Is Medicare Plan F Worth the Cost?

Is Medicare Plan F Worth the Cost? Understanding If Plan F Premium Justifies the Coverage

If you have Medicare Plan F, or you are thinking about buying it, you have probably asked yourself one big question: Is this plan really worth what I pay for it?

I asked the same thing when I started digging into Medicare supplement plans. Plan F has a great reputation. People call it the “Cadillac” of Medigap plans. But a great plan is not always a great deal. So I looked at what Plan F covers, what it costs in 2026, and how it compares with other choices.

In this article, I will walk you through it all in plain language. By the end, you should know whether Plan F makes sense for you, or whether your money could do more somewhere else.

Let’s start with the basics.

What Is Medicare Plan F?

Medicare Plan F is a type of Medicare Supplement Insurance. Many people call these plans Medigap plans. That name makes sense, because they fill the “gaps” in Original Medicare.

Here is how it works. Original Medicare (Part A and Part B) pays for a lot of your health care, but not all of it. You still have deductibles, coinsurance, and copays. Those costs can add up fast, especially if you get sick or end up in the hospital.

A Medigap plan steps in and pays some or all of those leftover costs. Plan F is the Medigap plan that pays the most. In fact, it is often called “first-dollar coverage.” That means after you pay your monthly premium, you usually pay nothing else for care that Medicare approves.

One more thing to know: Medigap plans are standardized. That means Plan F from one insurance company covers the same benefits as Plan F from another. The only real differences are the price, the customer service, and how often the company raises its rates.

What Does Plan F Cover?

Plan F covers every benefit a Medigap plan can offer. Here is the full list:

1. Part A hospital coinsurance, plus hospital costs for up to 365 extra days after your Medicare benefits run out
2. Part B coinsurance or copays (usually 20% of the Medicare-approved amount for doctor visits and outpatient care)
3. The first 3 pints of blood you need for a medical procedure
4. Part A hospice care coinsurance or copays
5. Skilled nursing facility coinsurance
6. The Part A deductible, which is $1,736 per benefit period in 2026
7. The Part B deductible, which is $283 for the year in 2026
8. Part B excess charges (extra fees some doctors charge above what Medicare approves)
9. Foreign travel emergency care (80% of the cost, up to your plan’s limits)

That last part of the list is what makes Plan F special. It is one of only two Medigap plans that cover the Part B deductible. The other one is Plan C, and it has the same buying rules as Plan F.

What Plan F Does Not Cover

Plan F is great, but it is not magic. It does not pay for:

• Prescription drugs (you need a separate Part D plan for that)
• Routine dental care
• Routine eye exams and glasses
• Hearing aids
• Long-term care, like living in a nursing home for a long time
• Your monthly Part B premium, which is $202.90 for most people in 2026

I always remind people of this list. Some folks think Plan F means “I never pay for anything again.” That is not quite true. It covers your Medicare gaps, not every health cost you will ever have.

Who Can Still Buy Plan F?

This is the most important part of the whole article, so I want to make it really clear.

A law called MACRA changed the rules starting January 1, 2020. Under that law, Medigap plans sold to people new to Medicare can no longer cover the Part B deductible. That is why Plan F (and Plan C) closed to new members.

Here is what the rule means for you:

• You already had Plan F before 2020? You can keep it as long as you pay your premiums.
• You were eligible for Medicare before January 1, 2020, but never bought Plan F? You may still be able to buy it if a company sells it where you live.
• You became eligible for Medicare on or after January 1, 2020? You cannot buy Plan F at all.

So if you turn 65 in 2026, Plan F isn’t on the menu for you. Your closest option is Plan G, which I’ll cover in a minute.

How Much Does Plan F Cost in 2026?

Plan F has no single price. Your premium depends on a bunch of things. Here are the big ones:

• Your age. Older people often pay more.
• Where you live. Prices can vary widely by state and even by ZIP code.
• Your gender. Many companies charge women and men different rates.
• Whether you smoke: smokers usually pay more.
• The insurance company. Since all Plan F policies cover the same things, the price is where companies really compete.
• How the company sets its prices. I explain this next.

The Three Ways Companies Price Medigap Plans

Insurance companies use one of three pricing methods:

1. Community-rated. Everyone pays the same price, no matter how old they are. Prices can still go up because of inflation or rising health costs.
2. Issue-age-rated. Your price is based on your age when you bought the plan. It does not go up just because you get older.
3. Attained-age-rated. Your price is based on your current age. It goes up as you age. These plans often look cheap at first, then get pricey later.

When you shop, always ask which method a company uses. It can make a big difference over 10 or 20 years.

Average Prices

Every study I looked at came up with slightly different averages, which makes sense since prices vary so much. But they all told the same story: Plan F costs more than Plan G.

For example, one 2026 study found that, at age 65, Plan F averaged about $271 a month while Plan G averaged about $220. That is a gap of $51 a month. By age 75, the gap grew to about $63 a month.

Your own numbers may be higher or lower. But that gap is the key to figuring out if Plan F is worth it.

The Simple Math: Plan F vs. Plan G

Here is the cool part. Plan F and Plan G cover almost the same things. The only coverage difference is that Plan F pays the Part B deductible and Plan G does not.

