Medigap Plan F Eligibility: Who Can Still Buy It?

If you are researching Medicare Supplement insurance, you have likely heard conflicting information about Medigap Plan F. Some people say it is the best coverage you can buy, while others claim it is illegal to purchase. The truth about Medigap Plan F eligibility comes down to a single date: January 1, 2020.

Because Plan F offers "first-dollar coverage"—meaning it pays for almost all of your Medicare-approved out-of-pocket costs—it was incredibly popular for decades. However, the federal government changed the rules to prevent new enrollees from buying it. If you already have Plan F, or if you were eligible for Medicare before the cutoff date, you are in a unique position.

In this guide, we will break down exactly who can still buy Plan F, what it covers in 2026, why its premiums are rising so quickly, and how to decide if keeping it is a smart financial move.

The Pre-2020 Medicare Rule That Restricted Plan F

To understand Medigap Plan F eligibility today, you have to understand the Medicare Access and CHIP Reauthorization Act (MACRA). Passed by Congress, this legislation fundamentally changed how Medicare Supplement plans are sold.

Before MACRA, Plan F was the default choice for millions of retirees because it covered the Medicare Part B deductible. You could go to the doctor, hand them your Medicare card and your Plan F card, and leave without paying a dime. The government realized that when patients have zero out-of-pocket costs, they tend to use more healthcare services—sometimes unnecessarily. This overutilization strained the Medicare system.

To solve this, Congress decided that all new Medicare beneficiaries needed to have some "skin in the game." They mandated that Medigap plans sold to new enrollees could no longer cover the Part B deductible. Because Plan F (and Plan C) covered this deductible, they were placed on the chopping block.

The law took effect on January 1, 2020. Anyone who became eligible for Medicare on or after that date is permanently barred from buying Medigap Plan F. Instead, the closest alternative available to them is Plan G, which offers identical coverage except that the patient must pay the Part B deductible themselves.

Who Is Still Eligible to Purchase Medigap Plan F Today?

The 2020 cutoff did not make Plan F illegal; it simply closed the door to new enrollees. If you were eligible for Medicare before January 1, 2020, you are grandfathered into the old rules. You are still legally allowed to purchase Medigap Plan F today, provided it is sold in your state.

Here are three common scenarios that explain how this works in practice:

Scenario 1: You Already Have Plan F

If you bought Plan F years ago and still have it, you can keep it. Your policy is guaranteed renewable. As long as you continue to pay your monthly premiums, the insurance company cannot cancel your coverage, even if your health declines.

Scenario 2: You Have a Different Medigap Plan

Let us say you turned 65 in 2018 and bought Medigap Plan N. Because you were eligible for Medicare before 2020, you meet the legal Medigap Plan F eligibility requirements. You can apply to switch from Plan N to Plan F today. However, because you are likely past your initial Medigap Open Enrollment Period, you will have to pass medical underwriting. The insurance company will ask about your health history and can deny your application or charge you a higher premium based on pre-existing conditions.

Scenario 3: You Are Switching from Medicare Advantage

If you turned 65 in 2017, enrolled in a Medicare Advantage plan, and now want to switch to Original Medicare, you are eligible to buy Plan F. Again, unless you qualify for a Special Enrollment Period or live in a state with specific guaranteed issue laws, you will have to pass medical underwriting to get the policy.

Medigap Plan F Coverage: What Exactly Does It Pay For?

For those who meet the Medigap Plan F eligibility rules, the coverage is incredibly comprehensive. It is designed to fill almost all the gaps left by Original Medicare (Part A and Part B). Here is a breakdown of what Plan F covers using the official figures for 2026:

• Medicare Part A Deductible: In 2026, the Part A deductible is $1,736 per benefit period for hospital stays. Plan F covers this entirely.
• Medicare Part B Deductible: In 2026, the Part B deductible is $283. Plan F pays this for you.
• Part A Coinsurance and Hospital Costs: Plan F covers your hospital coinsurance and provides up to an additional 365 days of hospital care after Medicare benefits are exhausted.
• Part B Coinsurance or Copayment: Medicare typically pays 80% of approved outpatient services, leaving you with 20%. Plan F covers that remaining 20%.
• Part B Excess Charges: If a doctor does not accept Medicare assignment and charges up to 15% more than the Medicare-approved amount, Plan F pays the difference.
• Skilled Nursing Facility Coinsurance: Plan F covers the daily coinsurance for days 21 through 100 in a skilled nursing facility.
• Blood: Plan F pays for the first three pints of blood needed for a medical procedure.
• Foreign Travel Emergency: Plan F covers 80% of billed charges for medically necessary emergency care outside the U.S. This benefit requires a separate $250 deductible and has a strict $50,000 lifetime maximum limit.

