Understanding Medicare Supplement Plan C
Medicare Supplement Insurance plans, also called Medigap, work alongside Medicare Parts A and B (Original Medicare). Medicare Supplement Plan C offers some of the most comprehensive supplemental coverage available among the standardized Medicare Supplement Insurance plans. Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans.
With Plan C, you get all the benefits of Medicare Supplement Plans A & B, plus much more. Plan C includes coverage for skilled nursing facility care coinsurance, it pays Original Medicare Part A deductible for hospitalization, it pays Original Medicare Part B deductible for medical and hospital outpatient expenses, and offers medical emergency expense assistance (up to plan limits) when traveling out of the country.
Important Update to Medicare Supplement Plan C
Medicare Supplement Plan C is no longer available to purchase due to new federal laws. Anyone enrolled in a Medigap Plan C as of December 31, 2019, will be grandfathered and will be able to continue to use the plan as long as the premiums are paid.
What does Medicare Supplement Plan C cover?
Medicare Supplement Plan C covers all the basic benefits as Medicare Supplement Plans A and B, plus additional benefits.
Hospital Expenses: Pays 100% of the Original Medicare Part A hospital expenses.
Pays 100% of the Original Medicare Part A hospital expenses.
Medical Expenses: Pays Original Medicare Part B coinsurance (20% of Medicare-approved expenses).
Pays Original Medicare Part B coinsurance (20% of Medicare-approved expenses).
Transfusions: Pays for the first three pints of blood you receive in a medical procedure.
Pays for the first three pints of blood you receive in a medical procedure.
Plus, these additional benefits:
Hospice Care: Pays Original Medicare Part A coinsurance or copayment.
Pays Original Medicare Part A coinsurance or copayment.
Skilled Nursing: Covers facility care coinsurance.
Covers facility care coinsurance.
Part B Deductible: Pays 100% of the Original Medicare Part B deductible.
Part B Deductible
Pays 100% of the Original Medicare Part B deductible.
Foreign Travel Medical Emergencies: Pays travel-abroad medical emergency expenses (80% of approved costs up to plan limits).
Foreign Travel Medical Emergencies
Pays travel-abroad medical emergency expenses (80% of approved costs up to plan limits).
Part B Excess Charges: Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Part B Excess Charges
Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Prescription Drugs: Medigap Plan C does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Medigap Plan C does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Who can benefit from this type of supplement plan?
Medicare Supplement Plan C is only available for Medicare beneficiaries who became eligible for Medicare before 2020. This plan is a good option for someone concerned about medical expenses such as deductibles, copays, coinsurance, and outpatient expenses, and is willing to pay a little more each month to make sure those expenses are covered.
Learn Why Karen Chose Medicare Supplement Plan C
Karen works part-time and has two teenage children. It’s important that she stays in control of her expenses—especially unexpected medical costs.
She knows that approximately 20% of her Medicare-approved medical expenses aren’t covered by Original Medicare, so she wants a Medigap plan that would cover expenses such as copays and coinsurance. Karen is in a financial position to pay a little extra each month for this peace-of-mind.
She wanted a Medicare Supplement Insurance Plan that would cover her hospital and healthcare deductibles and outpatient expenses. A regular world traveler, Karen also wanted a plan that would help with medical emergencies out of the U.S.
For these reasons, Karen chose Medicare Supplement Plan C.
Advantages to Medicare Plan C
- Provides the same basic benefits as Medicare Supplement Plan A and Plan B as well as additional benefits.
- Coverage for skilled nursing facility care coinsurance.
- Pays Medicare Part A and Part B deductible.
- Coverage for foreign travel medical emergencies.
Drawbacks to Medicare Plan C
- Beneficiaries who become eligible for Medicare on or after January 1, 2020 won’t be able to buy Plan C.
- No coverage for excess charges.
How much does Medicare Supplement Plan C cost?