In 2026, the Part B deductible is $283. So with Plan G, you pay that $283 yourself once a year. After that, Plan G covers everything Plan F would.

That makes the math pretty easy. Just ask yourself this:

Is Plan F more than $283 a year more expensive than Plan G?

If it is, you are paying extra for coverage that is worth less than what you pay for it.

Let’s break that down by month. $283 divided by 12 months is about $23.58 a month.

• If Plan F costs less than $23.58 more per month than Plan G, Plan F could save you money.
• If Plan F costs more than $23.58 more per month than Plan G, Plan G is the better deal.

A Quick Example

Let’s say you are 70 years old. You get two quotes:

• Plan F: $250 a month
• Plan G: $205 a month

The difference is $45 a month. Over a year, that is $540.

With Plan G, you would also pay the $283 Part B deductible. So your total extra cost with Plan G is $283.

With Plan F, your extra cost is $540 in higher premiums.

Plan G saves you $257 that year. And that is in a year when you use enough care to hit the full deductible. If you are healthy and barely see a doctor, Plan G could save you even more.

In most quotes and studies I have seen, the gap between Plan F and Plan G is more than $23.58 a month. That is why many experts say Plan G is the better value for most people.

The “Closed Pool” Problem

Another reason Plan F prices tend to climb is the “closed pool” problem. I call it the “closed pool” problem.

Since no new people under the 2020 cutoff can join Plan F, the group of people on Plan F keeps getting older. Older people, on average, use more health care. When a group uses more care, the insurance company pays out more money. And when the company pays out more, it raises prices.

Think of it like a swimming pool that nobody new can jump into. Over time, the pool only has the people who were already there, and they are all getting older together.

This does not mean your Plan F price will shoot up for sure. But it is a real risk to keep in mind. Plan G, on the other hand, keeps getting new, younger members every year. That can help keep its prices steadier over time.

What About High-Deductible Plan F?

Some states also offer a high-deductible version of Plan F. It works like this:

• You pay a much lower monthly premium.
• But you have to pay the first $2,950 of your Medicare-covered costs yourself in 2026.
• After you hit that amount, the plan pays the same as regular Plan F for the rest of the year.

This can be a good fit if you are pretty healthy and want protection in case something big happens, like a surgery or a long hospital stay. It is a little like car insurance with a high deductible. You save money every month, but you need to be ready to pay more if something goes wrong.

Just like regular Plan F, the high-deductible version is only for people who were eligible for Medicare before 2020. If you are newer to Medicare, there is a high-deductible Plan G that works similarly.

Plan F Pros and Cons

Let me lay it all out side by side.

Pros of Plan F

1. Almost no surprise bills. You pay your premium, and that is mostly it for Medicare-approved care.
2. Easy to budget. You know what you will pay each month.
3. No deductible to track. You never have to think about whether you have met your Part B deductible.
4. Freedom to see any doctor who takes Medicare. No networks, no referrals needed.
5. Covers excess charges. If a doctor charges more than Medicare approves, Plan F covers you.
6. Great for people who use a lot of care. If you see doctors often, the peace of mind can feel worth it.

Cons of Plan F

1. It usually costs more than Plan G. Often by more than the $283 it saves you.
2. Prices may rise faster. The closed pool can push premiums up over time.
3. You can’t buy it if you’re new to Medicare. Anyone eligible on or after January 1, 2020, is shut out.
4. It doesn’t cover drugs, dental, vision, or hearing. You need to plan for those separately.
5. Switching away later can be tricky. I explain why below.

When Is Plan F Worth the Cost?

In my opinion, Plan F can still be worth it in a few situations:

• Your Plan F price is close to Plan G’s price. If the gap is less than about $23.58 a month, Plan F is a fair deal.
• You have health problems that would make switching hard. If an insurance company might turn you down for Plan G because of your health, keeping Plan F could be the safe choice.
• You really value simplicity. Some people hate dealing with deductibles. If paying a little extra gives you peace of mind, that has value too.
• Your current company has a good track record. If your Plan F company has kept its rate increases small, you may be in a good spot.

When Is Plan F Not Worth the Cost?

On the flip side, Plan F is probably not worth it if:

• The gap between Plan F and Plan G is big. If you’re paying $40, $50, or more extra each month, you are likely overpaying.
• Your premiums keep jumping every year. That may be the closed pool at work.
• You are healthy and can pass health questions. If you can qualify for Plan G, you may be able to save hundreds of dollars a year.
• You need help paying for drugs, dental, or vision. That extra Plan F money might be better spent on other coverage.

Should I Switch from Plan F to Plan G?

I hear this question a lot. The answer is: maybe, but be careful.

Here is the catch. When you first sign up for Medigap, you get a special window called your Medigap Open Enrollment Period. It lasts six months and starts when you are 65 or older and enrolled in Part B. During that window, companies have to sell you a plan no matter your health.

But after that window, things change. In most states, an insurance company can ask you health questions before it sells you a new Medigap plan. It can charge you more, or even say no, based on your answers. This is called medical underwriting.

