I'm enrolled in a Medigap Plan F, and I'm not sure how my emergency room visits are handled. Is there a copay I should expect?

Question

Pamela Camey · Accepted Answer

If you have a Medigap plan F there would be no copayment for emergency room visit, but if you are travelling internationally that is a different story. Plans provide 80% to a lifetime maximum of $50,000 in coverage after the first $250 deductible each calendar year

Answered by Pamela Camey on March 28, 2025

Broker Licensed in IL, FL, IA & 7 other states

Answered by Pamela Camey Medicare Insurance Agent

Larry Dalton · Answer

With your Medigap Plan F, there should not be any cost for an emergency room visit unless you are traveling outside of the U.S. Plan F will then cover 80% of most of your medical expenses for international travel, provided they accept Medicare. If not, you may need to file it with your insurance when you return to the States to recover your cost. There is a lifetime maximum on international travel expenses.

Answered by Larry Dalton on April 7, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Lt Col Tim Brown · Answer

Plan F pays it all.  There is no deductible.  Just present your medicare card and your Plan F card and your good to go.

Clarence &quot;Mark&quot; Christiansen · Answer

That's a "Cadillac" Plan F and you will not have any medical bills for Medicare-approved services including E.R. visits from USA providers who accept Medicare. (I cannot think of an Emergency Room that does not accept Medicare.) Medicare will be primary and your Medigap plan will pay after Medicare leaving you with zero out of pocket costs.

Answered by Clarence "Mark" Christiansen on April 27, 2025

Agent Licensed in WI, AZ, CA & 16 other states

Answered by Clarence "Mark" Christiansen Medicare Insurance Agent

Robert Vaughan, R.Ph., MBA · Answer

Medigap Plan F covers all costs associated with an emergency room visit. Plan F will cover all medical costs as long as they are covered by Medicare and considered to be medically necessary.

Amy Twary · Answer

Plan F will cover your ER expenses as long as you go to an ER that accepts Medicare. Your Plan F will cover you 100% for all Medicare services.

Kent Pike · Answer

No, plan F covers everything that is Medicare Approved.  If you are on Plan F, you are on a Grandfathered plan that has first dollar coverage.

Carolee Turner · Answer

Medicare Plan F, If it is NOT a HIGH DEDUCTABLE F Plan, will have no copay or Co-insurance billing. To make sure you have the full coverage Medicare Suppliment Plan F, simply call the number on the back of your card. Full Medicare Suppliment Plan F is the most care you can possibly have at this time. You should not recieve any bill for your medical care as long as the facility also accepts MEDICARE for their payment.

Answered by Carolee Turner on May 5, 2025

Agent Licensed in FL, IL, MI, OH, SC & TN

Answered by Carolee Turner Medicare Insurance Agent

Robert Krauthamer · Answer

If you are enrolled in a Plan F you should not expect to have a copay. 

Feel free to call me if you have additional questions about your Plan F or other Medicare related questions.

-Robert Krauthamer
(206) 274-4030

David Brown · Answer

No, you should not expect to have a copay.  Basically, Medicare is primary and your plan F is secondary.  The plan F will pick up the costs left over from Medicare so you won't have anything further to pay.  

Emergency Room services are covered under Medicare Part B.  With Medicare Part B there is a yearly deductible of $257 (paid by your plan F carrier).  After the deductible, Medicare pays 80% of the costs.  The remaining 20% is paid by your plan F carrier.

Steven Bleicher · Answer

Nope. Based on your DOB, the F plan only has a monthly premium with no deductibles. A visit to the ER is totally covered and therefore, don't fall for the claim that you owe something for that visit! Just because it is not available for t
newbies to Medicare does not mean that those perks are no longer pertinent!

Diana Salisbury · Answer

There is no medical copay for anything with plan F.  This includes, doctor's visits, hospital stays, emergency room visits, etc.  It is a fabulous plan!

Aaron Solomon · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/im-enrolled-in-a-medigap-plan-f-and-im-not-sure-how-my-emergency-room-visits-are-handled-is-there-a-copay-i-should-expect#aaron-solomon

Joseph Peck · Answer

With the F plan, there is no copay. The F is the last plan that  was able to cover the part b deductible. It was ended in Jan of 2020 for new enrollees.

Michael Crocker · Answer

There are no co-pays on Plan F for Medicare-covered services, which of course include emergency room visits. Plan F covers the entirety of the 20% that Medicare doesn't cover. If a medical procedure is covered at 80% by Medicare, your supplement will cover the 20%.

