How AARP Plan F Covers Your Medicare Part B Excess Charges?

Medicare Part B is designed to cover outpatient services such as doctor visits, medical supplies, and preventive care. However, not all healthcare providers accept Medicare’s assigned rates for services. When a provider charges more than what Medicare covers, the difference is known as a Medicare Part B excess charge.

For example, if Medicare approves a service for $100 but the provider charges $115, Medicare will cover 80% of the approved $100 (i.e., $80), and the patient is responsible for the remaining $20, plus the additional $15 excess charge. This extra amount can add up over time, creating significant out-of-pocket costs for beneficiaries.

What Is AARP Plan F?

AARP Plan F is a Medicare Supplement (Medigap) policy offered by UnitedHealthcare through AARP. It is considered one of the most comprehensive Medigap plans, covering all deductibles, copayments, and coinsurance costs associated with Medicare Parts A and B. One of the most important benefits of AARP Plan F is that it fully covers Medicare Part B excess charges, preventing beneficiaries from paying out-of-pocket for these additional costs.

Benefits Of AARP Plan F

• Full Coverage for Medicare Part B Excess Charges: Unlike some other Medigap plans, AARP Plan F pays 100% of any excess charges that Medicare-approved providers may impose.
• Covers Medicare Part A and Part B Deductibles: This plan eliminates the need to pay annual deductibles, reducing the financial burden on beneficiaries.
• No Copays or Coinsurance: Plan F pays for Medicare-covered services in full, meaning no surprise expenses for doctor visits or hospital stays.
• Foreign Travel Emergency Coverage: Provides coverage for emergency medical care while traveling abroad.
• Predictable Healthcare Costs: With Plan F, beneficiaries can budget their healthcare expenses without worrying about unexpected charges.

How AARP Plan F Protects You From Excess Charges?

AARP Plan F works by covering the difference between the Medicare-approved amount and the provider’s actual charge. Since Medicare places a 15% cap on excess charges, Plan F ensures that the patient does not have to bear this cost.

Scenario Example

Imagine you visit a specialist who does not accept Medicare assignment. The total bill is $500, but Medicare only approves $450.

• Medicare covers 80% of the $450, which is $360.
• You would normally owe the remaining $90 (20% coinsurance) plus the excess charge of $50.
• With AARP Plan F, both the $90 coinsurance and the $50 excess charge are covered, leaving you with zero out-of-pocket expenses.

Comparing AARP Plan F To Other Medigap Plans

While AARP Plan F provides full coverage, other Medigap plans offer different levels of benefits:

• Plan G: Covers everything Plan F does except for the Medicare Part B deductible.
• Plan N: Covers most costs but requires copays for doctor visits and emergency room trips and does not cover Part B excess charges.
• Plan K and Plan L: Offer partial coverage and require the beneficiary to share more costs.

If avoiding Medicare Part B excess charges is a priority, Plan F remains the best option. However, it’s important to note that Plan F is no longer available to new Medicare enrollees as of January 1, 2020. Only those who were eligible for Medicare before this date can enroll in Plan F.

Why Choose AARP Plan F?

1. Trusted Brand

AARP, in partnership with UnitedHealthcare, has a strong reputation for providing reliable and comprehensive Medigap coverage.

2. Nationwide Acceptance

Plan F is accepted by any provider that accepts Medicare, ensuring flexibility in choosing healthcare services.

3. Peace of Mind

With full coverage of excess charges, deductibles, and copays, beneficiaries can receive care without financial concerns.

4. Easy Claims Process

UnitedHealthcare handles claims directly with Medicare, ensuring a seamless experience for policyholders.

Alternatives For New Medicare Beneficiaries

Since Plan F is closed to new enrollees, those newly eligible for Medicare must consider other options. Plan G is the closest alternative, covering everything except the Medicare Part B deductible ($240 in 2024). Although beneficiaries must pay this deductible, Plan G still protects them from excess charges.

Conclusion

AARP Plan F is an excellent choice for Medicare beneficiaries looking for comprehensive coverage and protection from unexpected medical costs, particularly Medicare Part B excess charges. It provides financial security by covering deductibles, copayments, and excess charges, ensuring predictable and manageable healthcare expenses. For those eligible for Plan F, it remains one of the most valuable Medigap plans available. For new enrollees, Plan G is a strong alternative that offers nearly identical coverage, with the exception of the Medicare Part B deductible. Understanding how AARP Plan F works helps beneficiaries make informed decisions about their healthcare coverage, ultimately leading to better financial and medical well-being.