Medicare Supplement Plan C is a Medicare Supplement plan which will pay most of the cost of healthcare that is not covered by the Original Medicare Part A or Original Medicare Part B.
Plan C is often confused with Medicare Part C, known as Medicare Advantage; however, these two plans are very different.
Plan C is supplemental insurance designed for people that are enrolled in Original Medicare. Medicare Part C is an alternative to using the Original Medicare.
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Medicare Supplement Plan C Coverage
Plan C is one of the more comprehensive Medicare Supplement plans available out of the ten plans offered. Original Medicare will not cover everything, and Medicare Supplement plans were created to cover Original Medicare’s costs. For example, you have an annual deductible for Medicare Part B, plus you have to pay 20% for additional medical costs. Plan C will pay for most of your healthcare expenses which Original Medicare does not cover.
Medicare Plan C includes:
- After Original Medicare benefits run out, you can have up to 365 days in the hospital
- Coinsurance and copayments when visiting your doctor and additional Medicare Part B services
- Coinsurance use in skilled nursing care and or hospice care
- First 3 pints of blood used for different medical procedures
- Deductible of $1,340 for your Medicare Part A
- Deductible of $183 for your Medicare Part B
- Foreign travel emergencies based on your plan’s limits
- Eligibility Medicare Supplement Plan C
Anyone enrolled in Medicare Part B will then be eligible to enroll in one of the Medicare Supplemental plans or Medigap plans like Plan C. The easiest way to qualify for this coverage will be during your 6-month open enrollment period (OEP). This will begin for you on (the 1st day of the 1st month) when you have turned 65; or older, plus you are enrolled in Part B.
Enrolling during the Open Enrollment Period will automatically qualify you for a policy and guarantees you won’t be rejected or charged higher premiums for any pre-existing health conditions. Conversely, waiting to enroll after the OEP will cause the policy to be “medically underwritten,” resulting in higher premiums or problems in finding coverage.
Signing Up for a Medigap Plan C
If you’re over the age of 65 and had employer health insurance when you turned 65 and did not sign up for Medicare Part B., your 6-month Medigap OEP begins during the month you sign up for Medicare Part B. For anyone over 65 who has already been enrolled in Medicare, your open enrollment period has ended. However, you may still apply for a Medigap Plan C, which is medically underwritten.
When disabled and also under the age of 65, Medigap eligibility depends on which state you live in. Some states have very few Medigap plans or no options for any plans for those who are disabled, and for most under the age of 65, you will have to pay a higher premium as opposed to those over the age of 65.
Costs for Medicare Supplement Plan C
Plan C monthly premiums amounts depend on where you live, the rate structure for the plan, and the health insurance company you have chosen if you are being charged more for your health and age.
Since Medicare Supplemental Plans, which include Plan C, are all standardized to ensure you get the same health insurance benefits as any insurance company’s policy.
Plan C versus Plan F
The difference between F and C is that Plan C will not cover your Medicare “excess charges,” which can be an additional surcharge from doctors up to 15% added to your bill for rates they think are too low. Otherwise, Plan F and Plan C are the same. However, Plan F, which offers the most insurance coverage, is often the most expensive insurance.
Note that some states do not allow excess charges, which is if you live in one of these states, or if your doctors do not charge the excess charge, you might save money by choosing Plan C instead of choosing Plan F.
Plan C versus Plan G
Plan G is like Plan F in that it will cover your excess charges. However, plan G differs from Plan C in that it will not pay your annual deductible for Medicare Part B. If you have concerns about any excess charges but also want to save money on your monthly premiums, then Plan G might be the better option for you rather than using Plan F or Plan C.
What about Kaiser? Does this fall under Medicare Plan C?
Both Medicare Supplement plans and the Medicare Advantage Part C plans are sold in several states.
Will Medicare C plans require medical underwriting?
No underwriting is required as long as you sign up during your OEP (open enrollment period), or if it’s during any time, you’ll have guaranteed issue rights. Signing up anytime outside these periods will allow the insurance company to check your health and medical history, giving them the right to refuse your application or charge higher premiums due to health and age. So, make sure you sign up for any Medicare Supplement plans once you are eligible. Use the chart below to compare Medigap Plan C to the other options available.
| Medigap Benefits | Medigap Plans | |||||||||
| A | B | C | D | F* | G* | K | L | M | N | |
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Part B coinsurance or copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes*** |
| Blood (first 3 pints) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A hospice care coinsurance or copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Skilled nursing facility care coinsurance | No | No | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A deductible | No | Yes | Yes | Yes | Yes | Yes | 50% | 75% | 50% | Yes |
| Part B deductible | No | No | Yes | No | Yes | No | No | No | No | No |
| Part B excess charge | No | No | No | No | Yes | Yes | No | No | No | No |
| Foreign travel exchange (up to plan limits) | No | No | 80% | 80% | 80% | 80% | No | No | 80% | 80% |
| Out-of-pocket limit** | N/A | N/A | N/A | N/A | N/A | N/A | $6,940 in 2023 | $3,470 in 2023 | N/A | N/A |
(source)
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