Who qualifies for plan F in Medicare?

Editorial team Published on

You are eligible for Medicare Supplement Plan F only if you were first eligible for Medicare before January 1, 2020.

Core Eligibility Rules

  • The 2020 Cutoff: Under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), new Medigap policies covering the Part B deductible cannot be sold to anyone newly eligible for Medicare on or after January 1, 2020.
  • Grandfathered Status: If you turned 65 or qualified for Medicare due to disability or end-stage renal disease (ESRD) prior to January 1, 2020, you keep the right to buy or keep Plan F.
  • General Medigap Rules: You must already be enrolled in Original Medicare Part A and Part B to add Plan F.

Key Details to Know

  • Existing Enrollees: If you already had Plan F before January 1, 2020, you can keep your coverage indefinitely as long as you pay your monthly premiums.
  • Alternative Options: If you became eligible for Medicare on or after January 1, 2020, you cannot enroll in Plan F. The closest alternative is Plan G, which offers identical comprehensive coverage except it does not cover the Part B deductible.

What are the disadvantages of plan F?

The main disadvantages of Medicare Supplement Plan F are its closure to new enrollees, higher and faster-rising monthly premiums, and lack of extra out-of-pocket benefits.

Key Disadvantages

  • Closed to New Enrollees: You cannot buy Plan F unless you were eligible for Medicare before January 1, 2020.
  • Shrinking and Aging Pool: Because no new (typically younger and healthier) members can join, the existing pool of enrollees is aging. This often leads to faster-accelerating annual rate increases compared to open plans.
  • Higher Monthly Premiums: It offers "first-dollar" coverage—meaning it covers everything, including the Part B deductible—which makes its upfront monthly cost higher than alternatives like Plan G or Plan N.
  • No Extra Benefits: Like other Medigap plans, it does not cover prescription drugs, dental, vision, or hearing care.
  • Risk of Overpaying: Because it covers the Part B deductible ($283 in 2026), you may pay a much higher annual price difference in premiums than the actual cost of that deductible.

How much will Medicare Plan F cost per month in 2026?

In 2026, the standard monthly premium for a comprehensive Medicare Supplement Plan F (Medigap) generally ranges between $150 and $300 per month for individuals in their mid-to-late 60s. For older beneficiaries (ages 75 and above), rates can scale higher, often sitting between $250 and $500+ per month.

The national average baseline cost for standard Plan F policies sits around $185 to $228 per month. Alternatively, if you opt for High-Deductible Plan F, the average monthly premium drops dramatically to around $82 per month, though you must pay a $2,950 deductible in 2026 before the plan covers your out-of-pocket expenses.

Key Details Influencing Your Cost

  • The "Eligibility" Rule: Because of federal law changes, standard Plan F is only available if you became eligible for Medicare before January 1, 2020. If you qualified after that date, you are not permitted to buy standard Plan F.
  • Rate Factors: Exact monthly premiums are set by private insurance companies. Your final rate depends heavily on your age, gender, tobacco use, zip code, and the carrier you choose.
  • The Plan G Alternative: If you are shopping around, Plan G averages $142 to $180 per month in 2026. Because the only difference between the two is that Plan F covers the $283 Part B annual deductible, many beneficiaries find that Plan F's higher premiums cost more annually than simply paying the Part B deductible themselves.

Which is better, Medicare F or G?

Medicare Plan G is generally the better and more practical choice for most people today, because Plan F is closed to new enrollees who became eligible for Medicare on or after January 1, 2020.

Both Medigap Plan F and Plan G offer nearly identical, highly comprehensive coverage for Original Medicare out-of-pocket costs. However, they differ in two main ways:

Key Differences

  • Part B Deductible: Plan F covers the annual Medicare Part B deductible ($283 in 2026). Plan G does not cover this deductible, meaning you pay it out of pocket before coverage starts.
  • Eligibility: Plan F is only available if you were eligible for Medicare before January 1, 2020. Plan G is open to all Medicare beneficiaries.

Cost and Value

  • Premiums: Plan F usually costs more per month because it provides "first-dollar" coverage that includes the Part B deductible.
  • Overall Savings: Plan G usually has lower monthly premiums. Even after paying the $283 Part B deductible out of pocket, Plan G is frequently the better financial value. Furthermore, because Plan F's risk pool is aging and closed to newcomers, its premiums may rise faster over time.

