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Medigap - Plan C
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Important Points
Medigap Plan C is one of ten different Medicare Supplement (Medigap) plans.
Plan C covers all the gaps in your Medicare coverage, except for Medicare Part B excess charges.
Medigap Plan C is not the same thing as Medicare Part C.
Medigap Plan C is a policy that covers nearly all of your Medicare gaps that you would usually be obligated to pay. The only exception is the Part B excess charges. Medigap Plan C is very popular in states that do not allow excess charges.
NOTE - The only people eligible to apply for Plan C are those who became Medicare-eligible before January 1st, 2020.
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Medigap Plan C Benefits
Excess charges are the surcharges that your doctor can charge above and beyond what Medicare will reimburse. By law, they are limited to 15% beyond what Medicare pays. Many providers do not charge excess charges, but sometimes they do. If this is of concern for you, then Medigap Plan G might be a better choice for you than Plan C. Plan G covers excess charges, so you don't have to worry about asking
Let's look at an example:
Michelle buys a Medigap Plan C policy. Most of her doctors are participating Medicare providers so she usually owes absolutely nothing. Michelle then twists her ankle while on a jog. She then notices swelling, so she visits an urgent care center for an X-ray. The clinic does not accept Medicare assignment rates by chooses to bill an excess charge. The fee for the X-ray is normally $50, but at this clinic there is a 15% excess charge, bringing the cost to $57.50. Since Michelle's Medigap Plan C does not cover excess charges, Michelle will owe the $7.50 difference directly to the urgent care center.
A Note About Plan C Excess Charges
When a Medicare doctor does not accept Medicare assignment rates, they can charge you an excess charge. By law, this charge cannot be more than 15% beyond the allowed Medicare charge. Additionally, some states do not allow their doctors to apply excess charges. People that live in these states find that Plan C functions just like Plan G, which is the most comprehensive Medicare Supplement (Medigap) plan.
Medigap Benefits - Plan C
Medicare Part A Coinsurance & Hospital Costs
(Up to an additional 365 days after Medicare benefits are used)
Medicare Part B Coinsurance or Copayment
Blood (First 3 Pints)
Part A Hospice Care Coinsurance or Copayment
Skilled Nursing Facility Coinsurance
Medicare Part A Deductible
Medicare Part B Deductible
Medicare Part B Excess Charges
Foreign Travel Emergency (up to plan limits)
Medigap Plan C is Different than Medicare Part C
Medigap Plan C is one of the various Medicare Supplement plans available to you, while "Part C" refers to Medicare Advantage policies. If you decide to purchase a Medigap Plan C policy, you will have the freedom to access to the top doctors and hospitals that you already get with your Original Medicare. You can rest assured that your Medigap policy will pay for things like your inpatient and outpatient deductibles, which makes Plan C a popular seller.
Medigap Plan C has benefits that are very similar to Plan F, so if the lack of coverage for excess charges is a worry for you, you may want to consider quotes for the Plan F policy so you can compare them. In many areas the prices are almost the same, making it a cost-effect way to buy the more comprehensive coverage if that is what appeals to you.
Quotes for Medigap Plan C
There are many insurance companies that offer Medigap plans in each state. Many of these companies have been around for decades and are big insurance companies that you might easily recognize. However, there are quite a few lesser-known companies that have solid ratings that also sell Medigap plans in your state. They can offer the same significant savings that the larger companies can offer to you.
Key Points
Plan C covers everything except for the Part B excess charges.
The premiums for Plan C can be high, so you may want to consider Plan N or Plan G instead.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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Rates are reviewed periodically and are subject to change in your state.
Cost Estimates are based on the information entered, using data about past experiences by beneficiaries with similar attributes and the premiums and benefits provided by the plan. Actual costs may vary. Monthly medical costs are represented by annual figures divided evenly per month.
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For plans that provide drug coverage, the formulary may change during the year.
Medicare beneficiaries may also enroll in Medicare plans through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.