Monthly premiums are set by the private insurance companies who offer Medicare Supplement Insurance plans and are based on age, health status, gender and various other factors. Depending on these factors including location, insurance companies may charge different premiums for the same Medicare Supplement Plan C. Companies may not cancel your coverage unless you don’t pay the plan premium, you weren’t truthful on the application, or the Medigap insurance company becomes bankrupt or insolvent.
How Pricing Works For This Plan
Pricing for Medicare Supplement Plan C varies by company. Medigap policies can be priced in 3 ways: community-rated, issue-age-rated, and attained-age-rated.
- Community-rated: Generally, the same monthly premium is charged to everyone who has the Medigap plan, regardless of age. Premiums may go up because of inflation and other factors, but not because of your age.
- Issue-age-rated: The premium is based on the age you were when you bought the Medigap plan. Premiums are lowered for people who buy at a younger age and won’t change when you get older. Premiums may go up because of inflation and other factors, but not because of your age.
- Attained-age-rated: The premium is based on your current age, increasing your premium as you get older. Premiums are lower when you are younger, but continually increase as you age. Premiums may also increase because of inflation or other factors.1
When to Enroll in Medicare Supplement Plans
When you’re first eligible: The best time to enroll in a Medicare Supplement plan is when you’re first eligible. You are eligible to purchase a Medicare Supplement policy (Medigap) on the first day of the month in which you turn 65. This marks the beginning of your Medigap Open Enrollment Period which lasts for six months.
You must already be enrolled in Medicare Part A and Part B at this time. During this period, you can buy any Medigap policy sold in your state, regardless of any health issues. And you’ll generally see better prices and more choices among Medigap policies during this period.
Outside open enrollment: While it’s often better to get coverage when you’re first eligible, you can still apply for Medigap insurance after your initial enrollment period. However, if you apply for coverage after your initial enrollment period, there’s no guarantee that an insurance company will sell you a policy if you don’t meet the medical underwriting requirements.
FAQs About Medicare Supplement Plan C
Learn more about Medicare Supplement Plan C with answers to frequently asked questions.
Is Medicare Supplement Plan C the same as Medicare Part C?
Medicare Supplement Plan C is a supplemental coverage to cover the gaps in coverage from Medicare Part A and Part B. Medicare Part C, also known as Medicare Advantage plans, provides an alternative to Original Medicare. Medicare Advantage plans are legally required to offer at least the same benefits that are provided from Original Medicare, but can include additional coverage, such as routine vision or dental benefits, prescription drugs or health wellness programs.
How can I lower the costs of my Medigap Plan C?
To make sure you’re getting the best price for Medigap Plan C coverage, it’s crucial to shop around. Each insurance company decides its monthly premium, and since the plans are all standardized, comparing the prices from multiple companies is the best way to find the lowest available cost for your coverage.
Do Medigap plans vary by state?
Medigap plans are standardized, meaning they offer the same benefits, across most of the states, except for Wisconsin Medicare Supplement Plans, Minnesota Medicare Supplement Plans, and Massachusetts Supplement Plans.
Do Medicare Supplement plans cover pre-existing conditions?
While insurance companies can’t make you wait for your coverage to start, they may make you wait for coverage for a pre-existing condition. Coverage for pre-existing conditions can be excluded if the condition was treated or diagnosed within 6 months before the coverage starts under the Medicare Supplement plan.
After the 6-month period, the Medicare Supplement plan will cover the condition that was excluded. However, it is possible to avoid or shorten the waiting period for a pre-existing condition if you buy a Medicare Supplement plan during your Medigap open enrollment period to replace “creditable coverage” Medigap plan.2
Compare Medicare Supplement Plans
There are a variety of Medicare Supplement plans available. The best way to figure out which plan could be right for you is by comparing advantages and drawbacks of each plan. Explore the different Medicare Supplement plan options below.
Find the Right Medicare Supplement Plan For You With SelectQuote
It’s understandable to be overwhelmed by all of your options for Medicare coverage. At SelectQuote, we’ll walk you step-by-step through the comparing and shopping process to find the Medicare Supplement plan that’s right for you.