You can check your official options and compare benefits directly through the Medicare Plan Comparison Tool.

Why is plan F being discontinued?

Medicare Supplement Plan F is being phased out for new enrollees because the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) prohibits new Medigap policies from covering the Medicare Part B deductible.

Why Lawmakers Made the Change

  • Eliminating "First-Dollar" Coverage: Plan F covered all out-of-pocket costs, including the Part B deductible, meaning beneficiaries faced no cost-sharing at the doctor's office.
  • Reducing Overuse: Lawmakers worried that zero out-of-pocket costs encouraged people to seek medical care for minor or unnecessary issues, driving up total healthcare expenditures.
  • Encouraging Cost Awareness: By requiring plans sold to new enrollees to exclude the Part B deductible, the government aims to make patients more mindful of medical utilization.

Who is Affected?

  • New Enrollees: Anyone who became eligible for Medicare on or after January 1, 2020, cannot enroll in Plan F.
  • Grandfathered Beneficiaries: If you were eligible for Medicare before January 1, 2020, you can keep Plan F or enroll in it if it is offered by your insurer.
  • Rising Premiums: Because new members cannot join Plan F, the remaining pool is aging, which often leads to faster premium increases compared to alternatives like Plan G.

Is Medicare Plan F Going Away? (The 2026 Truth)

9 related questions found

Is it a good idea to keep Medicare Plan F?

Keeping Medicare Plan F is generally only a good idea if your rate remains competitive, because closed enrollment pools cause premiums to rise faster than open alternatives like Plan G.

📊 Financial Comparison

  • Part B deductible: $283 annually (2026)
  • Monthly threshold: Roughly $24 difference
  • Plan G savings: Switch if gap exceeds $24 monthly

📈 Premium Dynamics

  • Closed pool: No new enrollees since 2020
  • Aging demographic: Higher average medical claims over time
  • Accelerated hikes: Rates outpace open plans

✅ When To Keep It

  • Convenience: Zero tracking of outpatient deductibles
  • Underwriting risk: Failed health screening prevents switching
  • Tight spread: Premium gap remains under $24 monthly

⚠️ When To Switch

  • High premiums: Paying significantly more than Plan G
  • Good health: Easily pass medical underwriting
  • Better value: Plan G provides identical coverage minus deductible

What is the big mistake people make with Medicare?

The single biggest and most costly mistake people make with Medicare is missing enrollment deadlines, leading to permanent late-enrollment penalties and gaps in coverage.

Missing Enrollment Deadlines

  • Initial Enrollment Period (IEP): This window lasts for seven months. It starts three months before the month you turn 65, includes your birthday month, and ends three months after.
  • Late Penalties: Failing to sign up for Part B or Part D on time can trigger permanent monthly or yearly financial penalties added to your premiums.
  • Delayed Enrollment Confusion: Many people wrongly assume they can delay Medicare past age 65 just because they have health coverage like COBRA, a marketplace plan, or small-employer insurance.

Other Costly Medicare Mistakes

  • Ignoring Annual Changes: Sticking with automatic renewal without reading the Annual Notice of Change (ANOC) can result in unexpected costs, as drug lists and doctor networks shift every year.
  • Choosing Solely by Low Premiums: Picking a plan based only on a low monthly cost while ignoring total out-of-pocket expenses like deductibles, copays, and coinsurance.
  • Missing the Medigap Window: Forgetting to apply for a Medigap (Medicare Supplement) policy during your open enrollment window. After this six-month period, insurers can use medical underwriting to charge more or deny coverage.
  • Skipping Financial Assistance: Overlooking programs like Medicare Savings Programs or Part D Extra Help that assist with out-of-pocket medical and prescription expenses.

Is Medicare Part F worth it?

Medicare Supplement Plan F is generally not worth the higher cost for most people today, though it offers complete coverage with zero out-of-pocket medical bills.

Coverage and Costs

  • What it covers: Plan F covers 100% of out-of-pocket costs for Medicare-approved services, including all coinsurance, copays, and the Medicare Part B deductible ($283 in 2026).
  • Who can get it: It is closed to new enrollees. You can only buy or keep Plan F if you were eligible for Medicare before January 1, 2020.
  • The cost problem: Because no new (and generally younger) members can join, the pool of enrollees is aging. This causes monthly premiums to rise faster than other plans.

