Is Plan F Going Away?

There has been some question if the Medicare Plan F will be discontinued. While Medicare Plan F will no longer be available for new enrollees, there could be some other options regarding Medicare insurance plans. Medicare Plan F is one of the most common supplement insurance plans and while many individuals will be affected by this change – there is still some time to make appropriate Medicare coverage changes. Congress will not put this change into effect until 2020.

What is Medicare Supplement Insurance and Plan F?

Medicare Supplement Plan F is also referred to as Medigap insurance. Plan F can offer support for Medicare Part A and Part B out-of-pocket expenses. Some of these expenses include copays, co-insurance, and deductibles. In the United States, 47 states offer up to ten Medicare Supplement plans that are regulated by letters. This includes Medicare Supplement Plan F. Each plan has its own set of benefits. Covered services for Medicare Plan F can consist of:

  • Additional charges to Medicare Part B
  • Co-insurance for Skilled Nursing Care
  • Hospice Care under Medicare Part A
  • Inpatient hospital expenses and co-insurance
  • Medicare Part A deductibles
  • Medicare Part B co-insurance and co-payments
  • Medicare Part B deductibles
  • The first three pints of blood
  • Up to 80% medical emergencies

Changes to Medicare Plan F

While the changes of Medicare Plan F can affect many individuals, the change will only affect new enrolled Medicare individuals beginning 2020. Those who were already eligible for Medicare Part F can still use their Plan F and Plan C benefits. Other situations where the new Medicare Plan F changes will not affect you include:

  • Individuals who have Medicare Plan F before 2020. You can still buy Plan F insurance coverage and policies from other health insurance carriers after 2020.
  • Those eligible for Medicare Plan F before 2020 but have not received insurance coverage because of a delay with an employer’s insurance company.
  • Individuals eligible for Medicare Plan F after open enrollment in 2020 will not be able to have the Plan F benefits, but can enroll in Medigap Plan D or G.

Medigap Plan G and Plan N are still available for those already enrolled. Also, a New High-Deductible Plan G will be produced to meet the needs of newly eligible individuals and those eligible before 2020.

Why is Plan F Being Discontinued?

The reason Medicare Plan F will be discontinued is because of the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015. This has also been referred to as the “Doc Fix” law. During this time, Congress passed a law to ensure that doctors would receive better compensation for participating in the Medicare program. Instead, laws earlier passed lowered compensation for these doctors over the years.

With the decrease in pay, this caused some questions, and some doctors even stated they would no longer participate in the Medicare program if pay continued to decrease. Over the last ten years, Congress tried to find solutions at the last minute to try and avoid pay cuts for doctors. In return, this costs about $200 billion. To cover the costs, Congress decided to modify Medicap plans.

Comparable Medicare Plan F Plans

While Medicare Plan F will no longer be available after January 1, 2020, individuals who are eligible for Medicare do have other Medicare Supplement options. Medicare Supplement Plan G has similar benefits as Medicare Plan F. Plan G does not have the Plan B deductible. If you are interested in Medicare Plan F but do not plan on getting health care coverage until after January 2020, let Koi Healthcare help you determine the right choice for your needs.

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