A few states have extra rules that make switching easier. Some give you a yearly window to change plans without health questions. Your state’s health insurance assistance program can tell you what rules apply where you live.

If you want to switch, follow these steps:

1. Get Plan G quotes first. Compare them to what you pay for Plan F now.
2. Do the $23.58 math. Make sure the savings are real.
3. Apply for Plan G before you cancel Plan F. This is a big one.
4. Wait until you are approved. Only cancel Plan F after your new plan is in place.
5. Ask about the start date. Make sure there is no gap in coverage.

Please don’t drop Plan F first and hope for the best. If you get turned down for Plan G, you may not be able to get Plan F back.

Plan F vs. Medicare Advantage

Some people also compare Plan F to Medicare Advantage (also called Part C). These are very different things.

Medicare Advantage plans replace Original Medicare instead of adding to it. Here is a quick look at how they differ:

• Monthly cost: Medicare Advantage often has low or even $0 premiums. Plan F has a higher premium.
• Doctors: Medicare Advantage usually has a network. Plan F lets you see any doctor who takes Medicare.
• Out-of-pocket costs: With Medicare Advantage, you pay copays as you go, up to a yearly limit. With Plan F, you pay very little beyond your premium.
• Extras: Many Medicare Advantage plans include drug, dental, or vision benefits. Plan F does not.

You can’t have both at the same time. And keep in mind that if you leave Plan F for Medicare Advantage, you may not be able to get a Medigap plan back later without answering health questions.

Medicare’s Open Enrollment runs from October 15 to December 7 each year. That is when you can join, switch, or drop Medicare Advantage and Part D plans. It is a good time to review all your choices, but remember that Medigap plans follow their own rules.

Common Questions About Medicare Plan F

Q: Is Medicare Plan F going away?

A: Not for people who already have it. If you have Plan F, you can keep it as long as you pay your premium. It is only closed to people who became eligible for Medicare on or after January 1, 2020.

Q: Can I still buy Plan F in 2026?

A: Only if you were eligible for Medicare before January 1, 2020, and a company sells Plan F in your area. You may also have to answer health questions.

Q: Does Plan F cover prescription drugs?

A: No. You need a separate Medicare Part D plan for prescriptions.

Q: Does Plan F have a deductible?

A: Regular Plan F does not. The high-deductible version has a $2,950 deductible in 2026.

Q: What is the difference between Plan F and Plan G?

A: Plan F covers the Part B deductible ($283 in 2026). Plan G does not. Everything else is the same.

Q: Will my Plan F premium go up?

A: Most likely, yes, at some point. Premiums can rise because of inflation, rising health costs, your age, and the closed pool problem I mentioned earlier.

Q: Can a company cancel my Plan F because I get sick?

A: No. Medigap plans are “guaranteed renewable.” As long as you pay your premiums on time and told the truth on your application, the company cannot drop you because of your health.

Q: Will these numbers change in 2027?

A: Yes. Medicare updates its deductibles and premiums every year, usually in the fall. The $283 Part B deductible and $2,950 high-deductible amount are 2026 figures. When the new numbers come out, redo the math.

My Bottom Line: Is Medicare Plan F Worth the Cost?

Here is my honest answer. For most people, Plan F is no longer worth the extra cost.

Plan F is a great plan. It covers almost everything. But Plan G covers the same things, except for a $283 deductible, and it usually costs much less than $283 extra a year. On top of that, Plan F’s closed pool may push prices higher over time.

Still, Plan F can be the right choice for you if:

• Your Plan F price is close to Plan G’s
• Your health would make it hard to switch
• You truly value having zero deductibles

My best advice is simple. Get quotes. Do the math. Compare your Plan F price to Plan G quotes from a few companies. If the gap is more than about $23.58 a month, look seriously at Plan G. If you decide to switch, get approved for the new plan before you cancel the old one.

And if you feel stuck, reach out to your State Health Insurance Assistance Program (SHIP). They offer free, unbiased Medicare help. You can also call 1-800-MEDICARE.

Why choose Steve Turner Insurance Specialist?

Because I’m an “Insurance Specialist.” An “insurance specialist” is a broad term that includes insurance agents and insurance brokers, but the key difference is who the agent represents versus who the broker represents.

An “insurance agent” works directly for an insurance company and sells its specific policies to clients.

An “insurance broker” acts as an independent intermediary, comparing policies from multiple companies to find the best fit for their client’s needs, essentially representing the client rather than the insurance company.

I am both a licensed Insurance Agent and a licensed Insurance Broker.

My number one goal in life is to help people and ensure, without a shadow of a doubt, that you and your family are secure and protected. I will always be by your side, helping you mitigate risk by providing the industry’s best and most affordable insurance solutions.

I will find insurance plans for the entire family to help cover whatever life throws at you. I can help you save on severe medical emergencies, find a health insurance plan with low- or no-cost doctor visits and affordable prescription medications, and protect your family in the event of an unexpected accident or illness.

Best of all, it doesn’t cost you anything extra to use an experienced Insurance Agent and Broker like me to help you find the Insurance Plans that fit your individual, family, or business needs.

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