Medicare Plan F vs. Plan G: Key Differences and Choosing the Right Plan

Medicare covers a lot, but it doesn’t pay for everything. That’s why Medigap plans like Plan F and Plan G exist—to help with extra costs like doctor copays, emergency room fees, and deductibles so you’re not stuck with surprise bills.

Plan F covers everything, but it’s only available to people who qualified for Medicare before 2020. Plan G is nearly identical, except you pay a small deductible. Choosing the right plan can help keep healthcare expenses predictable and fit your budget—so let’s break it down in simple terms.

What Are Medicare Plan F and Plan G?

Medicare Plan F and Plan G are different Medigap policies designed to help cover out-of-pocket healthcare expenses that Original Medicare doesn’t pay for, such as doctor copays, emergency room fees, and deductibles. These plans offer predictable costs, making it easier for beneficiaries to budget for their medical needs.

• Medicare Plan F–Maximum Coverage, Limited Availability: Plan F is known for its comprehensive coverage benefits, covering all Medicare-approved cost-sharing requirements—including deductibles, coinsurance, and copayments. This means beneficiaries have zero out-of-pocket costs for covered services.
• However, Plan F is only available to individuals who became eligible for Medicare before January 1, 2020. If you qualify for Medicare after that date, you cannot enroll in this plan.
• Medicare Plan G–Nearly the Same Coverage, More Accessible: Plan G offers almost identical coverage, with one key difference—it does not cover the Medicare Part B deductible. This means beneficiaries pay that amount ($240 in 2024) out of pocket before their plan begins covering other costs.
• Since Plan G is open to all Medicare beneficiaries, it has become one of the most popular Medigap options, especially for those looking for lower monthly premiums and long-term premium savings compared to Plan F.

Both plans offer strong coverage benefits, but choosing the right one depends on factors like premium differences, cost-sharing structure, and your long-term healthcare budget.

Eligibility for Plan F and Plan G

• Plan F Eligibility: Only available to individuals eligible for Medicare before January 1, 2020. If you were eligible before this date but haven’t enrolled, you can still apply for Plan F.
• Plan G Eligibility: Available to all Medicare beneficiaries, regardless of when they became eligible. It’s a great option for new enrollees looking for comprehensive coverage.

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What Does Medicare Plan F Cover?

Medicare Plan F is the most comprehensive Medigap policy, covering 100% of out-of-pocket costs for Medicare-approved services. This means beneficiaries don’t have to worry about doctor copays, emergency room fees, or deductibles, making it a popular choice for those who want predictable costs and no surprise medical bills.

Plan F covers the following:

• Medicare Part A deductible and coinsurance: Covers hospital stays, skilled nursing facility care, and hospice care without out-of-pocket costs.
• Medicare Part B deductible and coinsurance: Pays for doctor visits, outpatient services, and preventive care, eliminating doctor visit copayments.
• Part A and Part B excess charges: Covers additional fees from doctors who don’t accept Medicare assignment (meaning they charge more than Medicare’s approved amount).
• Skilled nursing facility care coinsurance: Helps pay for extended stays in a skilled nursing facility after a hospital visit.
• Foreign travel emergency care (up to plan limits): Provides coverage for emergency medical care while traveling outside the U.S.
• The first three pints of blood: Covers the cost of blood transfusions that Medicare doesn’t pay for.

Because Plan F eliminates nearly all cost-sharing requirements, beneficiaries don’t need to budget for unexpected medical claims or higher premiums due to out-of-pocket expenses. However, it’s only available to those who became eligible for Medicare before January 1, 2020. If you’re new to Medicare, Plan G is the closest alternative.

What Does Medicare Plan G Cover?

Medicare Plan G provides almost the same coverage as Plan F, with one exception: it does not cover the Medicare Part B deductible. After meeting this deductible, Plan G covers:

• Medicare Part A deductible and coinsurance
• Part B coinsurance or copayment
• Part A and Part B excess charges
• Skilled nursing facility care coinsurance
• Foreign travel emergency care (up to plan limits)
• The first three pints of blood: Covers the cost of blood transfusions that Medicare doesn’t pay for.

With Plan G, beneficiaries pay the Part B deductible themselves, but all other expenses are covered. This plan has become a popular option for new Medicare enrollees due to its broad coverage.

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Comparing Costs: Plan F vs. Plan G

While Plan F offers the most comprehensive coverage, Plan G typically comes with lower monthly premiums, making it a popular alternative for those who want to save on healthcare expenses while maintaining strong coverage.

