What is Medigap High F?

Plan F, you would pay the 20% share until your total deductible and co-payments reach the limit, $2,340 in 2020.

What is the Medigap High F Plan?

This plan provides the same benefits as standard Plan F after a $2,340 (2020) deductible has been met.

The standard Plan F is a Medigap policy that pays the Medicare hospital and medical Parts A and B deductible and co-insurance – the dollars not paid by Original Medicare. Plan F is one of the most comprehensive supplemental plans, but the premium cost can be prohibitive for some people. The high deductible version of the plan, Medicare Plan F High Deductible, is more affordable for some.

Many people are accustomed to paying a some out of pocket costs for a hospital or doctor visit. Others would rather pay a higher monthly premium and have these costs covered in full. Standard plans F, G and N leave members with very little costs outside of their premiums, but the premiums tend to be higher than many budgets support.
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The Medicare Plan F High Deductible Alternative.

The High F deductible plan covers everything Plan F does, but the member must pay a certain amount of co-pays out of pocket before the plan will pay. Once the out of pocket cost has been paid, the coverage is the same as the regular Plan F, 100%

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Q: Does that mean I have to pay the first $2,340 in claims?

A: No – it’s more like maximum $2,340 in annual co-pays. Here is a detailed example of how the plan pays claims. Beginning each January 1, Medicare Part B claims are subject to an initial deductible which the member pays, the amount is adjusted annually and is $198 for 2020. After that, claims still get billed to Medicare which approves the claim, however usually at a reduced amount. Medicare Part B pays 80% of the claim and a standard F Plan would pay the remaining 20%. With the High Plan F, you would pay the 20% share until your total deductible and co-payments reach the limit, $2,340 in 2020.

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Q: Which hospitals and doctors will accept my High F card?

Medigap High-F plans have the largest nationwide network of doctors and hospitals, because they have the same network as Original Medicare. Compare that to a HMO Plan which may restrict you to receiving care only from participants in the HMO network, often local.

Q: How does a High F compare to Medicare Advantage plan?

• For Medicare Advantage plans in New York Capital Region, the 2020 yearly limit on out-of-pocket costs for all in-network medical services can be as high as $6,700. With Medicare Supplement High F plan, the maximum out-of-pocket costs for all medical services (no network) is the $2,340 deductible.
• Medicare Advantage plans have restrictive (HMO) or preferred (PPO) network of doctors and hospitals. Medicare Supplement plans offer greater flexibility – the same network as Original Medicare.
• Most Medicare Advantage plans include Part D prescription drug plans. With Medicare Supplement, you will need to obtain separate creditable drug coverage; VA benefits meet that requirement.
• Medicare Advantage plans may include features like fitness membership, eyewear and hearing aid benefits not available with Original Medicare.

Q: Will a High F save me money?

A: It’s Possible.

1. Compared to a Standard F plan, you compare the combined premium and out-of-pocket costs.
   • Annual Standard F premium (average $250 monthly below) equals $3,000 with $0 copays
   • Annual High F premium (average $60 monthly below) equals $720 plus maximum $2,340 co-pays totals $3,060 worse case scenario. (Think $12,000 approved Part B claim amounts at 20% copays to reach $2,400)
2. • Medicare Supplement plans require a separate Part D drug plan. Dan offers stand alone drug plans.

Q: Which Medicare High F Plans are available in New York State?

Dan is authorized to represent Globe Life Insurance Company and Humana Medicare Supplement High Deductible F Plans. (Ref: New York State Department of Finance web site.)

Questions?

Please call me at (518) 346-2115 or send a quick note with your contact information and question.

Daniel G. Alcorn, a licensed and independent agent, represents licensed insurance companies in New York and other states. Dan may receive compensation for individual enrollments in Medicare Advantage, Medicare Supplemental Insurance , Medicare Prescription Drug or Long Term Care plans.