For many Medicare beneficiaries, choosing the right Medicare Supplement (Medigap) plan is crucial for managing healthcare costs. Two plans often come up in discussions about comprehensive coverage: Medicare Plan G and Medicare Plan F. While both offer extensive benefits, there’s a key difference that impacts eligibility and cost, making one a better choice for most new enrollees today.
Let’s break down the distinctions between g medicare and Plan F.
The Elephant in the Room: Eligibility
The most significant difference between Medicare Plan F and Plan G lies in eligibility, specifically for new Medicare beneficiaries:
- Medicare Plan F: Due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Plan F is no longer available to individuals who became eligible for Medicare on or after January 1, 2020. If you were already eligible for Medicare before this date (even if you enrolled later), you can still purchase or keep a Plan F policy. This means Plan F is being phased out for a large portion of the Medicare population.
- Medicare Plan G: Plan G is available to all Medicare beneficiaries, regardless of when they became eligible for Medicare. This makes it the most comprehensive option for those new to Medicare in 2020 or later.
What They Both Cover (The Similarities)
Despite the eligibility difference, Plan G and Plan F are remarkably similar in the extensive benefits they offer. Both plans are designed to cover the major “gaps” in Original Medicare (Part A and Part B). They both cover:
- Medicare Part A Coinsurance and Hospital Costs: Both plans cover the coinsurance for inpatient hospital stays, including an additional 365 days after Medicare benefits are exhausted. They also cover the Medicare Part A deductible (which is $1,676 per benefit period in 2025).
- Medicare Part B Coinsurance or Copayment: After the Part B deductible is met (more on that below), both plans cover the 20% coinsurance or copayments for Medicare-approved outpatient services, such as doctor visits, lab work, diagnostic tests, and durable medical equipment.
- First 3 Pints of Blood: Both plans cover the cost of the first three pints of blood needed for transfusions each year.
- Part A Hospice Care Coinsurance or Copayment: Both plans cover the copayments associated with Medicare-approved hospice care.
- Skilled Nursing Facility (SNF) Care Coinsurance: Both plans cover the daily coinsurance for skilled nursing facility stays from day 21 through day 100.
- Medicare Part B Excess Charges: This is a crucial benefit of both plans. If a healthcare provider does not accept Medicare assignment, they can charge up to 15% more than the Medicare-approved amount. Both Plan F and Plan G cover these “excess charges” in full, protecting you from these additional costs.
- Foreign Travel Emergency: Both plans provide coverage for emergency medical care received outside the United States. They typically pay 80% of the billed charges after a $250 annual deductible, up to a lifetime maximum of $50,000.
The Key Coverage Difference: Medicare Part B Deductible
Here’s the single, yet significant, difference in coverage:
- Medicare Plan F: Covers the Medicare Part B deductible in full. For beneficiaries with Plan F, once Medicare approves a service, they generally pay nothing out-of-pocket for Part A or Part B covered services, except for their monthly Medigap premium. The Part B deductible in 2025 is $257.
- Medicare Plan G: Does NOT cover the Medicare Part B deductible. Beneficiaries with Plan G are responsible for paying this deductible themselves each calendar year before their Plan G coverage for Part B services kicks in.
Cost Comparison: Premium vs. Deductible
Because Plan F offers that “first-dollar coverage” by covering the Part B deductible, its monthly premiums are typically higher than those for Plan G.
- Plan F Premiums: Generally higher, as they include the cost of covering the Part B deductible.
- Plan G Premiums: Generally lower than Plan F premiums, because you are responsible for the Part B deductible.
For many beneficiaries, especially those newly eligible for Medicare, Plan G often proves to be the more cost-effective choice, even with the Part B deductible responsibility. If the annual difference in premiums between Plan F and Plan G is more than the Part B deductible ($257 in 2025), then choosing Plan G would result in overall lower out-of-pocket costs. In most cases, the premium savings with Plan G significantly outweigh the annual Part B deductible.
High-Deductible Options
Both Plan F and Plan G also offer high-deductible versions in some states. For these plans, you pay a higher deductible ($2,870 in 2025) before the plan begins to pay for any Medicare-covered costs. The high-deductible Plan F covers the Part B deductible as part of that overall high deductible, while the high-deductible Plan G still requires you to meet the Part B deductible within the higher plan deductible. These options come with lower monthly premiums and are suited for individuals who prefer to self-insure for routine costs and only need catastrophic coverage.
Which Plan is Right for You?
- If you were eligible for Medicare before January 1, 2020: You have the option to choose either Plan F or Plan G. It’s highly recommended to compare the annual premiums for both plans in your area. If the premium difference between Plan F and Plan G is greater than the Part B deductible ($257 in 2025), then Plan G will likely save you money overall.
- If you became eligible for Medicare on or after January 1, 2020: Plan F is not an option for you. Plan G is the most comprehensive Medigap plan available and is likely your best choice if you desire minimal out-of-pocket costs for Medicare-approved services.
In essence, while Plan F once offered the ultimate in “zero out-of-pocket” for Medicare-approved services (after premiums), the change in eligibility rules has firmly established Plan G as the new gold standard for comprehensive Medigap coverage for the vast majority of today’s Medicare beneficiaries.