How It Compares to Alternatives

  • Medigap Plan G: Plan G offers identical coverage to Plan F, except you pay the annual Part B deductible ($283 in 2026) yourself. However, Plan G's monthly premiums are almost always low enough that you save money overall compared to Plan F. You can learn more details on the NerdWallet Plan F Guide.
  • Medigap Plan N: Plan N offers even lower monthly premiums in exchange for small copays at the doctor or emergency room, making it a strong value for healthier beneficiaries.

Is It Right For You?

  • When it might be worth it: If you have high medical needs, visit doctors constantly, and value the complete peace of mind of never seeing a medical bill, keeping Plan F can make sense.
  • When to switch: If your monthly premium difference between Plan F and Plan G is greater than the annual Part B deductible, switching to Plan G will save you money. (Note: Changing plans outside your initial enrollment may require passing medical underwriting depending on where you live.)

How much does AARP Medicare Supplement plan F cost?

The average cost of an AARP Medicare Supplement Plan F (insured by UnitedHealthcare) typically ranges between $150 and $400 per month.

Because Plan F is a legacy plan with comprehensive coverage, exact monthly premiums depend on individual factors such as your age, gender, location, and tobacco use.

Cost Breakdown by Individual Scenarios

Depending on where you live and your specific demographics, initial base premiums for Plan F can vary significantly:

  • Starting Premiums: Depending on the specific state and zip code, starting rates for a 65-year-old female non-tobacco user can range from roughly $173 to $255 per month.
  • Age-Based Brackets: Average group premiums generally sit around $211 per month for individuals aged 70–71 and scale up to $250+ per month for individuals aged 75 and older.
  • High-Deductible Option: Some states offer a high-deductible Plan F. This option features drastically lower monthly premiums (often $50 to $70 per month), but requires you to pay a $2,950 deductible before the policy pays anything.

Key Eligibility Rule

You are only allowed to enroll in or buy an AARP Plan F if you were first eligible for Medicare before January 1, 2020. If you became eligible for Medicare after this date, federal regulations block you from purchasing Plan F. You must also maintain an active AARP Membership to qualify for their UnitedHealthcare-insured plans.

Standard Out-of-Pocket Costs Covered

Plan F is highly popular because it minimizes unpredictability by covering 100% of Original Medicare gaps. With this plan, your out-of-pocket expenses for Medicare-approved medical services are $0 for:

  • Medicare Part A Deductible ($1,736)
  • Medicare Part B Deductible ($283)
  • Part B Excess Charges
  • Coinsurance, copayments, and hospital costs

Looking for a Lower Premium?

If you are ineligible for Plan F or find the premiums too high, Medigap Plan G is the closest alternative. Plan G covers everything Plan F does except for the Part B annual deductible ($283). Plan G premiums are generally lower, often saving you more money annually than the cost of the deductible itself. You can compare available choices and check regional pricing directly via the AARP Medigap Cost Estimator or the official Medicare Policy Finder Tool.

Should I change from plan F to plan G?

Yes, you should usually switch from Medigap Plan F to Plan G if your annual premium savings for Plan G are larger than the Medicare Part B deductible ($283 in 2026).

Key Differences Between Plan F and Plan G

  • Coverage: Plan F covers the annual Medicare Part B deductible, while Plan G does not. Once you pay that deductible out of pocket, both plans offer identical coverage for all other Medicare-approved costs.
  • Availability: Plan F is closed to new beneficiaries who became eligible for Medicare on or after January 1, 2020. Plan G is open to all members.
  • Price Trends: Because Plan F has a "closed pool" of older members with no new younger enrollees joining, its rates tend to rise faster and become more expensive over time. Plan G tends to have more stable, moderate rate increases.

When Switching Makes Sense

  • Lower Premiums: If Plan G costs at least $24 less per month ($283 divided by 12 months) than Plan F, switching will save you money overall. Many beneficiaries save $50 to $100 per month by making the switch.
  • Long-Term Value: Even if the immediate savings are small, future rate hikes on Plan F make Plan G a safer financial choice in the long run.

Important Considerations Before Switching

  • Medical Underwriting: In most states, switching from Plan F to Plan G requires answering health history questions to pass underwriting. If you have underlying health conditions, you could be denied or charged a higher rate.
  • State Exceptions: Some states allow you to switch without health questions during specific windows, such as an annual birthday rule (like in California or Oregon) or specific trial rights.