Medicare Supplement Plan C
Medicare Supplement Plan C is one of 10 Medicare Supplement plans that help Medicare beneficiaries cover out-of-pocket medical expenses. It is also frequently called Medigap Plan C or Medicare Plan C.
Original Medicare reimburses health care providers 80 percent of its approved rate for medical services. Original Medicare consists of two parts:
After Original Medicare pays its portion, the remaining 20 percent becomes the responsibility of Medicare beneficiaries. In addition to the 20 percent coinsurance, beneficiaries have to meet copayments and deductibles. Medicare Supplement Plan C helps you pay these patient-responsibility medical expenses.
Medicare Supplement Plan C Overview
As with all Medigap plans, private insurance companies sell Medigap Plan C. The benefits for Plan C are standard between health insurance providers, but rates vary widely.
Finding the best Medicare Supplement Plan C depends a lot on a careful comparison of the benefits, costs, and coverage of each Medicare Supplement insurance plan. Our licensed insurance agents are available to help you compare plans, but here’s what you need to know to get started.
What is covered by Medicare Supplement Plan C?
Plan C is one of five Medicare Supplement insurance plans that offer comprehensive benefits coverage. Here’s what Medigap Plan C covers:
- Medicare Part A deductible
- Medicare Part A coinsurance and hospital costs
- Part A hospice care copayment or coinsurance
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Medicare Part B deductible
- Part B copayment and coinsurance
- Foreign travel emergency (up to plan limits)
What is not covered by Medicare Supplement Plan C?
The only basic benefit that Plan C doesn’t cover is Medicare Part B excess charges. Health care providers who don’t participate in the Federal Medicare Program are allowed to charge up to 15 percent above Medicare’s approved amount for medical services. The difference between Medicare’s approved amount and the additional 15 percent is called excess charges.
How does Medicare Plan C cover Medicare Part A Deductible?
You have to meet a deductible for each benefits period before Medicare pays anything on hospital services. Plan C pays that deductible for you.
How does Medicare Plan C cover Medicare Part A coinsurance?
Hospital costs can be expensive, and you might face steep coinsurance amounts even after your Medicare benefits are applied toward your bill. Medicare Supplement Plan C pays this coinsurance for you, leaving you with no out-of-pocket expense.
How does Medicare Plan C cover Medicare Part B deductible?
Plan C pays for your Part B deductible. Due to changes in federal law, after Jan. 1, 2020, no Medicare Supplement plan will cover the Part B deductible. However, your Plan C will still be in effect and will continue to cover your deductible.
How does Medicare Plan C cover Medicare Part B coinsurance?
Just like with Medicare Part A, you’re responsible for the remaining 20 percent after Medicare pays on your outpatient medical costs. Medical Supplement insurance Plan C covers this 20 percent coinsurance.
How does Medicare Plan C cover the docs office?
Medicare Part B covers 80 percent of the approved amount for doctor’s office visits. Plan C pays the remaining 20 percent coinsurance. If the doctor doesn’t participate in Medicare and bills you excess charges, you’ll be responsible for paying any excess charges stemming from doctor’s office visits.
How does Medicare Plan C cover part b excess charges?
Plan C does not cover Part B excess charges. You are responsible for paying these charges out-of-pocket.
How does Medicare Plan C cover foreign travel?
If you frequently travel outside of the country, it might be best to look at Medigap plans that offer coverage for emergency care abroad. Plan C pays 80 percent of your foreign travel expenses (up to plan limits) providing you meet these criteria:
- You pay your $250 deductible
- Services occur within the first 60 days
- Medicare Part A and Part B wouldn’t otherwise cover the care
How Much does Medigap Plan C Cost?
Although that might sound straightforward, Medicare Plan C rates can be confusing because each insurance company sets its own Medigap Plan C rates.
The first stage in finding the best Medicare Plan C rates is to compare the pricing method the insurer uses. The pricing method affects your future monthly premiums. Health insurance providers use one of three ways:
- Community-rated is when everyone pays the same premium when they buy the policy. Age has no bearing on the premium amount.
- Issue age involves your age when you buy the Medigap policy. A 65-year-old will have a lower monthly premium than a 75-year-old. Both premiums might increase in future years due to inflation or other economic factors, but increases aren’t related to age.
- Attained age bases monthly premium calculations on your current age. Under this method, your monthly premium will increase each year because you’re getting older. This is critical to consider because a monthly premium that’s affordable when you’re 65 might become costly when you reach 75.
