Medicare Plan F vs G

When comparing Medicare Plan F vs. G, the biggest difference is simple: Plan F pays the Medicare Part B deductible, while Plan G does not. In most other ways, their standardized benefits are nearly identical, but Plan F is no longer available to people newly eligible for Medicare after January 1, 2020.

Your best choice often comes down to eligibility, monthly premium and whether the savings on Plan G outweigh paying the Part B deductible yourself. Here’s how the two Medigap or Medicare Supplement plans compare.

A Medicare supplement plan, also called a Medigap plan, works alongside Original Medicare to help pay approved out-of-pocket costs such as deductibles, coinsurance and copayments. Plan F and Plan G offer many of the most comprehensive standardized plan benefits: both cover Part A hospital coinsurance, skilled nursing facility coinsurance, Part B coinsurance or copayments, blood, hospice coinsurance and foreign travel emergency care within plan limits.

The practical distinction is straightforward. Plan F pays the Medicare Part B deductible; Plan G does not. Once a Plan G member has paid that annual deductible, its coverage generally mirrors Plan F’s for Medicare-covered services.

Neither plan includes routine dental, vision, hearing aids or prescription drug coverage, so beneficiaries may need separate arrangements for those needs. Eligibility is decisive. Plan F is generally available only to people who became eligible for Medicare before January 1, 2020.

Those newly eligible after that date can consider Plan G instead. Insurers set premiums independently, so the same Medigap plan can cost differently based on location, age, household discounts and pricing method. Compare the premium with the Part B deductible and the carrier’s rate history, not simply the lowest first-year price.

Medigap plans are designed to supplement Original Medicare by paying certain deductibles, coinsurance and other approved expenses. Plan F covers all Medicare-approved cost-sharing gaps that a supplement can cover. Plan G delivers nearly identical plan benefits, with one important exception: the annual Part B deductible remains your responsibility.

The practical difference between these policies is the Medicare Part B deductible. With Plan F, the policy pays it; with Plan G, you pay that amount yourself before your Plan G benefits begin covering eligible Part B coinsurance and copayments.

Afterward, both plans generally leave very little in routine out-of-pocket costs for Medicare-covered doctor and outpatient services. Both Plan F and Plan G also cover the Part B excess charge.

This can arise when a physician who does not accept Medicare assignment bills up to 15% above Medicare’s approved amount. That protection may matter in areas where such providers are more common, although many people never encounter an excess charge. Neither policy turns noncovered care into covered care.

You may still have expenses for services Medicare excludes, such as most routine dental, vision and hearing care, as well as care outside a policy’s foreign-travel emergency benefit limits. Plan F is no longer available to people who became eligible for Medicare on or after January 1, 2020; those already eligible before that date may still be able to enroll.

• Plan F pays the Medicare Part B deductible; Plan G requires you to pay it before benefits begin.
• After the deductible, both plans generally cover eligible Part B coinsurance and copayments.
• Both Plan F and Plan G cover Part B excess charges from nonparticipating providers.
• Excess charges can reach 15% above Medicare’s approved amount, though many members never encounter them.
• Neither plan covers services Medicare excludes, including most routine dental, vision, and hearing care.
• Foreign-travel emergency coverage remains subject to each policy’s benefit limits.
• Plan F is generally unavailable if you became eligible for Medicare on or after January 1, 2020.

Medigap Plan F is no longer available to people who became eligible for Medicare on or after January 1, 2020. That change does not eliminate private insurance options for everyone else. Eligibility depends on when you first qualified for Medicare, while available Medigap policies can vary by insurerand state.

Yes. Beneficiaries already enrolled in Plan F may keep their Medigap policy for as long as they continue to pay the premium and the policy remains in force. The 2020 rule did not cancel existing coverage, reduce its benefits, or require current members to move into another Medicare plan.

Plan F continues to provide its established benefits, including coverage for Medicare Part B’s deductible for people who were eligible for Medicare before 2020. Medicare insurers, such as eHealth, may still service these policies and, in many cases, continue to offer them to people who became Medicare-eligible before the cutoff date.

That said, keeping Plan F is not always the best financial choice indefinitely. Premiums can change over time, and a person who wants to switch to a different Medigap policy may face medical underwriting unless they have a guaranteed-issue right. Before making a change, compare the new premium, benefits, network rules if considering Medicare Advantage, and whether you would be able to return to Plan F later.

A simple calculator can turn a confusing choice into a practical comparison. Start with each plan’s monthly premium and multiply it by 12. Then add the expenses you reasonably expect in a year: primary-care and specialist visits, tests, hospital care, prescriptions, dental services if relevant, and any regular therapies.

For Original Medicare, include the Medicare Part B deductible and the share you generally pay after meeting it. If you are considering a Medicare Advantage plan, use that plan’s deductible, copays and coinsurance instead.

Do not overlook a plan’s annual out-of-pocket maximum, which can matter greatly in a year with surgery, a hospital stay or ongoing treatment. Next, compare a low-premium plan with a richer plan. The break-even point is where the premium savings from the less expensive option are erased by its higher cost sharing.