It is important to remember that while Plan F covers your medical deductibles, you must still pay your standard Medicare Part B premium to the government to keep your Medigap policy active. In 2026, the standard Part B premium is $202.90 per month.

Plan F vs Plan G: Is Full Deductible Coverage Worth the Price?

Because of the MACRA rules, Plan G has become the new gold standard for Medicare Supplement insurance. If you are eligible for Plan F, you are also eligible for Plan G. The question is: which one makes more financial sense?

The coverage between the two plans is identical, with one single exception: Plan G does not cover the Medicare Part B deductible. In 2026, that deductible is $283 for the entire year. Once you pay that $283 out of pocket, Plan G functions exactly like Plan F, covering 100% of your remaining Medicare-approved costs.

To decide if Plan F is worth it, you have to look at the premium difference. Insurance companies know they are paying that $283 deductible for you on Plan F, plus administrative costs, so they charge a significantly higher monthly premium.

Comparing the Math

Let us look at a realistic comparison for a 72-year-old beneficiary in 2026.

In this scenario, the beneficiary is paying $1,080 more in premiums over the year for Plan F just to avoid a $283 deductible. This is what industry experts call the "Premium Trap." You are essentially overpaying the insurance company to handle a small medical bill for you. For most people, understanding the Plan G Part B deductible makes it clear that Plan G is the better financial choice.

High-Deductible Plan F: A Lower-Cost Loophole?

If you meet the Medigap Plan F eligibility requirements but cannot stomach the high monthly premiums, there is another option: High-Deductible Plan F (HDF). This plan offers the exact same benefits as standard Plan F, but you must reach a substantial out-of-pocket deductible before the plan pays anything.

The deductible for HDF changes annually based on inflation. For 2026, the HDF deductible is $2,950. The government has already announced that the 2027 HDF deductible will rise to $3,050.

Because you are taking on more financial risk upfront, the premiums for HDF are dramatically lower. For example, an 85-year-old might pay between $250 and $500+ per month for standard Plan F, but only $70 to $155 per month for High-Deductible Plan F.

HDF is a great fit for beneficiaries who want catastrophic coverage and have the cash reserves to pay the $2,950 deductible if they face a major health crisis. However, you must still pay your Part B premiums, and you must track your medical expenses carefully to know when you have hit the deductible.

Why Plan F Premiums Tend to Increase Faster

If you currently hold a Plan F policy, you have likely noticed your monthly rates climbing steadily each year. In 2025, the average Medigap premium across all plans was $244 per month, but Plan F policies often exceed this average, especially for older beneficiaries.

Why is this happening? It comes down to how insurance risk pools operate.

When an insurance pool is open, new 65-year-olds join every month. These newly eligible beneficiaries are generally younger, healthier, and have fewer medical claims. Their lower costs help subsidize the older, sicker members of the pool, keeping premiums stable for everyone.

Because of the 2020 MACRA cutoff, the Plan F risk pool is permanently closed to new 65-year-olds. The youngest person who can buy Plan F today is aging every year. As the entire group gets older, they naturally require more medical care. More hospital stays, more surgeries, and more doctor visits lead to higher claims for the insurance company. To cover those claims, the insurer must raise premiums for everyone in the pool.

Typical Plan F Premium Ranges by Age in 2026

Because the pool is aging, the cost of keeping Plan F becomes a heavy burden late in life. Based on broker industry data, here is what beneficiaries can expect to pay for standard Plan F in 2026:

If you are in your late 70s or 80s, you could easily be paying over $4,000 a year just in premiums. This closed-pool dynamic is the primary reason so many people are looking for ways to drop Plan F in favor of more stable options.

State-Specific Rules for Switching to or from Plan F in 2026

Federal law dictates the baseline rules for Medigap Plan F eligibility, but individual states have the power to enact consumer protections that make it easier to switch plans. This is known as a "guaranteed issue" right, meaning the insurance company cannot ask you medical questions, deny your application, or charge you more due to pre-existing conditions.

If you want to leave your expensive Plan F for a cheaper Plan G, you normally have to pass medical underwriting. However, several states have recently expanded their rules to help seniors escape rising premiums.

• Rhode Island: Enacted an annual guaranteed issue protection in 2025, allowing beneficiaries to switch plans without medical underwriting during a specific window each year.
• Delaware: Also enacted annual guaranteed issue protections in 2025. However, it is important to note that while Delaware requires insurers to issue the policy, they still allow medical underwriting to determine the rate you will pay.
• Minnesota: Effective August 2026, Minnesota added an annual guaranteed issue window specifically for beneficiaries ages 65 to 70, making early switching much easier.

