Medigap Plan C – Plan C is one of several Medigap options beneficiaries can use to fill in the gaps of Original Medicare. Not to be confused with “Part C,” which is Medicare Advantage, Plan C offers great benefits for those who are eligible to enroll.
What Is a Medigap Plan?
First, let’s decipher what a Medigap plan is. Medigap plans, also called Medicare Supplement plans, help pay the costs that remain after Original Medicare (Parts A and B) pays. Original Medicare offers great benefits, but you’ll be responsible for deductibles, copayments, and coinsurance costs. A Medigap plan will help pay some or all of those leftover costs that you’d be responsible for otherwise.
Benefits of Plan C
Medigap Plan C offers some of the most extensive benefits of all the Medigap plans. It includes payment for the following out-of-pocket costs:
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Part A deductible
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Part B deductible
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Part A inpatient copayments, with an extra 365 days of coverage
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Part A hospice copayments
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Part B copayments and coinsurance
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First 3 pints of blood
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Skilled nursing facility coinsurance
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Foreign travel emergencies (up to 80% of plan limits)
The only thing you’ll find missing from this list is the Part B excess charges. “Excess charges” are additional amounts that non-Medicare providers can add to your final bill. If a provider does not agree to accept Medicare assignment, that means they’re allowed to charge up to 15% more than the Medicare-approved cost for services. Plan C will not pay those additional fees.
Many people find this weakness in benefits to be negligible. The reason is that most providers do accept Medicare. In addition, there are eight states that prohibit the practice of excess charges. This is called the Medicare Overcharge Measure law. If you live in one of those eight states, this lack of benefits is a non-issue. The eight MOM states include Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont.
Alternatives to Medigap Plan C
To enroll in Plan C, and any other Medigap plan, you must also enroll in Original Medicare. On top of that, Plan C enrollment is limited to Medicare beneficiaries who turned 65 prior to January 1, 2020. Fortunately, if you don’t qualify for Plan C, there are alternative options to consider.
Medigap Plan D
Plan D is very similar to Plan C, except for one benefit. In addition to not covering the Part B excess charges, it also does not pay the Part B deductible. However, it does not have the enrollment limitations of Plan C. Anyone who is on Original Medicare can apply for Medigap Plan D. Benefits include:
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Part A deductible
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Part A inpatient copayments, with an extra 365 days of coverage
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Part A hospice copayments
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Part B copayments and coinsurance
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First 3 pints of blood
-
Skilled nursing facility coinsurance
-
Foreign travel emergencies (up to 80% of plan limits)
Medigap Plan G
Plan G is another great alternative and is actually more popular than either Plan C or Plan D. Plan G does include coverage for excess charges but does not pay the Part B deductible. But again, there are no birthday cutoffs to enroll in Plan G. Benefits include:
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Part A deductible
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Part A inpatient copayments, with an extra 365 days of coverage
-
Part A hospice copayments
-
Part B copayments and coinsurance
-
Part B excess charges
-
First 3 pints of blood
-
Skilled nursing facility coinsurance
-
Foreign travel emergencies (up to 80% of plan limits)
If you have questions about Medigap plans, we’ve got answers. Our dedicated team of licensed agents specializes in Medicare and will make sure you understand your coverage. We’ll provide education and resources, help you weigh the pros and cons of different kinds of plans, and then submit your applications when you’re ready. Call to speak to a Medicare advisor today.
