Medigap Plan F
Medigap Plan F – is on our recommend list
Medigap Plan F is available to those eligible for Medicare before 1/1/2020 AND enrolled in Medicare Part A and B
Medigap Plan F and C are available for people that were new (or eligible) for Medicare prior to January 1, 2020. You must also be enrolled in Medicare Part A and B to have your application be accepted by an insurance company.
Enrollment rules are explained here.
What should you do if you do not qualify for Plan F? Consider Medigap Plan G. Learn more here.
Other important information about Medigap Plan F
Medigap Plan F has the highest enrollment of all Medigap plans in the United States
This plan is the ‘gold standard’ for health insurance for people on Medicare. Why? Because this plan pays all of the left over costs that Medicare Part A and B do not completely pay.
You can budget with confidence for your Medicare covered health care costs. How do you do this? Simply multiply your Plan F monthly premium by 12. Remember, dental, hearing, and vision are not typically covered by Medicare. You have to consider these annual costs when doing your budgeting.
When you have a Medigap plan all doctors/hospitals/other providers in the US that accept Medicare are available to you
This can become a significant benefit. Especially if you develop a serious health issue and prefer to be treated by the top specialists/hospitals in the US. The publication found here helps you identify these resources. If this is of interest to you, you can find which clinics in the top US hospitals have the consistent and better outcomes when compared to all 4500+ hospitals in the US.
Monthly Premiums for Plan F vary noticeably between the companies offering this plan to Idaho residents
Why do companies have such a wide variance in their monthly premiums when the plan offers the same health coverage?
Companies offering this plan set their own initial rates when then enter a market (like Idaho).
All companies that chose to remain in the Idaho marketplace on 3/1/2022 had to refile their paperwork with the Idaho Department of Insurance and define their new ‘community rates’.
After reviewing their rates on 3/1/22 it is obvious which companies are after market share (offer lower/competitive rates) and which are more conservative (have higher rates).
What influenced their initial rate setting process? The company’s business goals, cost structure, company’s risk profile, and the claims history of their existing policy holders.
Annual Medigap Plan F Rate changes
Remember, monthly premiums for all Medigap plans can change annually. Budget 7-9% and be pleased if it comes in lower.
Personnel in the Idaho Department of Insurance review each company’s financials before approving any request for an annual rate increase. If the company’s financials do not support the request it can be denied.
If you experience an attention getting rate increase, that can be a signal you should look for a different company with a lower premium. Yes, with ‘community rating’ in place now, you can switch companies, get the same plan if there are lower rates available without going though underwriting. We encourage Medigap policy holders to manage this expense annually by simply keeping the same plan but switch to a different company with a lower premium.
A 20% increase was the largest we witnessed in 2020. Some other companies had lower double digit increases.
If you work with a broker, they should monitoring this and notify you when lower premium opportunities are available.
When you enroll in a Medigap plan, your monthly premium will not change for 12-months.
What else you need to know about Community rating
There are separate Community rate charts for individuals which use tobacco and for those that do not/have not for the past 12 months. Within these 2 categories there are two additional rate charts. These are for people age 65/over; the second is for others on Medicare and under age 65.
When Idaho was an ‘issue age’ State, each company had a specific rate, based on the age of the applicant when they enrolled in the plan. The older a person is when they decide to enroll in a Medigap plan, the higher their rate.
Check current monthly premiums for Medigap Plan F (and the other plans) here.
Learn more about Community rating and the birthday rule
Additional details about Idaho Community rating and the ‘birthday rule’ are available here.
The ‘frequently asked questions’ section should reinforce your understanding of Community rating AND the ‘birthday rule’. Call us if you have questions on this content.
Insurance Companies with the lowest monthly premiums
When Idaho was an ‘issue age’ State, we reviewed companies on 8-different criteria to see if they would make our ‘recommend’ list.
We have eliminated this screening for the intermediate time period. Why? Because we can change companies annually and get the same plan at a lower premium, if one is available. This can be done without going through ‘underwriting’.
This is a significant law change and was implemented on 3/1/2022. When Idaho was ‘issue age’ based and we wanted to change companies to get a lower premium, we had our application reviewed by underwriting. The application could be denied based on our answers to health history questions and/or what prescription medications we had been taking. This meant we could not get lower rates by changing companies.
Who are the top rated Insurance companies offering Medigap Plan F?
We are placing less emphasis on rating companies as we feel Medigap products have become a commodity. We prefer to do business with companies with a solid track record in the Medigap business, has at least 10000 policies in force, is continuing to expand market share, last years medical loss ratio is no more than 2 points above the natiinal average of all companies in this business, and their monthly premium are in the 1st quadrant (sorted by monthly premium) of all companies in Idaho in the Medigap business.
