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Medicare Supplement Insurance Plan C

Medicare Supplement Insurance Plan C is among the more comprehensive Medigap plans available in most states.

Medicare Supplement Insurance works alongside Original Medicare (Part A and Part B) to cover some of the program’s out-of-pocket costs, like coinsurance, copayments and deductibles. 

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What Is Medicare Supplement Insurance Plan C?

Medicare Supplement Plan C offers coverage for 8 of the 9 available Medigap benefits. Medigap Plan C may work well for individuals who need frequent medical care. Medigap Plan C basic benefits include:

  • Medicare Part A hospital coinsurance and hospital costs (up to 365 days after Original Medicare benefits are used up)
  • Medicare Part B coinsurance or copayment coverage (20% of Medicare-approved charges)
  • Medicare Parts A and B blood deductibles (first three pints)
  • Medicare Part A hospice care coinsurance or copayment
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Skilled nursing facility (SNF) care coinsurance coverage
  • Foreign travel emergency coverage (80%, up to plan limits)

What Doesn’t Medigap Plan C Cover?

The only benefit not included in Medigap Plan C is coverage for Medicare Part B excess charges. Excess charges are additional expenses you may have to pay for if the doctor or provider you use doesn’t accept assignment — meaning they won’t accept the Medicare-approved amount as full payment for covered services.

The difference between what Medicare pays for a certain medical service, and what your doctor or provider charges for it, is the Medicare Part B excess charge, which you’re responsible for paying out-of-pocket. In some cases, you may be charged up to 15% more than the Medicare-approved amount for a service.

You can avoid Medicare Part B excess charges by choosing doctors who agree to accept assignment, which can be found using Medicare’s Physician Compare tool

To see how the basic benefits of Medicare Supplement Insurance Plan C coverage compares to those of other Medigap plans, refer to the chart below.

2019 Medigap plans comparison chart

What You Pay With Plan C 

Medigap Plan C is one of the most comprehensive Medicare Supplement Insurance plans you can buy. If you only choose to see doctors who accept assignment, it provides the same amount of coverage as the most extensive plan, Medigap Plan F.

Without Medigap Plan C, your costs under Medicare Part A in 2019 include:

  • A $1,364 deductible during inpatient hospital stays (per benefit period)
  • $341 coinsurance per day after day 60 in the hospital
  • $682 coinsurance per day for up to 60 “lifetime reserve days” after day 90 in the hospital
  • All costs for inpatient hospital care after day 150

With Medigap Plan C, your costs under Medicare Part A during each benefit period include:

  • $0 for the Medicare Part A deductible
  • $0 coinsurance during inpatient hospital stays for days 1-150 in the hospital
  • $0 coinsurance for an extra 365 days in the hospital after Medicare stops paying

Without Medigap Plan C, your costs under Medicare Part B include:

  • A $185 annual deductible in 2019
  • 20% coinsurance for most Medicare-approved services after the deductible is met
  • Up to 15% additional excess charges if your doctor does not accept assignment
  • All costs for foreign travel emergency coverage

With Medigap Plan C, your costs under Medicare Part B include:

  • $0 for the Medicare Part B deductible
  • $0 in coinsurance for Medicare-approved services
  • Up to 15% additional excess charges if your doctor does not accept assignment
  • 20% of your medically necessary emergency care outside of the U.S. after you meet a $250 deductible

Plan C in 2020

Effective Jan. 1, 2020, Section 401 of the Medicare Access and CHIP Reauthorization Act (MACRA) stipulates that newly eligible Medicare beneficiaries will be unable to sign up for a Medicare Supplement Insurance plan that covers the Medicare Part B deductible (which is $185 in 2019). 

Beneficiaries who already have Plan C or Plan F prior to 2020 will be able to keep their plans. Beneficiaries who came eligible for Medicare prior to 2020 may be able to buy Plan C and Plan F if they are available where they live after Jan. 1, 2020.

If you become eligible for Medicare in 2020 and beyond, Medicare Supplement Plan C and Plan F will no longer be options.

Enrolling In Medicare Supplement Insurance

To find out more about Medicare Supplement Insurance Plan C coverage and other plan options, speak with a licensed agent. We’ll help you assess your personal health needs and budget, determine which plan type is the right one for you and leverage quotes from leading insurance companies to help you save. 

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