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Medigap Plan F High Deductible Details

Find out how Medigap Plan F High F works and what it covers

by Senior 65+ on Oct 28, 2015 | 34 Comments

Medigap Plan F High Deductible Overview

Medigap Plan High F is the name one of the federally regulated Medicare Supplement Insurance plans. Medigap High F offers the same coverage as traditional Medigap plan F, but it has a high deductible of $2,300. These plans are regulated, so, every insurance company that offers Plan F must offer the exact same benefits.

Remember Medicare Plan F plans are designed to complement Original Medicare Part A and Part B.  Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you purchased Medigap Plan F. 

Medigap Plan High F Benefit Details

Benefits Original Medicare Alone Original Medicare With Medigap Plan High F (must meet $2,300 deductible before coverage kicks in)
Doctor Network All Doctors that accept Medicare All Doctors that accept Medicare
Part A Hospital Benefit Period Deductible You pay $1,364* You pay $0****
Hospital days 61-90 You pay $335 per day per day You pay $0****
Hospital Days 91-150 You pay $670 per day per day (lifetime reserve days) You pay $0****
Beyond Lifetime Reserve Days You pay 100% You pay $0 up to an additional 365 hospitalization days****
Skilled Nursing Facility Care Days 1-20 You pay $0 (Part A deductible applies)** You pay $0****
Skilled Nursing Facility Care Days 21-100 You pay $170.50 per day You pay $0****
Hospice Respite Care You pay 5% You pay $0****
First 3 Pints of Blood You pay 100% You pay $0****
Additional Blood You pay $0 You pay $0****
Part B Annual Deductible You pay $185 You pay $0****
Ambulance You pay 20% (Part B deductible applies) You pay $0****
Doctor’s Office Copays/Coinsurance You pay 20% (Part B deductible applies) You pay $0****
Durable Medical Equipment You pay 20% (Part B deductible applies) You pay $0****
Part B Excess Charges You pay 100% (Part B deductible applies) You pay $0****
Foreign Travel Emergency You pay 100% You pay 20%***
Out-Patient Surgery You pay 20% (Part B deductible applies) You pay $0****
Urgent Care You pay 20% (Part B deductible applies) You pay $0****


Next Steps for Medigap Plan F High Deductible

Get quote: Click here to see prices for Medigap Plan High F
Learn More: Get a better understanding of Medigap Plan F High Deductible

  *Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,364).
***Foreign Travel Emergency requires a deductible of $250. You will have to have your emergency within the first 60 days of travel, and the plan has a lifetime coverage amount of $50,000.
****You must meet your plan’s deductible of $2,300, before any coverage kicks in.
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Reader Comments and Questions

Click Here if you have a question

By Trampas on September 18, 2019

Do you cover west Texas, by any chance? Thank you.

Trampas,
We are indeed licensed in Texas so if you are looking to enroll in Medigap, Medicare Advantage or Part D, give us a call!
-Michelle from Senior65.com


By Lynda on August 06, 2019

Where can I get a list of common Medicare-approved rates for Part B services?

Lynda,
You will have to check with Medicare directly. While this site can offer general explanations of how Medicare works, our main goal is to help people enroll in Medigap, Medicare Advantage or Part D, and we charge you nothing by doing it.
-Chris from Senior65.com


By Everett on July 24, 2019

I am considering changing from Medicare Plan F to Plan F High Deductible in Sept of this year. It looks to me like I might be better off changing at the end of this calendar year because of the deductible. Your comments please.

Everett,
Your logic makes sense. If you do make the switch to a high deductible plan, you should consider doing it near the start of the year. Give us a call when you are ready to switch. We charge nothing for our services.
-Michelle from Senior65.com


By Tracy on May 20, 2019

With a high deductible Medigap plan can I contribute to my HSA?

Tracy,
If you enroll in Medicare Part A and/or B, you can no longer contribute pre-tax dollars to your HSA. Given that you need A and B to enroll in Medigap, the answer would be no.
-Chris from Senior65.com


By Ted on April 11, 2019

If I own a high-deductible F policy, does my deductible amount change year after year? (It's unclear whether the yearly change in deductible applies only to new policies or also to existing policies.)

