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Medicare Supplement Insurance Plan C

Medigap Plan C is one of 10 standardized Medicare Supplement insurance plan options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options.) Even though it’s moderately priced, it covers many of the standardized Medigap benefits.

Medigap Plan C: An Overview

Medicare Supplement Insurance Plan C should not be confused with Medicare Part C, which is also referred to as a Medicare Advantage. Medicare Advantage is an alternative to Original Medicare coverage in which you receive Medicare benefits (and in many cases, some additional ones) from a private insurance plan. Medigap policies, on the other hand, supplement your Original Medicare coverage.

Plan C is the 2nd-most popular Medigap plan option. Plan C is a mid-range cost insurance plan. The Kaiser Family Foundation found that Plan C has the 5th-lowest monthly premiums out of the 10 standardized Medigap plans.1

Plan C is widely available. If an insurer wants to offer plans other than Plan A, it must provide either Plan C or Plan F.

Keep reading for details on Plan C’s benefits and enrollment rates, in addition to how the benefits compare to other Medigap plans.

Plan C Benefits

Plan C covers 8 out of the 9 available 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 co-insurance and hospital costs

Medicare Part B co-insurance or co-payment

First 3 pints of blood

Part A hospice care co-insurance or co-payment

Co-insurance for skilled nursing facility

Medicare Part A deductible

Medicare Part B deductible

Medicare Part B excess charges

 

Foreign travel emergency

80%

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days.  Medigap Plan C pays for all of these co-insurance fees.

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a co-insurance and co-payments 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% co-insurance in most cases. Plan C pays the 20% co-insurance or co-payment costs.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond. If you need blood while in the hospital, Medigap plans cover the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments 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.

Co-insurance for skilled nursing facility: Co-insurance for medical care provided at skilled nursing care facilities is fully covered by Plan C.

Medicare Part A deductible: 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 $1,364 in 2019.2

Medicare Part B deductible: Plan C is one of two Medigap plans to fully cover the Medicare Part B deductible, which is $185 in 2019.3

Foreign travel emergency: This benefit provides coverage for medical care provided outside of the United States. This insurance benefit pays for 80% of the billed charges. Coverage is provided after a $250 deductible has been met for the year.

The only missing benefit for Plan C is for Medicare Part B excess charges. If there are any excess charges for a Medicare-approved doctor’s visit, the person insured under Plan C would have to pay for these charges, which can be up to 15% higher than Medicare-approved amount for a service.

For more detailed information, read our page about Medicare Supplement Insurance benefits.

Plan option comparison

The only other plan with more covered benefits than Plan C is Plan F. This plan is suitable for Medicare beneficiaries who expect to need medical care frequently and worry about the cost of co-pays and deductibles. Although the premiums are higher than other plans, it includes more covered benefits.

To see the difference between Medigap Plan C and the other standardized plans, please review the chart below.

Plan C vs. other Medigap plan options

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility 50% 75%
Medicare Part A deductible 50% 75% 50%
MedicarePart B deductible
Medicare Part B excess charges
Foreign travel emergency 80% 80% 80% 80% 80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything. 2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

 

Enrollment Statistics

Plan C is the 2nd-most popular Medicare Supplement Insurance plan. Plan F is the most popular plan.

About 10% of Medigap policyholders chose Plan C in 2014, according to AHIP.4

Even though Plan C is popular, it’s becoming less popular. Enrollment in Plan C dropped 6% from 2013 to 2014.


1 https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8412-2.pdf

2 https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

3 https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

https://www.ahip.org/wp-content/uploads/2016/04/MedigapEnrollmentReport_Linked.pdf

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