Answered by Michael Crocker on June 3, 2025

Broker Licensed in SC

Answered by Michael Crocker Medicare Insurance Agent

Joanna Gebhart · Answer

With a Medigap plan F policy your emergency room visits are first covered 80% by Original Medicare with the Medigap policy covering the remaining 20%.  There should be no copay for this visit.

Fred Manas · Answer

With a Medigap Plan F, you generally won't have any out-of-pocket costs for emergency room visits. Medigap Plan F is designed to cover all the copays, deductibles, and coinsurance associated with Medicare Part A and Part B, which includes ER visits. However, there might be a small copay in some instances, according to Medigap Seminars. 
Elaboration:
Plan F Coverage: Plan F is known for its comprehensive coverage, aiming to reduce out-of-pocket expenses. It covers the Medicare Part A and Part B deductibles, as well as copayments and coinsurance. 
ER Visits: While most ER services are covered, there might be a small copay, typically around $50, if you are not admitted as an inpatient. This copay is separate from the coinsurance and deductible that Plan F covers. 
Admittance as Inpatient:  If the ER visit leads to an immediate hospital admission within three days for the same or related condition, the visit is considered part of the inpatient stay, and ER copays would not apply. 
Foreign Travel Emergency:  Medigap plans, including Plan F, generally cover emergency care outside the United States, but with a lifetime limit. 
Other Medigap Plans:  Other Medigap plans might have different copay structures or require you to pay a deductible before coverage kicks in. 
In summary: With Plan F, you should generally have minimal or no out-of-pocket costs for ER visits, even though there may be a small copay in certain situations. It's always best to verify your specific plan details and contact your insurance provider for any uncertainties, says Healthline.

Marcie Barnes · Answer

Plan F picks up the difference that Medicare doesn't pay.

There are no copays with plan F all you pay is your part B and D premiums and your Plan F premium

Andrew Kramer · Answer

Simple answer... Plan F has no co-pays for any Medicare allowable service of any kind. An ER visit is Medicare allowable, assuming that the accident or illness could not have been handled by an urgent care.

Answered by Andrew Kramer on May 9, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Areasha Lockhart · Answer

On a Medicare plan F you will not have any co-pay for ER visits. When you visit the ER, you present your Medicare card (Red, White & Blue card), your plan F card to admissions upon arrival. Medicare will be billed first and pay their part, then your plan F will pay their part. If you do happen to receive a bill from that visit, it is usually because the facility does not have your current card on file. It is a simple fix, just call the facility and give them your Member ID to have them re-bill.

Answered by Areasha Lockhart on May 27, 2025

Broker Licensed in CO, IA & ME

Answered by Areasha Lockhart Medicare Insurance Agent

Lawanda Radford · Answer

Great question! With Medigap Plan F, most out-of-pocket costs are covered—including emergency room visits—so you typically won’t have a copay. It’s one of the most comprehensive Medigap plans available.

Answered by Lawanda Radford on May 8, 2025

Agent Licensed in GA, AZ, FL & 10 other states

Answered by Lawanda Radford Medicare Insurance Agent

Penny Wegner · Answer

Here is a quick breakdown of your Medigap Plan  F for emergency for visits. *Your plan generally covers 100%  of out-of-pocket costs for Medicare-approved services. 
*You will not have any copayments or coinsurance.
*No Excess charges. Meaning the plan covers anything over and beyond what Medicare approves.

Kimberly Griego · Answer

You should not have any costs billed to you for an emergency room visit. Medicare will pay it's share at 80%, and your Plan F will pick up the remaining 20%.

Raquel Weir · Answer

Medicare Supplement Plan F (Medigap Plan F) generally does not have copays for covered services. It's designed to cover the cost-sharing requirements of Original Medicare (Part A and Part B). This means it covers deductibles, coinsurance, and copayments, potentially leaving you minimal out-of-pocket expenses.

Answered by Raquel Weir on April 22, 2025

Broker Licensed in TX & LA

Answered by Raquel Weir Medicare Insurance Agent

Keith Brown · Answer

There are no out of pocket for emergency room visits. Plan covers Medicare approved expenses at 100%,

Roxanne Robertson · Answer

Medigap Plan F is 100% comprehensive within ty he United States. You should expect to have no copays for an emergency room visit.

I'm enrolled in a Medigap Plan F, and I'm not sure how my emergency room visits are handled. Is there a copay I should expect?

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I'm enrolled in a Medigap Plan F, and I'm not sure how my emergency room visits are handled. Is there a copay I should expect?

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