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While not a common Medicare question we receive I am going to address it anyway. In this article, I’ll provide a breakdown of the High Deductible Plan F itself and suggest the ideal “consumer” who I believe is a good candidate. 

So why am I choosing to write about the High Deductible Plan F you ask?  After all, it isn’t a common plan by the sales data anyway.

Well, now days, most senior health insurance agents are highlighting Medigap Plan G or N.  I have done it a fair share myself.  Started doing it 25+ years ago.

For several years now, agents have seeming discouraged the standard Plan F.  Why? Plan F is the most expensive Medigap plan of the 10+ standardized choices.  However, it does offer 1st dollar coverage for everything approved by Original Medicare. Your only “skin in the game” is the higher monthly premium.

Now, High Deductible Plan F (HD-F) is at the other end of the spectrum and is very, very affordable.  Each year you will have deductible to meet before Medicare and the plan HD-F absorb your medical expenses. With that said, you should always have coverage you are comfortable with, first and foremost.  Listen to what your indepedent Medicare specialist (agent/broker) has to say carefully. Buy the coverage you want and can comfortably afford to live with. Insurance is a personal thing. That is why Medicare created several plans to choose from.

There are 3 typical plans that are by far the the most popular choices for those seniors who have or will elect Original/Traditional Medicare.

The key word from above is “typical.”

There are exceptions to this general rule. However, it seems that many, many agents are not catching on or are refusing to promote it.

The High Deductible Plan F or Is It… Plan F High Deductible?

Call it what you will.  It is a matter of choice.  If you live in Southern Florida…say Boca Raton, Miami or even up in Tampa for example, premiums for most Medicare Supplements are much higher than most other areas of the country.  Premiums are so high in fact, that paying the deductible in the “High Deductible” Plan F because of the pure premium savings it offers.

Never heard of the Medicare Supplement High Deductible Plan F?  You’re not alone.  Many have not.  Similar information can be found in your “Medicare and You Guide Book” (2024 edition) on pages 75-78.  The high deductible option is denoted as Plan F* and the details were available at the bottom of the page.

If you live in specific areas of the country like Florida or even New York, it may be something to take a serious look at.  Just remember, you have to satisfy a yearly deductible before the Medicare Supplement will start paying any portion of any Medicare approved claims. That will be your “skin in the game” every year.

How Does The Plan F High Deductible Work?

Here is the all important item to note.  As of January 1, 2024, the “high deductible” required by Medicare before supplemental benefits paid to your provider is $2800.

If medical care is required, the $2800 annual deductible would be paid by you before any supplemental benefits are paid by the insurer.

Therefore, you would be responsible for the balance of Medicare approved charges typically paid by the Plan F including coinsurance, co-payments and deductibles until you have reached the “high deductible” out of pocket.  So, as of now, you may be responsible for up to $2800 in 2024 for out of pocket,  Medicare approved services. If you are traveling in a foreign country, you would also be responsible for an emergency services deductible of $250 if you needed immediate care. After that however, any approved Medicare claim is paid in full.

Now that sounds like a good deal of money to have to pay if you end up in the doctors office or hospital.  However, when you look at the premium savings each year and the benefits offered, this plan will keep your total out of pocket for healthcare on Original Medicare to minimal amount yet offer great benefits if your health turns for the worse.

Nothing changes regarding your base Medicare Part A and B benefits.  The deductible is applied towards the 20% that Medicare does not pay on approved claims.

Who Is The High Deductible Plan F For?

A 65 year old Male, non smoker in Boca Raton, FL would have a premium for Medigap Plan G of $212/mo. at this time in 2024 with Mutual of Omaha. This is aggressively priced for comparison sake and not easy to qualify for.  Plan G is considered to be a value plan by most senior health insurance agents/brokers.  It is typically purchased for its affordability and the excellent benefits it offers.  Your only responsiblity for Medicare approved claims is the Part B deductible. In 2024 – $240. Our example 65 year old Male, Medigap Plan G owner would pay $2544 a year as of January 2023. His only responsibility for approved care is for the first $240 of outpatient care each year.

Now, let’s take a closer look at the Medigap High Deductible Plan F which pays full benefits after you meet the annual deductible of $2800 in 2024.  The monthly cost for a 65 year old male would be $64 for the United American High Deductible Plan F.  This particular example from United American, a High Deductible Medigap Plan F would save you $1676 a year in insurance premiums with their standard Plan G. This money could be put in savings in a separate bank account to accumulate over time. You are self insuring yourself with an accumulation strategy versus giving it to the insurance company in monthly premiums.

How much more could you save if you didn’t have $1676 in additional premiums each year for their Plan G?  You see, you aren’t paying this money out via insurance premiums so it is potential savings.  Remember, this plan is full benefits after you meet the annual deductible which is $2800 this year. Nothing more out of pocket on any Medicare approved claim for 2024. On a Plan G, you would have already paid thousands out in additional premiums ($2544) and be required to pay the $240 Medicare Part B deductible for outpatient care.

As you age, your insurance premiums will rise. The opportunity to save money on premiums is there. You must lay this money aside and have the necessary nest egg set aside if you end up hospitalized. You will be responsible for the 20% that Medicare does not cover in hospital.

So, in summary, you risk paying up to $2800 this year less your premium savings by electing the High Deductible Plan F.  If you travel abroad, a emergency services deductible of $250 should be added into your maximum out of pocket.

