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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.)

Learn more about what Plan C covers, its cost and why it might be the right Medigap plan for you.

 

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What Happens to Medigap Plan C in 2020?

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 will not be available for sale to new Medicare beneficiaries who become eligible for Medicare on or after January 1, 2020.

If you become eligible for Medicare before Jan. 1, 2020, you may still be able to enroll in Plan C after that date (if Plan C is available in your area).

If you are enrolled Plan C before Jan. 1, 2020, you may be able to keep your Plan C coverage going forward (see below for more information).

What Does Plan C Cover?

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 Coinsurance

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 Coinsurance and Copayment

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.

First 3 Pints of Blood

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. 

Part A Hospice Care Coinsurance or Copayment

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.

Coinsurance for Skilled Nursing Facility

Coinsurance 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.

Plan C covers the entire cost of the Part A deductible.

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.

Plan C fully covers the Medicare Part B deductible.

Foreign Travel Emergency Care

This benefit provides coverage for medical care provided outside of the United States. Plan C pays for 80% of the billed charges after a $250 deductible has been met for the year.

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

 

Compare Medigap plan benefits in your area.

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Part B Excess Charges

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.  

How Does Medigap Plan C Compare to Other Plans?

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

Plan C vs. Plan F and Other Medigap Plan Options

2019 Medigap plans comparison chart

Plan C Enrollment Statistics

As of 2017, 75 percent of all insurance companies that sold Medicare Supplement Insurance offered Plan C.¹

More than 781,000 people were enrolled in Plan C in 2017, which  made it the 4th-most popular Medigap plan that year.

How Much Does Medigap Plan C Cost?

The average premium paid for Medigap Plan C in 2018 was $189.88 per month

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.

When Is the Best Time to Sign Up for Plan C?

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.

How Do I Sign up for Plan G?

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.

 

Find Medigap Plan C in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 


1 AHIP. The State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.

2 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

 

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