Open Enrollment Ends in:



Medigap Plan F 2020 Rules: MACRA explained

MACRA is legislation that changes Medicare Supplement plans. Find out how it affects you!

by Lisandro Bustos+ on Mar 14, 2019 | 14 Comments

The Medicare Access and CHIP Reauthorization Act (MACRA) is a law that will change Medicare Supplement plans in all states, which becomes effective January 1, 2020. MACRA is a federal law that will change who can buy Medigap Plans F, High F, and C. As of 2020 only beneficiaries that are not newly eligibles will be able to keep Plan F, High F and C.

What’s new with Medigap?

Due to MACRA, on January 1, 2020:

  • Medicare Supplement plans with Part B deductible coverage (Plans C, F and high deductible F) cannot be purchased by “newly eligible” Medicare recipients.
  • The following guaranteed issue plans will be accessible for “newly eligible” Medicare recipients: Plans D, G, and high deductible G (which is brand new!)

What is the meaning of “newly eligible” Medicare recipients?

People who are 65 years of age or become first eligible for Medicare because of age, disability or end-stage renal sickness on or after January 1, 2020 are considered “newly eligible”.  If you already have Medicare part A and B and are reading this in 2019, then you are NOT considered “newly eligible” and the MACRA rules do not apply to you.

How are present enrollees in Plans C, F, and High Deductible F influenced by these changes?

Current enrollees (those qualified for Medicare before January 1, 2020) with Plan C, F, or High Deductible F are able to keep their plan. What’s more, they can keep on purchasing Plans C, F, and High Deductible F after January 1, 2020. Current enrollees will likewise have the capacity to purchase the new Plan High Deductible G on or after January 1, 2020.

Learn More about Medigap Get a Medigap Quote

What will happen to Guaranteed Issue Medigap?

Medicare Supplement Plans D and G will be two of the guaranteed issue plans for “newly eligible” beneficiaries on or after January 1, 2020. As stated before, current enrollees can stay with their purchased Plans C, F, and High Deductible F. Even after 2020, People who don’t fall inside the category of “newly eligible” will still have the capacity to buy Plans C, F, and High Deductible F for the first time as well.  So when you hear rumors that “plan F is going away” those statements are misleading because Medigap plan F will always be available to current enrollees.

Since MACRA is coming in 2020, which Medigap Plan should I purchase now?

You want to select the gap plan that best meets your needs now and in the future.  For most of our clients, Medicare Supplement Plan G is usually the best short and long-term fit but this isn’t true for everyone in every area.  You can get prices and enroll in Medigap Plan F and G here.  If you want to discuss your specific case, give us a call at 800-930-7956.

Print Friendly Version

Reader Comments and Questions

Click Here if you have a question

By Lisa on October 09, 2019

I am eligible Jan 1 2020 for parts A&B. I need to have Eyecare & dental & prescription coverage at a low cost. I want to bridge the gap with Parts A&B. Can this be done low cost effective? I am healthy.

Sounds like Medicare Advantage might be a good fit. You can learn more about Medicare advantage here and then give us a call to discuss specific plans.
-Eric from Senior65.com


By Michael on September 30, 2019

I am 67 and have Medicare A and B, I also have a Supplemental Plan F, and I live in FL. If I move my residence to NY in 2020, will I still be able to keep my F Plan ? Does NY state offer an F Plan ? Will my premiums change as well ?

Michael,
New York does offer Plan F. If you move you can almost always keep your Medigap plan. Premiums can be based on your original state, your new state or a combo of both since prices are set by each carrier.
-Michelle from Senior65.com


By Pam on September 24, 2019

Wont be eligible for Medicare until Mar, 2020 due to a disability, I am not a senior. Will plan G be an option for me?

Pam,
That is correct. Once you are enrolled in Part A and B you will be able to get a Medigap plan, such as Plan G.

When the time comes give us a call to get you enrolled. We charge nothing for our services.
-Michelle from Senior65.com


By Robert on September 18, 2019

Spouse and I are both 70 and currently have Plan F with High Deductible. I realize we will be able to continue with Plan F going forward if we choose. Any barriers or hoops (to go through) required to change to Plan N, Plan G or Plan G HD for 2020? I guess I am asking if physicals or medical underwriting is required to get qualified? Thanks for your help.

Robert,
Unless you live in a state that has special switching rules you will have to go through medical underwriting to switch.

Give us a call if you decide to go forward with it. We charge nothing for our services.
-Michelle from Senior65.com


By Kevin on September 17, 2019

I am 66 and have been on my wife's insurance the last year, I need to get a plan B now...I was wondering if I could start with a "Advantage" plan for the rest of this year and be able to switch to a plan F say in about 6 months ....can I get a "D " plan to go along with the F plan at that time ? I was told there is a trial period allowing me this option.

There is a Trial Right if you had joined a Medicare Advantage Plan when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decided you wanted to switch to Original Medicare. That would trigger your right to purchase a Medigap plan without medical underwriting. The timing of this and a drug plan can be tricky so please give us a call so we can go over it together.
-Chris from Senior65.com


By Tina on September 13, 2019

My 65th birthday is on January 1, 2020. I will be eligible for Medicare Part A and Part B as of December 1, 2019. Am I eligible to purchase plans C or F?