Hi Ted,
Yes, each year Congress can adjust the deductible amount. The new deductible is updated on this page regularly.
-Chris from Senior65.com


By Aa on January 31, 2019

If one has an F-hd policy, OR no supplemental policy at all - just basic Medicare A and B - Does Medicare not pay a single penny of medical coverage UNTIL one's expenses hit their stated deductibles for A and B? In other words, do they stay totally out of the picture until deductibles are met by paying doctors or hospitals? Thanks!

Hello,
Yes. You must pay 100% of the part A deductible before you will receive Medicare Part A services. Likewise, you must satisfy 100% of part B deductible before Medicare will cover their portion of Part B services.

To avoid paying for these deductibles you should consider a Medigap plan such as Plan F that pays 100% of the part A and Part B deductible. Plan F also covers 20% of coinsurance and excess charges not covered by Medicare. Give us a call and we can help you select and enroll in a plan at no additional price.

-Chris from Senior65.com


By George on November 18, 2018

I currently have Plan F-HD. After Jan 2020, if I elect to move to another plan, will underwriting be required? I understand that I will be grandfathered but the plan is discontinued. My primary concern is that the insurance company is likely to spike premiums due to the eventual decline in the pool of healthy participants in F-HD. If this occurs, I may as well move to another plan now. I'm 68 and have saved thousands over the past three years on premiums with F-HD. Thankfully, good genes, diet and reasonably healthy living have rewarded me with little health concerns to date.

In most cases you will have to go through Medical underwriting to switch from Plan F high deductible. If you want help with this, contact our team here at Senior65.com


By Miguel on November 05, 2018

Thank you ahead of time for these questions and answers. I am confuse with max. out of pocket for a year. If an insurance said the max out of pocket let's say $2400 for a year. Does this mean if you gonto a hospital as a patient and the bill is $100,000 the most you will pay is $2400 and no more even though there could be deductibles and co-insurance at play? So confusing, thanks!

In general you are correct! An out of pocket max typically only applies to in network covered services. Also you monthly premium does not count towards the out of pocket max.
-Chris from Senior65.com


By Brad on October 13, 2018

If I have a medigap N now can I switch to HD F? Assuming I can, do I switch during the annual period starting Oct 15?

Once I have a HD F plan I do not see any reason to every switch again. I understand that sometimes when you switch plans you may have to go through underwriting - what kind of medical questions would be asked, what would disqualify someone from switching?

I have and will always have enough funds to pay the HD F deductibles so is there any reason why I would not just stay with HD F until I die?

BRAD,

Unless you qualify for special enrollment, you will most likely have to go through Medical Underwriting when switching from N to High Deductible plan F. You can do this at any time and do not have to do it during open enrollment.

They types of questions you will be asked vary by provider but usually are based on your health history in the last 3 to 5 years. If you have had major issues recently, you may be turned down. Minor issues may affect your approval but that will depend on which company you apply for. We can help you find a company that is the best match for your situation. Please contact us if you are considering switching.

You should be able to keep your high deductible F for as long as you would like and we cannot foresee you switching again if you are OK with the high deductible.

-Amy from Senior65.com


By Roger on August 23, 2018

I have Plan F High Deductible. It is great. I have a new health issue so I'm thinking about 'what Medigap Plan for 2019. Can one switch to Plan F, $0 Deductible for a year or two - then switch back to the Plan F High Deductible? Do they let you do that? Thanks.

Roger,
Glad to see that your Plan F High Deductible is working out. You may switch from a High F to a regular F but it would require you to answer medical questions before accepted on your new plan. They want to make sure there is no upcoming medical reason why you are moving to a plan with no deductible. Switching back to the High Deductible often also requires you to go through medical underwriting but should you have no major health issues it should be very possible.

Finally, there is the issue of Plan F "going away" in 2020. It is our understanding that Medicare Plan F and Plan F high deductible will not be available to those NEW TO MEDICARE. If you already have Medicare before 2020 we have been told you should be able to select (or switch) from Plan F at any time in the future.

If you would like help switching we are here to help you. We like to think switching specialist and will walk you through the process with no additional fee or cost to you.

