What Does Medicare Supplement Plan F Cover? | GoMedigap
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What Does Medicare Supplement Plan F Cover?

Medicare Supplement Plan F

Medicare Supplement Plan F Coverage

Medicare Supplement Plan F is one of the most popular Medicare Supplement Insurance plans because it offers the most comprehensive coverage of the currently available Medicare supplement insurance plans.

Medigap Plan F covers the most amount of benefits compared to the other Medicare Gap plans.  Plan F covers the ‘gap’ in coverage associated with Parts A and B. This plan enables someone to be able to visit a doctor’s office or hospital to receive approved treatment and walk out without paying anything, virtually eliminating all out of pocket costs. (It is important to understand that these plans do not cover prescription drugs.)

Plan F also includes coverage for other Medicare-approved expenses not associated with Parts A or B. This includes foreign travel emergencies and skilled nursing facility coinsurance. Importantly, Plan F is one of only two plans that include coverage for Medicare Part B excess charges.

Medigap Benefits of Plan F

Plan F Coverage of Medicare Part A Expenses

Plan F covers the Medicare-approved expenses not covered under Medicare Part A (deductibles, coinsurances, and copays). Part A is the hospitalization component of Original Medicare and covers Medicare expenses typically associated with a hospital stay.

Generally, Medicare covers approved charges for hospitalization at 80%.  This leaves the remaining 20% of expenses to be the responsibility of the Medicare patient. Plan F covers the 20% of Medicare-approved hospital expenses not covered under Part A. Plan F also covers other costs, such as:

  • Part A hospital deductible and coinsurance
  • Hospital costs up to an additional 365 days after Medicare benefits are exhausted
  • Part A Hospice care coinsurance or copayment
  • Blood (the first three pints)
  • Other Medicare-approved expenses associated with Part A hospitalization

Plan F Coverage of Medicare Part B Expenses

Plan F also covers the Medicare Part B expenses. Part B covers doctor visits and related charges covered under Medicare for providers. Like Part A, Part B only covers 80% of the Medicare-approved expenses. It leaves the remaining 20% on the Part B participant.

Plan F covers Medicare Part B approved services at the doctor’s office, such as:

  • Medicare Part B coinsurance and copayment
  • Medicare approved doctor’s office fees
  • Part B deductible
  • Medicare Part B excess charges
  • Other Medicare-approved expenses associated with Part B coverage

Plan F is one of only two Medicare supplement plans that cover the Medicare Part B excess charges (the other being Plan G).

Plan F Coverage for Other Medicare-Eligible Expenses: Foreign Travel Emergencies and Nursing Facilities

This plan coverage also includes 80% of approved costs associated with foreign travel emergencies, which is vital for the many seniors who enjoy taking cruises or other trips outside the United States. There are plan limits, but this coverage can help offset charges associated with becoming sick or injured while traveling outside of the U.S.

Plan F also includes Medicare-approved skilled nursing facility coinsurance costs. This coverage is essential as hospitalization (among other causes) can lead to the need to stay for an extended period in a skilled nursing facility for recuperation. Medicare limits this benefit to the first 100 days of a stay in a skilled nursing facility. Because of this, If you need extended coverage beyond 100 days, individuals should consider a long-term care plan.

Medicare Supplemental Plan F is Not Plan F Everywhere

There are some exceptions to Plan F benefits, specifically in the States of Massachusetts, Minnesota, and Wisconsin, where State laws provide for different versions of standardization in the plan. These states are often called “a la carte” states as there are no standardized plans. Medicare recipients essentially “build their own” plans benefit-by-benefit. However, individuals in these states would have the ability to build a plan identical to Plan F.

Medigap Plan F vs. Other Medigap Plans

When comparing pricing of Plan F to the other plans, it is critical to remember that based on utilization and other factors, other Medigap plans may sometimes be a better fit and have lower total overall cost than the comprehensive coverage Plan F.

This is where shopping with a licensed, expert like the GoMedigap Medicare Supplement Insurance Agents can help. They can identify the best plan and price based on your unique needs. Sometimes that plan may be Plan F, but in some instances, another plan may be a better choice for you.

Cost of Medicare Supplement Plan F

Plan F costs can be relatively reasonable regarding monthly premiums for the level of coverage. Although Plan F offers the most comprehensive coverage, Plan F can often allow for lower total health expenses compared to other options available.

Pricing for Plan F is the only variable among insurance companies that offer that plan in a particular state. This is because the Federal Government standardized Plan F and all the other Medicare Supplement plans. They did this with the specific goal of making shopping for a plan more manageable. No matter which company provides Plan F, they all must pay for Medicare approved expenses.