Even when insurers use the same pricing method, Medicare Supplement Plan C rates can differ because providers include other information in their premium calculations:
- Location (both zip code and state)
- Household discounts
- Tobacco use
Which Companies Offer Medigap Plan C?
Insurance companies range from well-known industry giants to mom-and-pop organizations. When you’re searching for the best Medicare Supplement Plan C, going with an insurance company you trust offers a satisfying peace of mind.
At SLP, we’ve established relationships with nearly all of the insurers offering Medicare Supplement Plan C. Over time, our insurance agency has come to appreciate working with the following companies:
We consider these three insurers to be the best Medicare Supplement insurance companies to work with because of the competitive Medicare Supplement Plan C rates they offer. In addition to competitive Medigap Plan C rates, they also have an excellent history in the health care field:
- Solid financial strength
- Sound ratings
- Long-term stability
- Focus on customer satisfaction
Medicare Supplement Plan C vs Medicare Plan F
Medicare Supplement insurance Plan C and Medicare Plan F are both considered “first-dollar” Medicare Supplement plans. They earn that name because they provide comprehensive benefits with the individual paying little or no out-of-pocket costs. Here’s how they compare.
- Benefits: The only difference between Plan C and Plan F is that Plan F pays for excess charges, Plan C does not. Eight states (Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont) prohibit excess charges. That means that in those states, Plans C and F are identical in benefits.
- Rates: Medicare Supplement Plan C rates are less expensive in comparison to Plan F rates, but the difference is not significant. The high deductible Plan F offers the same benefits as Plan F except you pay a $2,490 (in 2022) deductible before the plan pays. The premium for high deductible Plan F is significantly lower than Plan F or Plan C. Because all three plans will close to new enrollees after Jan. 1, 2020, premiums might increase because younger, healthier people aren’t joining.
- Access to care: There is no difference between the two plans in your access to a doctor or hospital. You can see any provider who signs up with Medicare without being subject to excess charges.
Medicare Supplement Plan C vs Medicare Plan G
Plan C and Plan G both offer broad coverage, but there are a few differences.
- Benefits: Medigap Plan C does not pay for excess charges whereas Plan G does. In the eight states that prohibit excess charges, Plans C and G offer beneficiaries the same coverage.
Plan C pays the Part B deductible; Plan G does not. However, as of Jan. 1, 2020, none of the plans that cover the Part B deductible, including Plan C, will be available to new Medicare beneficiaries.
- Rates: Medicare Plan C rates are typically higher than Plan G rates. After Jan. 1, 2020, Plan G will be the plan that offers the broadest health insurance coverage. That means that Plan G could take in a lot of individuals who are in poor health, and the plan would need to hike its premiums.
- Access to care: There is no difference between the two plans regarding doctors or hospitals. You can see any provider who participates in Medicare without being subject to excess charges.
When can I enroll in Medicare Supplement Plan?
Your best opportunity to enroll in Medicare Plan C is when you’re first eligible. This time frame is called your Open Enrollment Period. It’s a six-month period that starts the month that you are both 65 and enrolled in Medicare Part B.
Open enrollment is the best time to apply because the insurance company has to issue you a policy. The insurer cannot deny you coverage, require you to take a physical exam, submit a medical history, or charge you higher premiums. These are called guaranteed-issue rights. If you buy a Medigap policy outside of this six-month window, the insurance company can require medical underwriting or even deny you benefits.
Because these rights aren’t guaranteed outside of your open enrollment period (there are a few situations where guaranteed rights still apply), it can be difficult for individuals to change Medicare Supplement plans in the future. That’s why it’s so critical that you find the best Medicare Supplement insurance right from the beginning. If you have existing health conditions, our insurance agents can help you compare Medicare Supplement plans to find the best plan, rates, and insurance company.
Medicare Supplement Plan C Review
Here’s a quick review of the highlights of Plan C:
- Medigap Plan C covers all coverage gaps except excess charges, making it one of the most comprehensive Medicare Supplement plans available.
- If you live in a state that prohibits excess charges, Plan C offers identical benefits to Plan F but at a lower premium.
- Plan C won’t be available to new enrollees after Jan. 1, 2020. If you enroll before then, you can still keep your policy.
If you’re confused as to whether a Medicare Supplement insurance plan or Medicare Advantage plan is best for you, feel free to give us a call. Our licensed agents are here to assist you in the education process. We’ll also help you compare Medigap Plan C rates, benefits, and coverage to see if it’s the best fit for your needs.