For anyone who is concerned that traditional Medicare coverage may leave too many gaps in their care, Medigap plans may help provide peace of mind. Medigap plans were created to work alongside your Parts A and B coverage to pay for extra expenses that Medicare may overlook.
Medigap Plan C is one of 10 plan offerings with very specific benefits. Read on to learn more about this supplemental insurance that may save you from paying excess charges for your medical care.
Note: Medigap Plans F and C are no longer available for new enrollees in 2020. Read more about what that means for you.
What is Medigap Plan C?
Medicare Supplement Insurance, also known as Medigap, is a policy designed to help pay some of the health care costs that Original Medicare doesn’t cover. Medigap Plan C is one such option, and (considering it covers all but one of the available Medicare Supplement benefits) it happens to be one of the most comprehensive.
Medigap Plan C is designed to provide enrollees with fewer out-of-pocket expenses because it covers a portion of the remaining balance of hospital or doctor bills not covered by Original Medicare (Parts A and B), such as Medicare deductibles, copayments, and coinsurance.
What does Medigap Plan C cover?
Like all Medigap plans, Plan C basic benefits are the same in most states—however, some plans may choose to offer extra benefits at an additional cost. At its most basic level, this plan specifically covers the following costs and benefits:
- Medicare Part A deductible
- Part A hospital and coinsurance costs (up to an additional 365 days after Medicare benefits are exhausted)
- Part A hospice care copayment or coinsurance
- Part B deductible
- Part B copayments and coinsurance
- First three pints of blood used in an approved medical procedure (annually)
- Foreign travel emergency coverage
- Skilled Nursing Facility coinsurance
Who should choose Medigap Plan C?
Medigap Plan C can make a substantial difference in out-of-pocket costs and coverage. If any of the following scenarios apply to you, it’s worth considering Plan C supplemental coverage:
- Do you travel frequently? Typically, Medicare doesn’t cover health care outside of the United States, which means a medical emergency while on vacation can leave you with 100% of the costs incurred. Plan C pays 80%of approved costs up to plan limits in foreign countries.
- Do you require frequent medical attention? If you suffer from any chronic illnesses or see doctors and specialists on a regular basis, those medical bills can pile up quickly. Plan C’s additional coverage will help manage your out-of-pocket costs.
- Are you on a fixed budget? When you’re on a strict monthly budget, unexpected medical bills can put your finances in jeopardy. Medigap policies help keep your money in your wallet by eliminating costly surprises.
To make the decision that’s right for you, consult this supplement plan comparison guide.
Charlie has been eligible for Medicare for a few years, but he’s just now retiring at age 71 and enrolling in Medicare for the first time. He plans to spend much of his free time traveling the world, so coverage while abroad is at the top of his needs list. While he plans to relax and exercise more now that he’s not working, he wants a safety net if his high blood pressure and cholesterol land him in the hospital. He’s heard that the Part A deductible can be quite expensive, so he’s chosen Medigap Plan C.
What is the difference between Medigap Plan C and Plan F?
Medigap Plan F is the most comprehensive Medicare Supplement plan on the market today. It covers everything that Plan C includes, plus one more benefit: Part B excess charges. If you have Original Medicare, and the amount a health care provider is legally allowed to charge is greater than the Medicare-approved amount, the difference is called an excess charge. With Plan F, excess charges will be taken care of, while with Plan C they become the beneficiary’s responsibility.
Learn more about upcoming changes to Medigap Plan C and F.
How do I enroll in Medigap Plan C?
The ideal time to purchase any Medigap policy is during your open enrollment period, which is a six-month period that begins the month you turn 65 and enroll in Medicare Part B. During this time period, insurance companies cannot decline coverage, even if you have pre-existing conditions or are in poor health. Once this period has passed, there’s no guarantee you’ll meet the medical underwriting requirements, unless you meet specific criteria.
The bottom line: a great plan, but not available to everyone
Medigap Plan C policies are still available to Medicare beneficiaries who were eligible for Medicare before January 1, 2020. If you frequently need medical attention, travel outside the United States, or are interested in lowering your out-of-pocket costs, then Medigap Plan C could be the ideal solution.
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How much does Medigap Plan C cost?
Even though Plan C basic benefits remain the same from state to state, the premiums will vary. Additionally, some plans may also offer extra perks that are factored into the pricing. It’s wise to shop around to make sure you’re getting the best deal and only paying for the coverage you need.
Is Plan C going away?
Yes, due to a new federal law, Plan C will be phased out for newly eligible enrollees in 2020. The same is happening for Plan F, in case you are deciding between the two. The good news is that beneficiaries who were eligible for Medicare before January 1, 2020 may still be able to buy Plan C or F after 2020. Or if you already had Plan C or F before 2020, you may keep your plan as long as you’d like.
Is Plan C available in every state?
Medigap Plan C is available in all but three states; Massachusetts, Minnesota, and Wisconsin.