The rates for Plan F will also depend on the current health conditions, age, gender, and tobacco use for the person interested in enrolling in that plan.

Contact GoMedigap for Free Medicare Help!

You can get an instant online Medigap quote to learn more about Plan F rates as well as the other plans that may be available for you. To learn more about Plan F or have additional questions answered, call one of our skilled and knowledgeable GoMedigap agents toll-free at (800) 310-2550 9 am to 5 pm Central time Monday through Friday.

Compare Your Medicare Supplement Rates Immediately!

49 Replies to “What Does Medicare Supplement Plan F Cover?”

    1. Thanks for your question. I’ll have one of our expert Medigap agents reach out to you to give more information on out-of-country coverage.

    1. Hi Ms. Becker,

      Medicare Part B may cover orthotics in some situations. Part B may cover your orthotics if both of the following are true:

    2. Your Medicare doctor prescribes orthotics for you as medically necessary
    3. You buy the orthotics from a Medicare-participating supplier
    4. Medicare Supplement plans will only cover something after Medicare first pays its share. So, if Medicare denies a claim, Medigap Plan F cannot pay anything toward it either.

      To learn more, I recommend that you give GoMedigap a call at (800) 310-2550. You will be able to speak with one of our educated and knowledgable agents, who will be able to understand your specific situation and provide the best recommendation for your coverage needs. We look forward to speaking with you soon!

    1. Hi Debra,

      Great question. When you have a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share. Medigap policies only cover services that Original Medicare covers (with the exception of foreign travel.

      Medicare does not cover room and board if the patient gets hospice care in their home or another facility where the patient lives (like a nursing home). Therefore, the patient’s Medicare supplement would not cover these costs either.

      If your hospice team determines that the patient needs short-term inpatient or respite care services that they arrange, Medicare will cover your stay in the facility (a small copayment for the respite stay may be required).

      As always, please feel free to give us a call at (800) 310-2550, and one of our knowledgeable agents will be readily available to help you with any questions you may have. Have a great day!

    1. Hi Ms. Johnson,

      Medicare does not cover dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, etc. Because Medicare supplements only cover services that Original Medicare covers, Medicare Supplement Plan F does not cover these either.

      GoMedigap represents 30+ of the top Medicare supplement carriers. Additionally, we offer Dental, Vision, and Hearing policies for as low as $31/month. With these plans, you get to choose your own provider, and there is no medical underwriting necessary. Further, you can use this comprehensive coverage for Dental, Vision and Hearing doctor visits however you’d like. You could use it all on dental coverage, or half for dental coverage and half for hearing coverage. If you’re interested in speaking with one of our knowledgeable agents, please give us a call at (800) 310-2550, and one of our agents will be readily available to help you.

    1. Hi Lori,

      Great question. No, Plan F does not cover the Medicare premium that is taken out of your Social Security check. While Plan F offers full coverage of your hospital and medical expenses that are covered by Medicare, it does not cover the premium for Medicare.

      Please let me know if you have any other questions. Or, feel free to give us a call at (800) 310-2550 and one of our agents will be readily available to answer any other questions.

    1. Hi Claire,

      For Medicare to pay for your stay in an acute care rehabilitation facility, your doctor must certify that you need:

      – Intensive physical or occupational rehabilitation (at least 3 hours per day, 5 days per week),
      – At least one additional type of therapy, such as speech therapy or occupational therapy,
      – Full-time access to a doctor with training in rehabilitation,
      – Full-time access to a skilled rehabilitation nurse.

      Medicare Part A reimburses stays at an inpatient rehabilitation facility in the same way as it reimburses regular hospital stays. Basically, you will have the same out-of-pocket costs. For the first 60 days you are an inpatient in an acute care rehabilitation center, Medicare Part A pays for everything. After your 60th day and through your 90th day, you must pay a daily co-pay. If you have not been admitted to the hospital for a certain number of days previously, you may have to pay a hefty Part A deductible upon arrival at an acute care rehabilitation facility.

      This is where a Medicare supplement can come in handy. Medicare supplement insurance covers the gap that Medicare does not cover, including your Part A deductibles and coinsurance, Part B deductibles and coinsurance, skilled nursing care coinsurance, and more.

      GoMedigap specializes in finding the best coverage for our clients at the lowest rate through our proprietary quoting system. Because we independently represent over 30 of the top providers, our agents are able to provide honest guidance for your unique situation. They also take the time to educate you first on Medicare and Medicare supplements, so that you have the information you need to be empowered to make a decision that you are comfortable with. If you’d like help shopping the market today, please give us a call at (800) 310-2550. I’m confident you’ll be glad you did!

