Medigap Plan C is one of the standardized Medicare Supplement insurance plan options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options.)
Learn more about what Plan C covers, its cost and why it might be the right Medigap plan for you.
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Plan C is one of the more comprehensive standardized Medigap plans. Plan C offers coverage for all of the standardized Medigap benefits except for Part B excess charges.
Due to recent legislation, Plan C is not available for sale to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020.
If you became eligible for Medicare before Jan. 1, 2020, you may still be able to enroll in Plan C if Plan C is available in your area.
If you were enrolled Plan C before Jan. 1, 2020, you may be able to keep your Plan C coverage (see below for more information).
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Plan C covers 8 out of the 9 standardized Medigap benefits.
The only other Medigap plan option with more benefits is Plan F. The only Medigap benefit that Plan C does not include is coverage of Medicare Part B excess charges.
|
Standard Medicare Supplement Insurance benefits |
Plan C |
|---|---|
|
Medicare Part A coinsurance and hospital costs |
✓ |
|
Medicare Part B coinsurance or copayment |
✓ |
|
First 3 pints of blood |
✓ |
|
Part A hospice care coinsurance or copayment |
✓ |
|
Coinsurance for skilled nursing facility |
✓ |
|
Medicare Part A deductible |
✓ |
|
Medicare Part B deductible |
✓ |
|
Medicare Part B excess charges |
|
|
Foreign travel emergency |
80% |
Medicare Part A is known as hospital insurance and it includes cost-sharing measures like coinsurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if they exceed 60 days.
Medigap Plan C pays for all of these coinsurance fees.
Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% coinsurance in most cases.
Plan C pays the 20% coinsurance or copayment costs.
If a blood transfusion is needed, Original Medicare only provides coverage for the blood beginning with the fourth pint. The cost of the first three pints is the responsibility of the patient.
Plan C fully covers the cost of the first three pints of blood.
Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires copayments. These copayments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care.
Plan C covers these costs completely.
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Coinsurance for medical care provided at skilled nursing care facilities is fully covered by Plan C.
This benefit pays for the deductible on Medicare-approved health care services such as hospice care, skilled nursing facilities, and inpatient hospital stays. The Part A deductible is $1,600 in 2023.
Plan C covers the entire cost of the Part A deductible.
Plan C is one of two Medigap plans to fully cover the Medicare Part B deductible, which is $226 in 2023.
Plan C fully covers the Medicare Part B deductible.
This benefit provides coverage for medical care provided outside of the United States. Plan C pays for 80% of the billed charges.
For more detailed information, read our page about Medicare Supplement Insurance benefits.
The only benefit area not covered by Plan C is Part B excess charges.
If a Medicare beneficiary receives health care from a provider who does not accept Medicare assignment, the provider reserves the right to charge up to 15 percent more for the service or item.
This extra cost is known as an excess charge and becomes the responsibility of the patient.
Plan C does not provide coverage for excess charges, but excess charges can be avoided if you visit only health care providers who accept Medicare assignment.
To see the difference between Plan C and the other standardized Medigap plan options, please review the Medigap plans comparison chart below. Use the scroll bar at the bottom to view all plans and information.
72 percent of all insurance companies that sell Medicare Supplement Insurance offer Plan C. Just 5 percent of all Medicare Supplement beneficiaries are enrolled in Medigap Plan C.1
The average premium paid for Medigap Plan C in 2022 was around $232 per month.2
It’s important to remember that Plan C offers more coverage than most other Medigap plans, which can affect the average cost of Plan C premiums.
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A great time to enroll in Medigap is during your Medigap Open Enrollment Period (OEP).
Your Medigap Open Enrollment Period lasts for 6 months, and it starts as soon as you are at least 65 years old AND enrolled in Medicare Part B.
If you sign up for a Medigap plan during your Medigap Open Enrollment Period, Medicare Supplement Insurance companies can’t use your health status to determine your eligibility for a plan. They also can’t charge you more for a Medigap plan based on your health.
You may be able to enroll in a Medigap plan anytime outside of your Medigap Open Enrollment Period. You may face medical underwriting if you do so, unless you qualify for a guaranteed issue right.
If you have a guaranteed issue right, Medigap insurance companies can’t use your health to determine your eligibility or plan rates.
A licensed insurance agent can help you determine whether or not you qualify for a guaranteed issue right. Not all plan types may be available for purchase if you have a guaranteed issue right.
You may have Plan G options available in your area.
A licensed insurance agent can help you compare Medigap plans available near you and help you find a plan that fits your coverage and budget needs.
Or call now to speak with a licensed insurance agent:
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