The chart below shows basic information about the different benefits Medigap policies cover.
✔ = the plan covers 100% of this benefit
X = the plan doesn’t cover this benefit
% = the plan covers that percentage of this benefit and you’re responsible for the rest
N/A = not applicable
The Medigap policy will only pay your coinsurance after you’ve paid the deductible (unless the Medigap policy also covers your deductible).
Medicare Still Pays 80%
All Medigap plans supplement your Original Medicare benefits. So Medicare will pay its share, and you will pay your share.
Many people enroll in Plan F because they like the first-dollar coverage. However, cost-conscious consumers can consider a high deductible version of this plan and get lower premiums.
Here’s how it works:
With High Deductible Plan F, Medicare first pays its share. Then you agree to pay the first $2,800 (in 2024) of your share. That is your maximum out-of-pocket on High Deductible Plan F.
Let’s say you had a hospital stay early in the year. Medicare Part A will pay for that hospital stay except for the $1,632 Part A deductible that you will owe. Since you have a $2,800 deductible on your Medigap plan, you will pay the $1,632. That money applies against the $2,800 that you are responsible for. If you have other charges throughout the year, you will pay your share only until you have reached the $2,800 limit.
Key Takeaways
The High Deductible Plan F is different from the standard Plan F.
- Medicare Part A and Part B pay their cost-sharing for services, and you pay the remaining amount until you satisfy the high deductible of $2,800 this year.
- Once you meet the high deductible, Plan F will cover you 100% for the remainder of the year.
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