no referral needed. Coverage is also guaranteed renewable, meaning it can never be canceled due to health conditions from the claims you file.
Remember that Medigap plans only cover treatments and measures insured by Medicare. That means they do not cover the following:
- Homeopathic treatments (e.g. acupuncture)
- Routine vision care/eyeglasses
- Routine dental care/dentures
- Foot care not related to medical conditions
- Hearing aids/routine hearing tests
- Cosmetic surgery
- Custodial care
- Prescription drugs (No Medigap plans include meds. Consider a Part D plan for your prescriptions)
Plan F vs G – The Bottom Line
Both plans offer comprehensive coverage, with the only difference being the Medicare Part B deductible—an $203 expense that Plan F covers but Plan G does not (in exchange for cost-sharing). If you’re not eligible for enrollment until after January 1, 2020, and are considering both plans, Plan G will be the option for you. If you’re not affected by this change, consider how much the deductible/premium trade off means to you. Either way you’ll want to schedule an agent call so you can make the best decision for your health and financial needs.
Compare Premiums
It’s important to know that Medigap plans are standardized by the government, so you get the same benefits regardless of where you are located and from which private insurance company you purchase your plan. When shopping for coverage, then, you’ll want to mostly consider companies’ rates and rate history increases. We make it easy to do just that. To compare premiums for your chosen plans in your area, get a free price report today.