Medicare Plan F Is Gone for Most — Here's What to Do Instead

For decades, Medicare Supplement Plan F was considered the Cadillac of Medigap policies. It covered virtually every gap in Original Medicare — the Part A deductible, the Part B deductible, coinsurance, copayments, excess charges, even foreign travel emergencies. You could see any Medicare-accepting doctor in the country, go to any hospital, and walk out without a bill. For millions of seniors, that kind of financial certainty was worth every penny of the premium. But as of January 1, 2020, Plan F was effectively closed to new enrollees under a federal law called the Medicare Access and CHIP Reauthorization Act, or MACRA. If you became eligible for Medicare on or after that date — meaning your 65th birthday fell on January 1, 2020 or later — Plan F is simply not an option for you, no matter which insurance company you call.

The reason Congress eliminated Plan F for new enrollees comes down to a policy debate about first-dollar coverage. Plan F paid the Part B deductible, which meant beneficiaries had no financial skin in the game when deciding whether to see a doctor. Policymakers argued this encouraged overutilization of medical services, driving up costs across the Medicare program. Whether you agree with that logic or not, the law is settled: Plan F and its close cousin Plan C (which also covered the Part B deductible) are now closed to anyone who didn't have Medicare eligibility before 2020. If you were already enrolled in Plan F before that cutoff, you can keep it — and insurers are still required to offer it to that grandfathered population. But for the roughly 4 million people who age into Medicare each year now, Plan F is history.

So what's the best alternative? For most beneficiaries who want comprehensive coverage, Plan G has become the new standard-bearer. Plan G covers everything Plan F did with one exception: the Medicare Part B deductible, which is $257 in 2025. You pay that $257 once per year — the first time you use an outpatient service — and after that, Plan G picks up 100% of your Medicare-approved costs for the rest of the year. No copays, no coinsurance, no surprise bills from participating providers. In practical terms, the difference between Plan F and Plan G comes down to that single annual deductible. If your Plan G premium is even $22 per month less than a comparable Plan F premium, you're breaking even — and in most markets, Plan G premiums run meaningfully lower than Plan F because the Plan F risk pool skews older and sicker as no new younger enrollees join it. That dynamic is expected to push Plan F premiums higher over time, which is one more reason Plan G looks attractive for new enrollees.

Plan G premiums vary significantly by age, location, tobacco use, and the pricing method the insurer uses. In 2025, a 65-year-old non-smoker might pay anywhere from $100 to $200 per month for Plan G depending on their state and the insurer. Community-rated states like New York and Connecticut tend to have higher base premiums but don't charge more as you age. Attained-age pricing — used in most states — means your premium rises each year as you get older, so a policy that costs $120 at 65 might cost $180 or more by 75. Issue-age pricing locks your rate based on the age you first enrolled, which can save money over the long run. Understanding which pricing method an insurer uses is one of the most important — and most overlooked — questions to ask before you buy a Medigap policy.

For beneficiaries who are in good health and want to keep monthly costs low, High-Deductible Plan G deserves serious consideration. This plan has the same coverage structure as standard Plan G, but you pay all Medicare-covered costs out of pocket until you hit the annual deductible — set at $2,870 in 2025 — before the plan kicks in. In exchange, monthly premiums are dramatically lower, often in the $40 to $80 range for a 65-year-old. If you're relatively healthy and your typical annual out-of-pocket spending under Original Medicare is well below $2,870, you could come out ahead financially compared to paying $150 per month for standard Plan G. The math shifts if you have a major health event, of course, but the $2,870 cap still provides a ceiling on your worst-case exposure. High-Deductible Plan G is not available in every state, and not every insurer offers it, so you'll need to shop specifically for it using Medicare's Plan Finder tool at medicare.gov or by working with a licensed insurance broker.

Plan N is another option worth understanding, particularly for beneficiaries who want lower premiums than standard Plan G but more predictability than the high-deductible version. Plan N covers the Part A deductible and coinsurance, and covers Part B coinsurance — but it does not cover Part B excess charges, and it requires copayments of up to $20 for office visits and up to $50 for emergency room visits that don't result in inpatient admission. If you live in a state where doctors are allowed to charge above Medicare's approved amount (known as excess charges), Plan N could leave you with unexpected bills. However, in states that prohibit excess charges — including Ohio, Massachusetts, Minnesota, Connecticut, Pennsylvania, and several others — Plan N can be a cost-effective middle ground. Premiums for Plan N typically run $20 to $50 per month less than Plan G, which adds up to real savings over a year.

One critical timing issue that every new Medicare beneficiary needs to understand: your Medigap Open Enrollment Period is a one-time, six-month window that begins the month you turn 65 and are enrolled in Medicare Part B. During this window, insurers must sell you any Medigap plan they offer at standard rates, regardless of your health history. Pre-existing conditions cannot be used to deny you coverage or charge you more. Once that window closes, you lose guaranteed issue rights in most states, meaning insurers can medically underwrite you — and if you have diabetes, heart disease, COPD, or other chronic conditions, you may be denied coverage or charged significantly higher premiums. Missing your Open Enrollment Period is one of the most expensive mistakes a Medicare beneficiary can make. If you're approaching 65, mark your calendar and start comparing plans at least 60 days before your Part B effective date.

A handful of states offer additional protections worth knowing about. If you live in California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, or Oregon, you have what's called a birthday rule — a 30-day window each year around your birthday during which you can switch to a Medigap plan with equal or lesser benefits without medical underwriting. This gives you an annual opportunity to shop for a lower premium without risking denial. New York and Connecticut go further, requiring guaranteed issue rights year-round regardless of health status, which is why premiums in those states tend to be higher but coverage is always accessible. If you're in one of these states and you've been stuck in a high-premium plan, your birthday window may be your ticket to savings.

If you're already enrolled in Plan F and wondering whether to stay, the answer depends on your premium trajectory. Call your insurer and ask directly: how much has your Plan F premium increased over the past three years, and what increases are projected? Compare that to what you'd pay for Plan G with a different insurer. Because Medigap plans are standardized by federal law, the benefits of Plan G are identical regardless of which company sells it — so price and financial stability of the insurer are the main differentiators. Switching from Plan F to Plan G outside of a guaranteed issue window typically requires medical underwriting, so if you have significant health conditions, staying in Plan F may be the safer choice even if premiums are rising. But if you're in good health and your Plan F premium has climbed well above comparable Plan G rates, the math may favor a switch. A licensed independent broker — one who represents multiple insurers rather than a single company — can run those numbers for you at no cost.