Individual companies may emphasize other merits, like customer satisfaction, trying to sway prospects their way. A recent national survey found 93% of policy holders ‘satisfied with their policy’. 80% were ‘very satisfied’.
What about a Plan F with a gym membership and/or a ‘Household Discount’?
Some companies offer ‘extras’ like a gym membership AND/OR a ‘household discount’. If a gym membership is important, only consider companies which include this feature and then shop these companies for the lowest monthly premium. If the premium(s) from these companies are higher than buying these products separately, buy them separately. Shop wisely. If you stop using the gym membership, change companies if you can get the same plan at a lower premium.
Be aware companies including gym memberships can drop this ‘extra’ at their discretion.
Household discounts…what else you need to know
Seeing a plan with a ‘household discount’ can be an attention getter. If you qualify for this feature, be sure and calculate the ‘net premium’ for that company. This is their advertised premium less the household discount Compare this net figure to the company with the lowest premium for this plan. We encourage you to shop for a plan based on their ‘net’ monthly premium…and do this annually during your birthday window. Do not get ‘teased’ by this advertising tool. Shop smart.
If you choose to work with a broker that specializes in Medigap plans, they will do this for you. Be sure and ask any broker you are considering if they will also follow up with you annually. We do this with the goal of keeping our customers from over paying for their health insurance. We feel the savings are better off in the pocket of our customers.
We encourage Idaho residents to avoid these Medigap Plans
Medigap Plan K, Medigap Plan L, and Medigap Plan M are NOT on our list of ‘Medigap plans Idaho residents should consider’. Why? Because of their low levels of national enrollment. Total Idaho membership in plans K, L, and M is less than 2% of all Idaho Medigap enrollees. Nationally, these three plans had similar enrollment numbers. We encourage Idaho residents to avoid these plans. Also keep in mind that later in life if you wish to switch to a Medigap plan with more ‘comprehensive’ coverage, you will have to answer the health history questions and, depending on your answers, your application could be denied. I encourage you to choose the Medigap plan you want 10-years from when you first get a Medigap plan.
What about Medigap Plan G and Plan N?
We like both of these plans too. Their monthly premiums can be noticeably lower than Plan F.
The differences between Plan F and these 2 plans is you will have left over costs when you use Medicare covered services. This means taking a bit more time to both reconcile the statements/invoices from Medicare, your Medigap insurance company and the provider. Keep in mind as we continue to age, this task can become tedious. Some people get around this issue by giving ‘power of attorney’ for their health care decisions and finances to a trusted party.
A general concern for both of these plans was the large increase in the Medicare Part B deductible in 2022. Neither Plan G nor N cover this deductible; Plan F does. If the Part B deductible continues to grow at a similar rate going forward, Plan F can become more attractive, if you qualify for this plan. In the long run, you may be better off with a Plan F.
Should you get your prescription drug plan and your Medigap plan from the same company?
It is easy to say yes to this question. However, there there is a process for selecting a prescription drug plan and we encourage you to consider the points below before you agree to enroll in any plan. These are:
if the plan covers all of the medications you take;
the plan’s Medicare star rating (learn more here); we do not recommend plans whose star rating is below 3 and prefer plans with at least a 3.5 star rating;
which pharmacies in the plan’s network offer the lowest fill/refill rates (pay attention to this);
if the plan offers a mail order pharmacy whose 90-day refill rates are lower than you going to the counter to get refills;
consider the plans meeting the above criteria that have the most medications in their own formulary; in 2022 the plans available to Idaho residents varies by over 780 medications in their respective formularies. This information is available here and was checked on 3/1/2022.
consider the 3 plans with the lowest annual out of pocket cost for the med’s you take and meet the above criteria; we encourage you to do this annually because insurance companies can and do change their plan details annually. These changes can affect your out of pocket cost.
Annual out of pocket costs can vary by 300%+/- for the same medications
Before enrolling in a Medicare prescription drug plan we suggest your med list be reviewed with all plans available. We suggest this be done annually.
We define your annual out of pocket costs as ‘plan’s monthly premium + fill/refill cost for the month) * 12. When we help people do this it is common for us to see a 300% +/- variance for the same set of medications between all plans available.
When you work with an independent agent that covers both Medigap and prescription drug plans, they should be able to help you find the plan with the lowest cost.
If you want help selecting a prescription drug plan and are a resident of Idaho, call us.
Idaho residents interested in a Medigap Plan F
Call us at (208)-867-0296 if you would like to learn more about Medicare Plan F coverage and benefits.
Be aware if you use non-Idaho based brokers they may not be licensed with all/most of the companies offering Medicare Supplement plans in our state. This means you not getting the complete picture.
Insurance companies offering Plan F are on different schedules for updating their rates. We update our files every month. This means you can count on the accuracy of our quotes.
We are here to help.
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