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Plan letterMACRA-2020 grandfathered

Plan F

Most comprehensive — closed to new enrollees as of 2020-01-01

Plan F has historically been the most comprehensive Medigap policy: it covers the Part A and Part B deductibles, skilled nursing facility coinsurance, Part B excess charges, foreign travel emergency, and the core federal benefits. Plan F is closed to people newly eligible for Medicare on or after 2020-01-01 per MACRA 2015. Beneficiaries first eligible BEFORE 2020-01-01 may still buy Plan F. Plan G is the closest comparable successor for newly-eligible beneficiaries.

A donut chart showing how Plan F covers the ten federally-defined Medigap benefit categories: 9 fully covered; 1 not covered.FPLAN

Coverage of the 10 federal benefits

  • 9 · Fully covered
  • 1 · Not covered

What Plan F covers (federal CMS standardization)

The covered-benefits matrix below is verbatim from medicare.gov. Every cell is federally frozen by the 1990 NAIC Medicare Supplement Standardization Act.

  • Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)Covered ✓
  • Part B coinsurance or copaymentCovered ✓
  • Blood (first 3 pints)Covered ✓
  • Part A hospice care coinsurance or copaymentCovered ✓
  • Skilled nursing facility care coinsuranceCovered ✓
  • Part A deductibleCovered ✓
  • Part B deductibleCovered ✓¹
  • Part B excess chargesCovered ✓
  • Foreign travel emergency (up to plan limits)Covered ✓
  • Out-of-pocket limit (applies to Plans K and L only)Not covered

¹ Plans C and F are closed to new Medicare-eligible beneficiaries on or after 2020-01-01 per MACRA 2015. Beneficiaries first eligible for Medicare BEFORE 2020-01-01 may still purchase Plans C and F.

State availability

Plan F is part of the federal 10-letter Medigap system. Massachusetts, Minnesota, and Wisconsindo not use the federal letter system — if you live in those states, your Medigap plan structure is different. See your state page:

When can you buy Plan F?

During your federal 6-month Medigap Open Enrollment Period (per 42 U.S.C. § 1395ss), every insurer that offers Plan F in your state must issue you a policy regardless of your health status. Outside that window, in most states, insurers may medically underwrite, deny, or surcharge (if you are eligible to buy Plan F under MACRA grandfathering).

Compare Plan F side-by-side

The full federal benefits matrix with Plan F highlighted:

Federal Medigap plan-letter benefits matrix (Plans A–N, CMS-standardized).
BenefitABCMACRA grandfatheredDFMACRA grandfatheredGKLMN
Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)
Part B coinsurance or copayment50%75%See note
Blood (first 3 pints)50%75%
Part A hospice care coinsurance or copayment50%75%
Skilled nursing facility care coinsurance50%75%
Part A deductible50%75%50%
Part B deductible
Part B excess charges
Foreign travel emergency (up to plan limits)
Out-of-pocket limit (applies to Plans K and L only)

Reading the matrix: ✓ = the plan covers 100% of the federally-defined benefit; 50%/75% = the plan pays that share of the benefit; ✗ = the plan does not cover the benefit. Plans C and F are closed to people newly eligible for Medicare on or after 2020-01-01 per MACRA 2015 grandfathering. Massachusetts, Minnesota, and Wisconsin do not use the federal 10-letter system; see your state page for the state-specific Medigap structure.

Plan footnotes

  • 1. Plan F · Part B deductible: Plans C and F are closed to new Medicare-eligible beneficiaries on or after 2020-01-01 per MACRA 2015. Beneficiaries first eligible for Medicare BEFORE 2020-01-01 may still purchase Plans C and F.