Tina,
That is a really good question that we haven't dealt with before. Since you will be Medicare eligible before 2020, we believe you will be able to purchase a plan F (we have never sold a Plan C in the last 12 years since they are not priced competitively). However, the point is somewhat moot as Medigap Plan G is almost always a better deal.

Give us a call and we can take a look at the prices of F and G and confirm if indeed you can get that plan F with your Jan 1, 2020 b-day.
-Chris from Senior65.com


By Letty on September 03, 2019

I am 66 and got part A only last year because I have health insurance from my employer. I plan to retire end of December this year. Am I eligible to enroll in Plan F starting January 2020?

Letty,
Yes, you will be able to get Plan F because you turned 65 before 2020. Nevertheless, you will want to consider Medigap Plan G because it is often a better deal.

We can help you price both plans and enroll you right over the phone. We charge nothing for our services.
-Michelle from Senior65.com


By Anthony on August 08, 2019

I have plan F Is F extra the same coverage as F with no deductible and we can see any doctor. Is it a PPO.? Is the only difference the additional three options What is the cost? What is a medigap plan? Thanks, Tony

Anthony,
Medigap Plan F Extra has the same benefits as Plan F but includes hearing and vision benefits. As any Medigap plan, it has the same network of doctors as Medicare and it is not considered either a PPO or HMO.

Medigap, as you may know, is a Medicare supplement plan, it basically helps you cover what Medicare doesn't like the 20% it leaves, deductibles, copays, etc. Click here to get a Medigap Quote.

If you wish to switch to F Extra, give us a call and we can help you enroll in no time. We never charge a fee for our services.
-Michelle from Senior65.com


By John on July 30, 2019

I will turn 65 in February of 2020. If I enroll for Medicare in Nov./Dec. of 2019, am I eligible for Plan F?

John,
Unfortunately since you are turning 65 in 2020 you won't be able to get Plan F. Nevertheless, when the time comes give us a call and we can review your options and get you enrolled in a Medicare insurance plan.
-Michelle from Senior65.com


By Kathy on July 23, 2019

Turning 65 in November, currently on Social Security also have BCBS insurance from previous employer I understand that I will automatically go on Medicare as of 11/1/19 with Medicare becoming my primary health care and BCBS as co insurance. Should I be searching for a medigap policy also?

Kathy,
That is correct, you should be automatically enrolled in Medicare A. If you have coverage through work you may want to postpone Part B and use your work coverage as a secondary payer.

If you currently have individual coverage you will usually not be able to keep that plan and we suggest you select Medicare Part B. Most seniors decide to get a Medigap plan to cover what Medicare doesn't. We can help you enroll at no additional cost to you. The same goes for Medicare Advantage and Part D drugs.
-Michelle from Senior65.com


By Kathleen on June 27, 2019

I have Medicare part A % Part B Medicare since 1/2004 because of a disability. I have been signing up for advantage plans with medications and now want to switch to a Plan F with Original Medicare for this coming year 2020. I was told that since I had Medicare since 2004 I could get Plan F for 2020. Is this correct?

Kathleen,
That is correct. Since you were Medicare eligible before 2020, you should be able to enroll in Plan F. You may want to check with us about Plan G as often they end up costing you less in the end.

Give us a call to help you switch. There is never a fee for our services.
-Michelle from Senior65.com


By paul boone on April 19, 2019

I am 67 and have group insurance at work. I have a friend who is telling me I should purchase Plan F since it is better coverage. He said I should do this before June 1 2019 and If I don't the rates will go up significantly. I have Plan A

Paul,
There is some speculation that the rates of Plan F will go up after 2020. You can read about it in our article/client question Should I switch to Plan G before 2020. However, we are not certain of that.

Give us a call and we can help you decide whether Plan F or Plan G would be a good option for your case. You can also Get a Quote here.

Oh and one more thing, we charge you nothing for our services so please feel free to contact us.
-Michelle from Senior65.com


By suzanne on April 02, 2019

Will the cost of plan F go up for current holders once the new laws are in effect in 2020?

Suzanne,
Many people are currently thinking that way and wondering if they should switch to Plan G before the changes in 2020. Please check our answer to this question here: Should I switch to Medigap Plan G before 2020?

Even if you are not currently working with us as your agent, we can help you switch at no cost to you!
-Michelle from Senior65.com


By Reed on March 15, 2019

So how does this affect Innovative F? I see so much stuff about plan F in 2020 but no one mentions Medigap innovative F. Thanks in advance, -Reed

Reed,
Since Innovative F is basically F with hearing and vision, it should be treated like all plan Fs. It will not be available to those new to medicare after 2020. If you need help signing up for this plan before that happens, please don't hesitate to call us!

-Michelle from Senior65.com



Have a question not answered above??? Click here

PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.




It's 100% FREE to work with Senior65

Call our licensed agent today at 800-930-7956. Click here to learn 5 great reasons to work with Senior65.com