Other states, like California, Oregon, and Nevada, have longstanding "Birthday Rules" that allow you to switch to a plan of equal or lesser benefit (like moving from F to G) around the time of your birthday without underwriting. If you live in one of these states, you have a massive advantage. You can read more about state rules in our guide on switching Medigap plans during open enrollment.

Common Mistakes When Evaluating Your Plan F Eligibility

Healthcare decisions are stressful, and the confusion surrounding Plan F leads to several costly mistakes. If you are evaluating your coverage, be careful to avoid these pitfalls:

Mistake 1: Believing You Must Drop Plan F

Many seniors receive aggressive marketing mailers implying that Plan F is illegal or being cancelled. This is entirely false. If you have Plan F, you are grandfathered in. You never have to drop it if you do not want to. The decision to switch should be based entirely on the math, not on fear tactics.

Mistake 2: Ignoring the Part B Late Enrollment Penalty

Some people delay enrolling in Medicare Part B because they are still working. If you delay Part B without having creditable employer coverage, you face a permanent late enrollment penalty. The penalty is 10% of the standard Part B premium for every full 12-month period you delayed. In 2026, the standard premium is $202.90, meaning a one-year delay adds about $20 a month to your costs for the rest of your life. This penalty applies regardless of whether you buy Plan F or Plan G.

Mistake 3: Cancelling Plan F Before Getting Approved for a New Plan

If you decide to switch from Plan F to a cheaper plan, never cancel your Plan F policy until you have the new policy document in your hands. If you cancel your Plan F and then fail the medical underwriting for the new plan, you will be left with no Medigap coverage at all, exposing you to unlimited 20% coinsurance under Original Medicare.

Checklist: What to Do Before Dropping Plan F

If the rising premiums have convinced you it is time to move on, run through this quick checklist before making any decisions:

• Calculate your true cost: Add up your annual Plan F premiums. Then, add up the annual premiums for Plan G in your area, plus the $283 Part B deductible. Compare the two numbers.
• Check your state laws: Call your State Health Insurance Assistance Program (SHIP) to ask if your state has a Birthday Rule or guaranteed issue window.
• Assess your health: If you do not have a guaranteed issue right, you must pass underwriting. Have you been hospitalized recently? Do you have chronic conditions like COPD, severe diabetes, or cancer? If so, you may not be able to switch.
• Consider Plan N: If Plan G is still too expensive, look into Plan N. It offers lower premiums but requires small copays (up to $20 for doctor visits and $50 for the ER). You can compare the details in our Plan G vs Plan N cost guide.

How to Safely Replace Plan F with Plan G or Plan N

If you meet the Medigap Plan F eligibility rules but want to transition to a more cost-effective plan, you must do it safely to avoid gaps in coverage. Here is the step-by-step process:

Step 1: Shop the Market. Prices for Plan G and Plan N vary wildly between insurance companies, even though the benefits are identical by law. You need to see quotes from multiple A-rated carriers in your zip code.

Step 2: Apply for the New Plan. Submit your application for Plan G or Plan N. You will be asked to choose an effective date. Set the effective date for the first of the upcoming month.

Step 3: Go Through Underwriting. Unless you have a guaranteed issue right, the insurance company will review your medical history. They may pull your prescription drug records or call you for a phone interview. Be completely honest on your application; lying is considered insurance fraud and will result in cancellation.

Step 4: Wait for Approval. Do absolutely nothing with your Plan F policy while you wait. The underwriting process can take anywhere from a few days to a few weeks.

Step 5: Cancel Plan F. Once you receive your new insurance card and the official approval letter for your new plan, you can contact your old insurance company to cancel your Plan F policy. Make sure the cancellation date aligns with the start date of your new plan so you do not pay double premiums.

How to Compare Medicare Supplement Rates Without the Hassle

Navigating Medigap Plan F eligibility and deciding whether to keep or drop your coverage is a major financial decision. The math usually points toward switching to Plan G or Plan N, but you cannot make an informed choice without seeing real numbers for your specific age and zip code.

Unfortunately, most websites force you to hand over your phone number just to see a price, leading to endless calls from high-pressure sales agents. At Rebel Rates, we do things differently. We believe you should be able to see the numbers clearly, privately, and without the BS.

If you are ready to see how much you could save by switching out of your expensive Plan F, you can compare Medicare quotes right now on our site. You will get direct, accurate pricing from top carriers so you can make the best decision for your healthcare and your wallet. If you want to explore other types of coverage, head over to the Rebel Rates home page to see all our independent comparison tools.