For example, paying $30 more per month means spending $360 more annually; if the richer plan saves more than $360 in expected copays and prescriptions, it may be the better value. Run a second scenario for an unexpectedly high-use year before deciding.

For many long-time Plan F members, the question is less about coverage quality than price. Plan G is often the closest alternative, but a switch can require a new policy and medical review. Compare plan premiums, expected out-of-pocket costs and your ability to qualify before giving up established coverage.

In most states, moving from Plan F to another Medigap policy after your initial enrollment window means applying through medical underwriting. The insurance company may review current conditions, prescriptions, recent treatment and health history before deciding whether to accept the application or what rate to offer.

Eligibility is not guaranteed simply because you already have a Medigap policy. That makes timing especially important. Do not cancel Plan F until the new coverage has been approved, you have reviewed the effective date and you understand any waiting-period or administrative requirements.

A lower advertised premium is not necessarily available to every applicant. State rules can materially change the analysis. Some states provide annual enrollment opportunities, birthday rules or other protections that let certain members change plans without medical underwriting.

Those rights vary by state and may limit the plans available or the time to apply. A licensed local insurance professional can confirm the rules where you live and help compare the likely savings against the security of keeping your current coverage.

• Compare monthly premiums for high-deductible Plan G, standard Plan G, and Plan N in your local market.
• Confirm the annual high-deductible Plan G amount and ensure savings could cover a costly medical year.
• Expect high-deductible Plan G to require Medicare-covered cost sharing before full plan benefits begin.
• Review Plan N office and emergency room copayments when estimating routine healthcare expenses.
• Check whether your doctors accept Medicare assignment, since Plan N does not cover Part B excess charges.
• Consider your health, expected care use, savings, and comfort with unpredictable out-of-pocket costs.

Medigap insurance, also called a Medicare supplement plan, works alongside Original Medicare to help pay certain deductibles, coinsurance and copayments. It is not used with Medicare Advantage.

Prescription drug coverage is generally purchased separately through Part D, making it important to compare the full coverage arrangement rather than a supplement plan alone.

Medigap policies are sold by private insurance companies, and the selection can look quite different from one state or county to the next. A carrier may offer several standardized Medigap plans in one market but only a limited lineup elsewhere; premiums, household discounts, underwriting practices and customer service also vary.

A local comparison should therefore look beyond the lettered plan name to identify which companies are actively accepting applications and how they price coverage over time. Federal standards set the core benefits for most Medigap plans, so the same plan letter generally covers the same basic benefits regardless of insurer. Massachusetts, Minnesota and Wisconsin follow their own standardized formats.

The timing of an application matters as much as the plan itself. During the six-month Medigap open enrollment period that begins with Part B enrollment, insurers generally must sell an available policy without medical underwriting.

Outside that window, a company in many states may review health history or decline an application unless a guaranteed-issue right applies. A trusted state insurance department guide can clarify local protections, approved rates and complaint information before enrollment.

• Confirm which carriers actively sell Medigap policies in your county or state.
• Compare premiums, household discounts, rate history, and customer service, not just plan letters.
• Remember that most standardized plan letters provide the same core benefits across insurers.
• Check special standardization rules if you live in Massachusetts, Minnesota, or Wisconsin.
• Apply during your six-month Part B enrollment window to generally avoid medical underwriting.
• Outside open enrollment, review guaranteed-issue rights before assuming coverage is available.
• Consult your state insurance department for approved rates, consumer protections, and complaint records.

The main difference is the Medicare Part B deductible. Plan F pays this deductible, while Plan G requires you to pay it yourself. After the deductible is met, Plan G generally provides the same Medicare-approved cost-sharing protection as Plan F.

Usually not. Plan F is unavailable to people who first became eligible for Medicare on or after January 1, 2020. If you became eligible before that date, you may still be able to purchase Plan F, depending on insurer availability and your state.

Yes. Current Plan F members can generally keep their policy as long as they continue paying premiums and the policy remains in force. The eligibility change did not cancel Plan F coverage or reduce its standardized benefits.

Yes. Both Plan F and Plan G cover Part B excess charges. These charges may apply when a provider does not accept Medicare assignment and bills above Medicare’s approved amount, subject to applicable Medicare limits.

No. Medigap Plan F and Plan G do not include outpatient prescription drug coverage, routine dental care, routine vision care, or hearing aids. Prescription coverage is commonly obtained through a separate Medicare Part D plan.

Neither plan is automatically better. Plan F may suit someone eligible to buy it who prefers having the Part B deductible paid by the policy. Plan G may offer stronger value when its lower premium exceeds the annual Part B deductible savings provided by Plan F.

Medigap benefits are standardized, but insurers set their own premiums. Pricing can vary by location, age, household discounts, tobacco use, and the company’s pricing method or rate history. Compare annual premiums, expected out-of-pocket costs, and potential future rate increases.