Medigap Plan F vs. Plan G: Is More Really Better?

By Kendra Knouff
eMedicareSupplements Senior Writer

What Are The Differences in Plans F and G?

For seniors who choose to enroll in Original Medicare, finding the right supplemental insurance policy is important. But with so many options, choosing the right one can seem like a burden. The two most popular types of Medigap policies are Plan F and Plan G, and it can be difficult to tell the two apart. What is the difference? Which one is right for you?

Medicare Supplement Plan F stands out from the many other plans available because it offers “Medicare excess charges.” This means that the plan will pay 100 percent of any excess charges accrued. Physicians can only charge up to 15 percent beyond the Medicare-approved rate for services (although they rarely do). For example, if you are scheduled to undergo a procedure that costs $2,000, but Medicare only approves $1,000, the doctor’s office can only charge you 15 percent above that $1000, which, in this case, is $150. Under Plan F, that extra $150 will be covered along with the $1,000 initial charge.

It is also possible to choose a high deductible Plan F policy. Under this type of policy, you are required to pay all fees until your annual deductible has been met. After meeting the deductible, Medicare will cover any other charges incurred. This deductible is commonly $2,000 per year. This type of plan helps protect against high out-of-pocket expenses if you need any extensive medical care and treatment.

Plan G is very popular because it covers many high-risk situations not taken care of by Medicare, and it is a very affordable plan. Plan G covers things like hospitalization coverage extension, hospital co-insurance, skilled nursing co-insurance and hospital care, among other things.

In order to decide which plan is best for you, it is important to examine these plans side by side. Plan G is relatively less expensive than Plan F. However, Plan F covers 100 percent of Medicare excess charges, while Plan G only covers 80 percent of these charges. Plan F also covers the Part B deductible, which is $162, while Plan G does not. However, because Plan G is significantly less expensive than Plan F, you could possibly be spending unnecessary funds on Plan F. If it is possible to get a Plan F policy for only $162 more than a Plan G policy (the amount of the Part B deductible not covered by Plan G), it is wise to pay the extra money for the coverage. However, most Plan F premiums are about $250 more than Plan G premiums. This means you will pay $250 to save $162, which still leaves you paying more for Plan F.

Consider this with excess coverage, as well. With the example listed above, Plan F covers 100 percent of the excess $150 charge. Plan G will pay 80 percent, which is $120. This means you are responsible for paying $30. If you pay an extra $250 to save an extra $150 in excess costs (which are extremely rare), you have still lost $100.

Therefore, because coverage is so similar between plans F and G, it is best to compare premiums before making a decision. It’s important to note that premiums vary in price depending on location and other factors. If you need help choosing between a Plan F and Plan G Medigap policy, please contact one of our insurance agents (at no extra charge) to help you make the best choice.

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