Remember, that potential savings will be adding up over the years.  If you end up in the hospital, you should have some of or all the funds to cover the $2800 deductible, right?

If you elect a Plan G or standard Plan F, you are going to pay a significantly higher premium each year to have.

Depending on your financial resources and good general health, you could deploying a high deductible stategy. Just understand, you could get trapped in that plan if your health takes serious nose dive. This could very well eliminate your ability to change to another a standard Plan G, N or F. The is another option to get out from under a drastic change in health but beyond the scope of this article.

It’s a frame of mind you must have, definitely. Having discipline to tuck money away to cover the $2800 is necessary if you have limited means. This is a year expense if you health does really turn for the worst. If money is real tight and need a Medicare Supplement, we recommend a standard Plan N. You must be in decent health for your age to make the change though.

No one likes to cough up money for medical bills when they are paying for insurance, right?  You can either open the wallet to the insurance company upfront or in the a health crisis, use your premium savings to cover a large medical claim with a HD plan. 

Insurance is a very personal choice.

If you’d like to get the rates in your area to do a side by side comparison, take a moment and get in touch with us.  Our help is free to you.

Has The High Deductible Plan F Gone Away?

With Medicare changes in January 1, 2020, there have been some definite Medigap disappointments.

Some of you may know the standard Plan F will not be available to newly eligible Medicare recipients. 

This also includes the High Deductible Plan F and the Plan C.

The reason it was changed…

Medicare decided they wanted new, eligible recipients to have more “skin” in the game.

The opinion of Medicare is…first dollar benefits drive “over utilization” of benefits.  Whether that is true or not, the fact remains, standard Plan F covers dollar one.

Those who already have it or where eligible for Medicare prior to January 1st, 2020 may purchase it from any company that offers it…if you qualify health wise. If you’re not “grandfathered” in and interested in a high deductible plan, check out the HD-G plan instead.

If you are already on a Plan F High Deductible policy, you can change to another company to save money if your health can qualify you.  Some states do allow Medicare beneficiaries the right to change to other Medigap plans without going thru medical underwriting to qualify. California is an example of this.

Is There Anything Else I Should Know About The High Deductible Plan F?

With any Medigap plan or Medicare Supplement (as it is otherwise known), the decision as to whether the policy will pay out benefits is dependent on Medicare.  If Medicare does not approve your healthcare claim, no supplement will pay a nickel.  It has absolutely nothing to do with the supplemental insurer.

Medicare pays 80% of their approved amounts while the rest is sent on to any carrier you have a Medigap policy with.  From there, any additional claim support will be determined by the standardized benefits in that plan.  Remember, if you do not have Medigap coverage, you are responsible for the remaining 20% whether these are hospital or outpatient care expenses.  Don’t lose site of this Medicare fact!!

There are particular parts of the country have some real opportunity to save lots of money, yet have protection when it is needed.  These areas are prime locations that demonstrate what I suggest might be a better way to go with your Medicare Supplement insurance. 

As a company article writer and agent, it is hard for me to advise anyone specifically without knowing your financial protection goals.  If you having been thinking about making a change, there is no better time than the present.  Give us a call and let’s talk about your options and what you can qualify for.

Final Thoughts…

Does High Deductible Plan F make sense?  Still wondering…should I get a Plan F High Deductible?  Take a good look at where you live. 

A high deductible Plan F supports the concept of affordability with fully comprehensive benefits after reaching $2800 (2024). Note, the high deductible amount will generally rise over time. You will be responsible for the increase. For reference, the annual deductible was $2240 in 2018 when we first released this article.

It should not be disregarded over the big 3 if you live in some select coastal areas. If you have a nice pot of gold that you can quickly access, this may make sense for you to consider seriously.

No one likes to overpay for insurance especially if their health has been good for many years. 

Have a tendency to feel nickled and dimed to death? If so, you probably will not be happy with any High Deductible Medicare Supplement. Medicare approved medical bills will all end up in your mailbox until you reach $2800 each year as of today.

The Medicare Supplement plan you select of course is a personal decision.  So why only the coastal areas and only healthy people? Medicare Supplement premiums tend fo be much higher in these areas. Healthy people file minimal claims and as a result don’t have high medical expenses. They are able to save most of the yearly deductible. If you have rocky health, your expenses a year can easily exceed the deductible. It just does not pan out as good insurance strategy.

Conclusion: Plan F High Deductible (HD-F)

Maybe our site was part of your nformation gathering from various high deductible Plan F reviews? My goal here has been to simply get you the information you need to make a good decision regarding your Medicare options.

I felt compelled to write about the Medicare Plan F High Deductible as so much emphasis is on the standard Plan F, Plan G and Plan N (most popular plans) without looking at high deductible options.  I am not picking on anyone as I’m guilty as charged of touting the same plans with good reason of course.

Plan HD-F can be a real premium saver for people who want to save money and have a solid nest egg to cover the annual deductible as it presents itself. The high deductible is annual, not one time. If you need care the end of a calendar year and additional care in January of the following year, you are required to meet the high deductible.

HD-F or Plan HD-G, can be a real winner especially if you have a good health history… regardless of popularity.

Medicare will be paying 80% of all approved charges. That leaves you with 20% up to the annual deductible of $2800.

Some seniors will purchase a dental, vision and hearing policy with some of their massive premium savings.

If you live near a coastal area in particular, the Medicare Supplement Plan F High Deductible is something to keep on the radar if you have good health and have the discipline to set aside funds you will likely need down the road for healthcare.

Food for thought.

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