What is Medicare Supplement (Medigap) Plan C?
Medicare Supplement Plan C, also called Medigap Plan C, is one of the most comprehensive of the 10 standardized supplemental Medicare plans available in most states. In fact, only Medicare Plan FMedicare Supplement Plan F is the most comprehensive Medicare supplement plan available. This plan covers all Original Medicare deductibles, coinsurance, and copayments, leaving you with no out-of-pocket costs on all Medicare-approved services.... offers more coverage. For its beneficiaries, this top-tier plan covers most Medicare-approved out-of-pocket costsOut-of-pocket costs (aka, out-of-pocket medical expenses) are costs that a beneficiary must pay because their health insurance does not cover them. Out-of-pocket costs are found in the deductibles, copayments, and coinsurance outlined in each health....
NOTE: Medicare Plan C, along with Plan F, is no longer open to people turning age 65. That means if you are first eligible for Medicare benefits on or after 1 January 2020, you can’t buy Plan C. People who already have Plan C can it, and you can still apply for this plan if you were eligible for Medicare before 2020.
Also, don’t be confused between Medicare Plan C and Medicare Part C. Despite the fact that they sound like the same thing, Medicare Part C is the Medicare AdvantageMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... program, which replaces your Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.... benefits with a managed health plan.
Medigap Plan C, as its name implies, covers gaps in your Original Medicare benefits, including the following:
- Medicare Part AMedicare Part A is hospital inpatient coverage for people with Original Medicare, whereas Part B is medical coverage for doctor visits, tests, etc.... hospital coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. ... and hospital costs up to 365 days after Original Medicare benefits are exhausted
- Medicare Part A hospice care coinsurance or copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service....
- Medicare Part BMedicare Part B is medical coverage for people with Original Medicare. It covers doctor visits, specialists, lab tests and diagnostics, and durable medical equipment. Part A is for hospital inpatient care.... copayments and coinsurance
- First three pints of blood for a medical procedure
- Skilled Nursing Facility care coinsurance
- Medicare Part A deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share....
- Medicare Part B deductible
- Foreign travel emergency coverage (80% of approved costs up to plan limits)
You can use this Medigap Plan Comparison Chart to see how Plan C stacks up with the other nine plans.
What’s Not Covered by Medicare Plan C?
It doesn’t cover Medicare Part B excess chargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment..... These are doctor charges that can legally extend beyond the Medicare-approved amount for service payment. When excess charges occur, the remainder of the cost is charged directly to the patient. For example, a doctor or physician may be allowed to bill up to 15% over the Medicare-approved amount in some cases.
Medicare Plan C Costs May Vary by Carrier and Where You Live
In all states, Medigap plans are regulated by state and federal government rules, but monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. ... are not regulated. That means all Medigap Plan C policies have the exact same benefits, no matter which company you choose, however, plan availability and premiums will be different. This makes shopping for Medicare supplement insuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage.... very easy. Simply shop for the best price on the level of coverage you need.
Here is what you should know before you compare Medigap plans. All Medicare supplement insurance companies set their premiums based on one of three rating systems:
- Issue-age-rated
- Attained-age-rated
- Community-rated
Using one of these rating methods, carriers factor in your age, gender, location, use of tobacco, and health. Insurance companies get their rates based on many factors, including the size, age, and health of the pool of members.
Here’s the good news. You only have to qualify once. Your coverage cannot be terminated unless you don’t pay your monthly premiums or you were not truthful on the application. In some circumstances, your policy can be canceled if the insurance company goes bankrupt. In this case, you can choose a new insurer and can’t be turned down.
Related Reading: Are Medicare Supplement Plans Really Worth It?
Medicare Supplement Plan C Enrollment Period
The best time to buy a Medicare Plan C policy is during your six-month Medicare Supplement Open Enrollment Period (OEP). Your OEP starts on the first day of the month that you’re age 65 or over and enrolled in Medicare Part B. During this six-month period, you have a guaranteed-issue rightGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting.... to get the Medicare supplement plan of your choice.
Having a guaranteed issue right is a serious benefit. It means that you can’t be denied coverage due to a pre-existing condition. So long as you live in the plan’s area of service and you are enrolled in both Medicare Parts A and B, the insurance carrier you choose must sell you a policy.
If you miss your OEP and later decide to apply, you will be required to go through medical underwriting and the carrier may deny coverage. However, in some situations, you may have a guaranteed issue right to enroll in a Medigap plan outside your Medigap OEP.
You can find out which Medicare supplement plans are available where you live using our Medigap Comparison Tool. Simply enter your zip code and you’ll be on your way.
Need help deciding which Medigap plan is best for you? Call 1-855-728-0510 (TTY 711) and speak with a licensed HealthCompare insurance agent. There’s no obligation, and they offer more plan options than any other national agency.