Monthly Premiums: Higher Coverage vs. Lower Costs

• Plan F premiums range from $150 to $250 per month, depending on your age, location, smoking status, and insurance provider.
• Plan G premiums are usually $100 to $200 per month, making it the more affordable option upfront.

The main reason Plan G costs less is that beneficiaries are responsible for the Part B deductible ($240 in 2024), which Plan F covers automatically. In exchange, Plan G premiums are often lower by more than the deductible itself, meaning you could save money annually even though you’re paying the deductible out-of-pocket.

Out-of-Pocket Costs: The Key Difference

• Plan F: No out-of-pocket costs for Medicare-approved services—deductibles, copays, and excess charges are fully covered.
• Plan G: Requires beneficiaries to pay the Medicare Part B deductible ($240 in 2024) before coverage kicks in. After that, it covers the same expenses as Plan F.

Overall Savings: Long-Term Considerations

• Plan F offers zero out-of-pocket costs, but its higher premiums may not always be worth it if you don’t frequently need medical care.
• Plan G’s lower monthly premium can result in significant savings over time, especially for those who don’t hit the Part B deductible every year.

Key Takeaway: Balancing Coverage and Cost

If you prefer no medical bills beyond your premiums, Plan F may be the better fit—but only if you were eligible for Medicare before 2020. If you’re looking for premium savings and don’t mind covering a small out-of-pocket deductible, Plan G offers nearly identical coverage with lower monthly prices.

Understanding these premium differences and cost-sharing structures can help you choose the best plan for your fixed budget, medical needs, and long-term financial goals.

How a Solace Advocate Can Help

Navigating Medicare can feel overwhelming, especially when comparing premium differences, cost-sharing structures, and long-term savings. Choosing between Plan F and Plan G isn’t just about monthly prices—it’s about finding a plan that fits your health needs, financial situation, and future medical expenses.

That’s where a Solace advocate can make a difference. Solace advocates help Medicare beneficiaries by:

• Explaining coverage benefits in simple terms so you fully understand your options.
• Comparing insurance providers to find the best monthly premiums and coverage.
• Helping with enrollment and paperwork, so you don’t miss deadlines like the Medigap open enrollment period.
• Assisting with insurance claims if you ever face billing issues or unexpected healthcare expenses.

With a Solace advocate on your side, you don’t have to figure it all out alone. Whether you need help choosing a Medigap plan, handling insurance disputes, or simply understanding your coverage, Solace is here to guide you.

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FAQ: Common Questions about Medicare Plan F and Medicare Plan G

Can I switch from Medicare Plan F to Plan G?

Yes, you can switch from Medicare Plan F to Plan G. However, depending on your state and insurer, you may need to undergo medical underwriting. This process involves answering health-related questions, which can affect your eligibility and premium rates. It's important to review the potential cost savings and coverage differences before making the switch.

Is Medicare Plan G better than Plan F?

Medicare Plan G is often seen as a better value due to its lower monthly premiums, especially for those who do not frequently reach the Part B deductible. While Plan F provides zero out-of-pocket costs, Plan G can offer significant savings over time. Your choice should depend on your healthcare needs, frequency of medical visits, and budget preferences.

What does Medicare Plan F cover that Plan G doesn’t?

The primary difference between Medicare Plan F and Plan G is that Plan F covers the Medicare Part B deductible, while Plan G does not. Both plans cover Medicare Part A and B coinsurance, skilled nursing facility care, and foreign travel emergencies, but Plan G requires you to pay the Part B deductible out of pocket.

Is Medicare Plan G available to all Medicare beneficiaries?

Yes, Medicare Plan G is available to all Medicare beneficiaries, regardless of when they became eligible for Medicare. This makes Plan G a versatile option for new enrollees seeking comprehensive coverage. It's important to compare Plan G's benefits and premiums with those of other available Medigap plans to determine the best fit for your needs.

How much is the Medicare Part B deductible?

As of 2024, the Medicare Part B deductible is $240. This amount can change annually, so it's advisable to stay updated on any adjustments. Beneficiaries enrolled in Plan G are responsible for this deductible, after which the plan covers all other Medicare-approved expenses, providing robust financial protection.

This article is for informational purposes only and should not be substituted for professional advice. Information is subject to change. Consult your healthcare provider or a qualified professional for guidance on medical issues, financial concerns, or healthcare benefits.