The deadline is December 31, 2019.
If you’re not enrolled in Medicare by then, you’ll never join Medigap Plan F.
If you’re already in Plan F, you can stay – but should you?
What is Medigap Insurance
Because Medicare doesn’t pay all medical costs, Medicare beneficiaries can choose to buy additional health insurance from private companies.
These are often called Medigap policies because they cover the “gaps” in Medicare’s coverage.
What is Plan F
The Medigap insurance industry is highly regulated by the government – and they’re removing the most popular option – Plan F.
54-60% of Medigap enrollees choose Plan F.
It’s often called “first dollar coverage” because you’re covered as soon as you go into a clinic, hospital, or doctor’s office.
The premiums are higher than the other plans, but for many retirees, that’s a small price to pay for the peace of mind.
The trouble is, the government believes people who never have to pay extra for medical care will demand too many unnecessary medical services – they’ll hit up their doctor for every little ache, pain, and sniffle.
And that will cost the Medicare trust fund too much money.
Therefore, the Medicare Access and CHIP Reauthorization law of 2015 took away the Plan F option effective January 1, 2020, for new Medicare enrollees.
What Can You Do?
If you’re going to turn 65 and become enrolled in Medicare after December 31 this year, you can forget about Plan F. Read on for the best alternative.
You first need to decide whether or not to enroll in Medigap insurance at all.
It’s not mandatory. However, you will have to pay money out of your pocket for medical care. A few visits to your doctor may not exceed your budget, but an extended stay in the hospital could force you into bankruptcy.
Plan G is almost as good as Plan F. It covers everything Plan F does, except the deductible for Medicare Part B.
Medicare Part B is the outpatient care section of regular Medicare. And the deductible is now $185. Under Plan F, you do not have to pay that $185 before Medicare Part B begins covering your bill at the doctor’s office. (That’s why Plan F is called “first dollar coverage.”) That’s what the 2015 law eliminated.
With Plan G, you must pay the $185 deductible for visiting your doctor – outpatient medical care – but everything else is covered.
Therefore, if you want as much “everything-is-already-paid-for” peace of mind as possible, Plan G is your best option.
What If You are in Plan F Now?
You can remain in it. However, you may be hit by premium increases sometime in the future. That could happen because new and younger people will not be enrolling in the plan.
As everybody in Plan F continues to age, the cost of covering them will go up. Therefore, insurance experts believe the premium will go up. Sooner or later.
But nobody knows for sure.
You can apply to switch to Plan G. However, that may not be approved if the insurance company believes your health is too poor.
What If You’re in Another Medigap Plan Now, but Wish to Switch to Plan F?
You can apply to switch to Plan F, but you may not be approved if the insurance company believes your health is too poor. If they allow you to switch to Plan F, you might see large premium increases in the future.
At this point, you’re probably better off trying to switch to Plan G. Don’t go to the doctor unless you really need to – and pay the $185 Part B deductible out of your pocket.
What If You’re Already on Medicare, but Not Enrolled in any Medigap Plan?
Are you enrolled in Part B as well as Part A (Part A is the inpatient hospital coverage of ordinary Medicare)? Maybe your outpatient care is already covered by health insurance through your employer, or you’re under another group healthcare insurance plan.
To enroll in Medigap, you must be both Parts A and B of original Medicare.
If you’re not now in Part B, you can sign up only during open enrollment. In 2019, that’s right now – October 15 through December 7.
Once you are covered by both Parts A and B, you have six months to choose to join any Medigap plan you prefer.
If you have been covered by Part B less than six months, you have until the end of that six months to join the Medigap plan of your choice, which can include Plan F.
If you have been covered by Part B over six months, but you chose not to join a Medigap plan, you can always apply for any of them, including Plan F, but they may reject you due to your medical condition.
What If You’re Under a Medicare Advantage Plan?
None of this applies to you.
In my opinion, the best health insurance is still a great diet, regular exercise, stress management, and getting 7-8 hours of sleep every night.
However, eventually, you will probably have to pay for some mainstream medical services, so be prepared.