  1. I have medicare and I am interested in the medigap plan f. My question is does plan f pay 100% after medicare pays for inpatient hospital stay? Will it pay the full remainder of the 20%?

    1. Hi Ms. Duke,

      Yes, Medigap Plan F pays for the remaining 20% of all Medicare-approved costs, including Medicare-approved inpatient hospital stay expenses.

      If you’re interested in shopping the market for your Medigap Plan F options, our agents at GoMedigap can review rates from 30+ top Medicare supplement providers for you. They’ll be happy to explain ALL of your options for you, so that you can rest assured that you made the best decision possible. If you’re interested, please give us a call at (800) 310-2550 and one of our agents will be happy to help you. We look forward to speaking with you soon!

    1. Hi Ms. Miller,

      Great question. No, the Plan F will always cover the 20% gap in Medicare-approved costs. The plan does not have a limit or “run out” of coverage.

      For additional questions, please feel free to give us a call at (800) 310-2550. One of our agents will be readily available to answer any questions regarding Medicare Supplements and their coverage. Have a fantastic weekend!

    1. Hi Mr. Ballas,

      Being confused is completely understandable. Trying to understand what Medicare Parts A & B cover, what different Medicare supplement plans cover, which plan is best for you and how to get the best price can be an extremely frustrating process if you go it alone. Most of our clients are confused when we initially talk to them, but feel very confident about Medicare and Medicare supplements after they speak with us on the phone.

      Plan F does not cover prescriptions. In fact, Medicare supplements don’t cover prescriptions at all.

      I think your needs may be best suited if you give us a call at (800) 310-2550 for a completely free consultation. Our agents are highly trained and enjoy helping Medicare supplement shoppers find the best plan and rate for their situation. Within a few short minutes on the phone, you will know how Medicare supplement plans work, which plan makes the most sense for you and which company can offer the best rate for that plan. Our agents are not provided incentives to promote one company over another, so you can rest assured that you will receive completely unbiased guidance.

      While we don’t sell Medicare Part D Prescription Drug Plans, our agents will be happy to help you find the best plan for you and point you in the right direction. Again, give us a call at (800) 310-2550. We look forward to speaking with you soon!

  2. My father recently suffered a stroke. He is in need of intense speech therapy and some physical therapy. Does Medicare Plan f cover the cost of this therapy and is there a limit as to how much it will cover?

    1. Hi Diane,

      I’m very sorry to hear about your father.

      Because Medicare Plan F covers the gap in coverage for all Medicare-approved costs, we must first look at whether or not Medicare covers these services. The information below is directly from the medicare.gov website:

      “Medicare Part B helps pay for medically necessary outpatient physical and occupational therapy, and speech-language pathology services. There are limits on these services, called ‘therapy caps’ or ‘therapy limits.’

      They therapy cap limits for 2017 are:
      * $1,980 for physical therapy and speech-language pathology services combined
      * $1,980 for occupational therapy services”

      Because Medicare Part B covers these services if medically necessary, a Medicare supplement Plan F would cover the remaining costs.

      If you’d like to shop the market for a Medicare supplement Plan F for your father and compare rates from the 30+ top providers, please give us a call at (800) 310-2550. One of our unbiased agents will be happy to explain ALL of the options available for your father.

    1. Hi Susan,

      Unfortunately, Medicare does not typically cover nursing home care, because most of this care helps with activities of daily living. Medicare may cover very limited and medically necessary skilled care if you need it for an illness or injury and you meet certain conditions, but this is very limited and will not cover much of your nursing home care.

      Because Medicare does not provide coverage for nursing home care, the Plan F does not cover this either.

  3. I am about to turn 65 YAO and anticipate purchasing plan F.

    I live in southern Indiana but work in Northern Kentucky and would like to have the freedom to choose providers and medical services in both states.

    Am I restricted, or are there financial penalties, if I choose to use medical care from Kentucky?

    1. Hi there,

      You are not restricted, nor are there financial penalties. Medicare supplement policies follow Medicare’s nationwide network. Therefore, as long as the doctor/hospital accepts Original Medicare, then you will be covered by your supplement as well – regardless of location.

      If you’d like to review Plan F rates across 30+ top providers, please feel free to give us a call at (800) 310-2550 for a free consultation. One of our agents will be happy to provide expert advice and guidance given your specific situation. We look forward to speaking with you!

    1. Hi there,

      We are not qualified to provide specific information on what medical services are covered by Medicare. However, we can assure you that if Medicare does cover it, a Medicare supplement would cover the difference it is designed to cover.

      In our research, we don’t find that proton therapy is covered. However, we recommend checking with Medicare directly by calling their toll free number at 800-633-4227. You can also call the cancer center and speak with their billing department to determine if Medicare has paid for proton therapy.