-Michelle from Senior65.com


By Arthur on June 26, 2018

January 1, 2020 Plan F will no longer be offered to new applicants. Existing Plan F enrollees are grandfathered in. Question: Will the High Deductible Plan F also no longer be offered to new applicants? I also heard that on January 1, 2020 Plan G will create a High Deductible option. Is this true? If so, how will it compare to existing High Deducible Plan F and/or the High Deductible Plan F after January 1, 2020? Thank you.

Arthur
We will take your questions one at a time:

1) Will the High Deductible Plan F also no longer be offered to new applicants? High Deductible F will not be available to those new to Medicare after 2020 (BTW We think this makes no sense!).

2)Will there be a Plan G High Deductible option? Not that we know of.

If a new high deductible plan is offered in the future we will update this site with information but as far as we know the only choice is high deductible F. If you need help selecting or enrolling in a plan, please contact us. There is no charge to you and enrolling individuals is how we continue to support this site.
-Michelle from senior65.com


By Linda on April 10, 2018

I'm interested in a high deductable F plan. As I don't turn 65 until June, is the deductable still $2,240 or is there a sliding scale for partial year insurance? Thx.

Linda,
There is no sliding scale with high deductible plan F. There are a few tricks we can go over to address this if you join high F mid year. Give us a call to discuss.
-Chris from Senior65.com


By Mary on January 15, 2018

In one of the comments, it says the Hi-deductible F plan is the lowest level, meaning you can't switch to another plan without underwriting. I followed the link in your answer, but the chart is for Oregon. Does this rule apply to California as well (that if I want something other than Hi-F I have to go through underwriting) ? Thank you,

Mary,
While there is not a chart available, typically those who want to switch from a Medicare Supplement Plan F high deductible to any other plan in California will have to go through Medical underwriting. Hope that helps.
Please let us know if we can help you enroll in a plan.
-Chris from Senior65.com


By Ken N on November 11, 2017

Is there a chart on the internet that I can review on my own for monthly premiums of medigap plans by company; so that I can compare costs between companies for the same plan? Thanks.

Ken,
While you can always get a quote to see monthly prices here: https://www.senior65.com/quote plan ,F high deductible plans are not always listed. If you county us your zip, date of birth and county we can get you a chart of monthly premiums of high F medigap plans. Visit our https://www.senior65.com/contact to contact us.
-Chris from Senior65.com


By Ann on November 02, 2017

With Plan F High Deductible does Original Medicare start paying 80% of the part B charges once the part B deductible of $183 is met? Once the deductible is met I would have to pay 20% of the Medicare approved charges plus any part A deductible until the $2200 plan deductible is met?

I would pay the $183 part B deductible and it would be applied to the plan F $2200 deductible. Is that correct?

Yes. Deductible and coinsurance payments that you make will be applied to your high F deductible.

Medicare would pay 80% after you meet the part B deductible (even if you haven't satisfied your total high F deductible).

Once you satisfied the total $2200 then your insurance company will cover any remaining deductible or coinsurance costs you have for the remainder of the year.
-Amy from Senior65.com


By Bev on September 01, 2017

I've heard that the premiums for plan F and plan F high deductible are apt to increase quickly after 2020 because the pool of healthy clients will be reduced once the plans close to new members. What do you think?

Bev
There are many people speculating about future price of F and F high deductible. At this point no one knows for sure what will happen. Medigap plans have been retired in the past and sometime the price went up and sometimes it did not.

While most of our clients now select G over F, this is largely due to the fact that G is a better priced plan in most states than F. If you need help determining what would be the best move in your area, please give us a call.
-Chris from Senior65.com


By JC on July 28, 2017

So I can switch from Plan F to Plan F high-deduct but can I switch back if I want to? If I ask to be switched to the Plan F High-deduct, can the insurance company I am with, Mutual of Omaha, deny this?

