Which plan would be most appropriate for an individual on Medicare and is concerned that Medicare will NOT pay for charges exceeding the approved amount?

• A. Medicare Advantage Plan
• B. Employer-Sponsored Plan
• C. Prescription Drug Plan
• D. Medicare Supplement Plan F

Answer: (D)

Medigap plans are designed to fill the gaps in Original Medicare, especially the out-of-pocket costs that Medicare doesn’t fully cover. The most protective option for someone worried about charges that exceed Medicare’s approved amount is the plan that specifically covers those excess charges as part of the broad coverage.

Plan F is the most comprehensive Medigap option. It pays the Part B deductible, as well as the coinsurance and copayments for Part A and Part B, and it also covers Medicare Part B excess charges. That means if a provider bills more than Medicare approves, Plan F would cover the difference, preventing you from paying above the approved amount for covered services. This makes it the best fit for someone who wants protection against charges that go beyond what Medicare allows.

Other types of coverage don’t address excess charges as completely. A Medicare Advantage plan works through a network and can still involve cost-sharing; a Prescription Drug Plan covers medications only; and an Employer-Sponsored Plan may coordinate with Medicare but doesn’t specifically guarantee against excess charges like a Medigap plan does.