      I’m sorry I couldn’t offer a direct answer, and I wish you a quick and full recovery.

  4. I have plan F with USAA. What exactly is covered for foreign travel? I know about the 80%, but what is the upper limit and is transport home covered?

    1. Mr. Hertl,

      Your Plan F covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care. It pays 80% of the billed charges for certain medically necessary emergency care outside of the U.S. after you meet a $250 deductible for the year. Your foreign travel emergency coverage has a lifetime limit of $50,000. Once it covers that amount, you will no longer have foreign travel coverage.

      Please let me know if you have any additional questions!

    1. Mr. Schmelz,

      Yes, Plan F covers emergency room services. Because Medicare covers emergency rooms services everywhere in the United States, your Plan F will cover all of the remaining Medicare-approved expenses that are not covered by Medicare. If you do not have a Medicare supplement Plan F, you will be required to pay a copayment for your emergency room services. Then, if you are admitted to the hospital, you will be responsible for your Part A deductible and coinsurance.

      However, with a Medicare supplement Plan F, these copayments and deductibles will be covered. If you are still shopping for the best Medicare supplement for you, please call us at 800-310-2550. Our independent agents are known for their unbiased and educational approach, and they would be happy to help you find the lowest rate for your Medicare supplement Plan F. We look forward to hearing from you.

    1. Mike,

      At-home testing supplies and equipment are covered by Medicare. As of 2008, Medicare Part B helps pay for the cost of your PT/INR equipment when used to determine how well your anticoagulants are working.

      To get coverage for testing, you must have a condition that requires you to take warfarin. Additionally, you must meet these 4 requirements to maintain coverage for in-home testing equipment:

      1. Be on the anticoagulant for at least three months before using a coagulation meter.
      2. Undergo an in-person educational program on managing your anticoagulation medication and demonstrate that you know how to accurately use the meter.
      3. Properly use the device throughout the duration of your at-home monitoring.
      4. Self-test no more than once per week.

      Please let me know if you have any additional questions.

    1. Hi Mr. Elton,

      The real question is this: Is it a covered service under Medicare? If so, then the supplement will pick up that copay. If not, then the supplement will not cover the copay.

      If it is covered by Medicare, and thus also covered by your supplement, then both Plans F and G will cover the entire copay.

      Please let me know if you have any additional questions. If you’d like to speak with a professional, please call us directly at (800) 310-2550. We look forward to hearing from you!

    1. Hi there,

      Your Plan F premium will vary quite a bit depending on a number of items, including: your current and past health conditions, tobacco usage, which company you purchase your plan from, and more.

      If you’d like, you can view your Plan F rates online from the various providers by following this link: View My Plan F Rates

      Please let me know if you have any additional questions!

  5. Does Medicare Part F cover expenses such as transportation and hotel accommodations when traveling to a major cancer center for treatment?
    Thank you.

    1. Hi there,

      Unfortunately, Medicare does not cover this service. Therefore, your Medicare supplement Plan F will not cover transportation/accommodations either.

      Please let me know if you have any additional questions. If you’d like to speak with a Medicare supplement expert on Plan F coverage, please feel free to contact us directly at (800) 310-2550.

    1. Hi Ms. Trover,

      Facility fees are covered under Original Medicare. As usual, if there are any other costs associated with the visit, such as the remaining 20% of expenses that Original Medicare does not cover, Plan F will take care of that cost. If you’d like to speak with a Medicare supplement expert about Plan F coverage, please call us directly at (800) 310-2550.

      Have a great day!

  6. What is the criteria for the Supplemental Plan F for a hospital stay with rehab needed? Is there a requirement for number of nights in the hospital before inpatient rehab will be approved? How many nights/days of inpatient rehab are allowed?
    Thank you.

    1. Hi Ms. Virt,

      Thank you for your question. Medicare Part A covers all of your hospital expenses, and this includes inpatient rehabilitation stay. Part A covers the first 60 days of your stay, but beyond that, you will have to pay an additional copayment. Medicare supplement Plan F should take care of any copays or coinsurance you accrue during your stay. This ensures you are completely covered.

      I hope this answers your question. If you have any more questions about the coverage you get with Plan F, please feel free to give us a call at (800) 310-2550! Have a great day!

  7. Do Plans F and G cover skilled nursing medically required after discharge from a hospital when one has only been admitted to the hospital as an outpatient for observation and has stayed 3 (overnight) days or more at the hospital with that outpatient observation status?

    Medicare will not cover the skilled nursing as it did not follow 3 (overnight) days of INPATIENT hospital admission. Will F or G cover that medically necessary skilled nursing?

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