In most state an insurance provider can decline a switch from High F to Medigap plan F
Eric from https//:www.senior65.com


By James on July 27, 2017

Thanks Chris. Is there some way for me to find out what medical questions will be asked in GA? Also the reason for my original question about switching from Plan F to High F is that I am lucky to be pretty healthy, and so chose to go without insurance since AHCA and have not regretted it. I am on no medications of any kind. So there would be some items on my health list to catch up on once I turn 65 in January, so I was thinking to get the best coverage for a year while I do that and then go to High F if I am as healthy as I think I am (Mom lived to 96.5). I have to wait until Oct.1 to apply and I still will need further education on all of the deductibles that count against High F.

James,
The health questions asked those who do not qualify for Guaranteed issued Medigap vary by insurance provider. If you have been "treatment and symptom free for 5 years," you will most likely be approved. If you have had recent treatment or on certain medicines, it is really treated on a case-by-case basis. Since each insurance company handles approval differently we can often help guide you to the one that you will have the best chance of approval.
Chris from https://www.senior65.com


By James on July 25, 2017

If you start out on F at 65 in 2018 can you switch to High F in 2019 or 20?

James,
In most states, you'll have to answer medical questions to switch from one Medigap plan to another Medigap plan. With that said, after 2020, Plan F (including, as we've been told High F) will no longer be a plan you can switch to -only those grandfathered in may keep their Plan F.
-Chris from https://www.senior65.com/


By Bill on July 12, 2017

Will a person be to stay in high f "grandfathered" after 2020, if they are in this plan before that date?

Bill,
As long as your current High F plan is offered in your area, you'll be grandfathered in.
-Amy from https://www.senior65.com/


By Elwood on June 24, 2017

If I have plan G and meet my 183.00 deductible do I still pay the Part A deductible if I have a hospital stay. Thanks

Elwood,
If you're enrolled in Medigap Plan G, your only out of pocket costs (as long as Original Medicare approves the service) is your Part B deductible. Even if you don't meet your Part B deductible, you would not owe the Part A deductible. If you need help finding the right Plan G in your area or learning more about what it covers, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Kitty on June 20, 2017

Under plan High deductible F , if I use up my 2200 deductible under part B Medicare is my part A deductible then paid if I should happen to use?

Kitty,
Your High F deductible is any combination of your Original Medicare out of pocket costs. So, yes, if you paid your entire deductible in Part B costs, you will have met your deductible. If you need help finding a Medigap High F plan in your area, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Ruth on June 03, 2017

As I understand it , what I pay directly to Medicare pr. month covers 80% of Plan B's charges. If I have a high deductible Medigap plan to cover the 20 %, does the deductible go to pay any of the first 80% of charges or only towards the 20% that is not payed by Medicare. Let's say the outpatient Dr's charge is 200$, and is what is allowed under Medicare. Does Medicare pay 80% of 200$ = 160$ and I pay 40$ which goes towards the 2200 deductible?

Ruth,
Here is the simplest answer: if you have Medigap High F anything you pay toward your Medicare approved costs will count toward your deductible. This is Part A and B copays, coinsurance (the 20% you're discussing above), and deductibles.
-Eric from https://www.senior65.com/


By dave on April 29, 2017

does plan g have a high deduct plan? if so how does cost comp to plan f hi dedut?

Dave,
Unfortunately, Plan G does not have a High Deductible. If you would like to compare Plan Gs in your area call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Chad on March 21, 2017

I have Medicare B and a high deductible plan F. I found a Doctor that accepts what medicare B will pay. Do I still have to pay the medicare B deductible each year if I just go for a office visit. That's $183 for 2017 I believe. If I do have to pay does this count towards my high d plan F yearly deductible? I sure hope you can help. Thank you

Chad,
With Medigap High F you meet your deductible by a combination of Medicare Part A and B's deductibles, copays, and coinsurance. So, yes, you would have to pay toward your Part B deductible.
-Amy from https://www.senior65.com/


By Kim Belgarde on February 11, 2017

I understand that a Medigap Plan F covers the annual $183 Part B deductible. Does the Hi F plan, in spite of its own $2200 deductible, cover the $183 original annual Part B deductible too?

Kim,
The High F deductible is a combination of the Part A and B copays, deductibles, and coinsurance. So, yes, it will cover the deductible, if you use that service. If you need help finding a High F plan in your area call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Renee Wenger on January 30, 2017

Is chiropractic covered?

Renee,
Medicare offers limited chiropractic coverage. Since Medigap plans will only cover what Medicare covers, it will cover the limited chiropractic services.
-Michelle from https://www.senior65.com/


By John Cory on December 26, 2016

I am confused about deductibles and out-of pocket charges. Examples would help especially with high deductible Plan F. Also if I am in high deductible Plan F will the plan still be available to me after 2020?

John,
You are not alone! Many people are confused about the difference between a deductible and an out of pocket max. A deductible is the amount you have to pay toward your plan before your plan pays toward your care. An out of pocket max is the most you can pay toward health services in a year.

With that said, Medigap High F does have a deductible BUT not an out of pocket max because once you pay your deductible you shouldn't have any other costs (as long as Original Medicare covers the service).

You will be able to stay in your High F after 2020. If you're interested in looking into other Medigap plans call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By Richard on November 30, 2016

I am considering plan F high deductible. I have heard that although plan F is the highest tier ( renew coverage to a lower tier plan without underwriting) plan F high deductible is positioned at the lowest tier. Meaning that renewal to any other than a high F plan would require underwriting. Please let me know the actual rules on this.

Richard,
You are correct! Here's a Medigap chart of equal or lesser benefits. Contact one of our Senior65 licensed independent insurance agents to help get enrolled in a Medicare Supplement plan in your area.
-Amy from https://www.senior65.com/


By Don Burkhead on October 26, 2016

As I have come to learn, all Plans offered cover the same benefits but the premiums can be greatly different. We currently have Plan F with Blue Cross. How do they stack up premium wise with other providers in Arizona?

Don,
We'd be happy to compare Medicare Supplement plans in your area for you. You can get an instant Medigap quote or call one of our Senior65 licensed independent agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Wayne Rodenboh on October 10, 2016

Does High F pay excess charges before the deductibleh is met?

Wayne,
You must meet your deductible before Medigap High F pays toward any of your Medicare costs, including Part B excess charges.
-Eric from https://www.senior65.com/


By Stuart Williams on October 05, 2016

I heard that after 3 years with owning a high deductible F medigap plan, that the deductible is waived and you will not have to meet it in future years and the plan would pay like the traditional plan F? Is that true? And is the high deductible plan F going away in 2020 like the plan F?

Stuart,
As far as we know, this is not true. You would have to continue paying your annual deductible for the lifetime of your Medigap Plan F High Deductible. And, yes, new High F plans will no longer be sold after January 1, 2020.
-Chris from https://www.senior65.com/


By Marcos D on December 22, 2015

You answered my question, kind of, but I still don’t understand how the High F requires you to pay $2180 in “deductibles” before the plan kicks in. You answered that the deductible is made up of Medicare's deductibles ($1454), copays, and coinsurance. Under what scenario would the copays and coinsurance add up to $726, which is the difference between the two stated “deductibles?” -- before the plan even pays a dime?

Marcos,
Thank you for the follow up. The High F deductible, if you are healthy, is unlikely to be reached, however if you have an injury or serious illness, you could easily meet the deductible through doctor's office visits coinsurance, Skilled Nursing Facility copays, physical therapy, etc. See the chart above, hopefully this will explain it better.
-Eric from https://www.senior65.com/


By Marcos D on December 22, 2015

I'm confused about out-of-pocket deductibles. According to the Medicare website, in 2016 the Part A deductible is $1288 + the Part B deductible is $166 = $1454 total deductibles. But High F requires you to pay $2180 in "deductibles" before the plan kicks in. What explains the different numbers?

Marcos,
We totally understand your confusion. One thing you should realize is that Medigap Plan F High Deductible is a completely separate plan that supplements Original Medicare. Therefore, the High F deductible is separate from Medicare's deductibles. Another thing you should understand is the Medicare Part A deductible is a benefit period deductible, not a yearly deductible, and you could pay this several times a year. However, this is not the only factor that would apply toward paying your Medicare Supplement High F deductible. Your deductible is made up of Medicare's deductibles, copays, and coinsurance. Hope this better explains it.
-Eric from https://www.senior65.com/



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


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