by Russell Noga | Updated July 10th, 2023
Medicare supplement plans (Medigap) assist seniors over 65 with financial support for out-of-pocket costs not covered by Original Medicare Parts A & B.
Original Medicare is a valuable resource for seniors, helping them deal with healthcare expenses as they age.
However, Original Medicare only pays 80% of Part A & B expenses. Beneficiaries are responsible for settling the remaining 20% of the costs associated with their treatments and care.
A Medigap plan helps seniors pay for the additional expenses not covered by Original Medicare. These plans can completely or partially cover out-of-pocket costs, assisting seniors to cope with their annual healthcare expenses.
What Is Medicare Supplement Plan C?
Medigap Plan C was one of the most comprehensive offerings in the Medigap range before its phasing out in January 2020. Plan C was similar to Plan F, with both offering coverage for the Part B deductible.
The difference between the two plans was that Plan C didn’t provide coverage for Part B excess charges.
Excess charges are the fees physicians and practitioners charge above Medicare-approved rates (known as Medicare Assignment).
Medicare network doctors can charge up to 15% above Medicare Assignment rates for their services. So, if you were to see one of these doctors, you would be responsible for paying the additional charge above the Medicare-approved rate.
Medicare Plan C was a great choice for seniors who used doctors in the Medicare network charging Medicare Assignment. You got all the same benefits as Plan F, making it close to the “first dollar coverage” offered by Medicare Plan F.
First-dollar coverage is a term used to describe how you don’t have any financial responsibility for Part A & B services other than paying your monthly premium.
What Does Medicare Supplement Plan C Cover?
The CMS, a federal agency, regulates the Medigap industry. You get the same benefits in a Plan C policy from Humana as you do from a Plan C policy with Cigna or Blue Cross Blue Shield.
Medicare Plan C offers excellent coverage for Part A & B benefits. You don’t have any out-of-pocket limit on your benefits, giving you comprehensive coverage for the following.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
- Part A deductible.
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
What Isn’t Covered by Medicare Supplement Plan C?
As mentioned, the only thing Plan C doesn’t cover is Part B excess charges incurred from seeing doctors charging more than Medicare-approved rates.
Plan C doesn’t cover the costs of cosmetic or preventative treatments. So, services from the chiropractor, physio, and acupuncture therapist are only covered if motivated by a doctor for medical recovery.
Plan C doesn’t cover dental, hearing, or vision services, nor does it cover private-duty nursing or stays at nursing homes.
You also don’t have coverage for prescriptions.
What are the Average Monthly Premiums for Medicare Supplement Plan C?
The costs of a Plan C policy vary between providers and states. The average premium for Plan C across all providers and locations in the United States ranges between $140-$420 per month for 2024.
While the CMS regulates the benefits offered in Medigap plans, it has no say over what healthcare insurers can charge for these policies.
As a result, the cost of a Plan C policy in New York might be higher than a Plan C policy in Louisiana.
Likewise, you might find premiums for a Plan C policy are more expensive in your state if you use a provider like Humana and cheaper if you use Aetna.
However, in other states, Aetna might be the more expensive option, and Humana the more affordable provider.
That’s why getting quotes on your premiums from more than one provider is important before settling on the right insurer for your Plan C policy.
Is Medicare Supplement Plan C Available in Massachusetts, Minnesota, or Wisconsin?
Medigap Plan C is not available in Minnesota, Massachusetts, or Wisconsin. These states have Federal waivers allowing them to standardize Medigap plans differently from other states.
As a result, you have a Basic plan, Basic with riders, Extended Basic, and Medigap plans F, K, L, M, and N. There is no option for Plan C from any insurer.
How Do You Enroll in Medicare Supplement Plan C?
Medigap Plan C, like Plan F, is only available if you’re eligible for Original Medicare before January 1, 2020.
The Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA, states that Medigap plans can no longer provide coverage for the Part B deductible.
If you’re newly eligible for Medicare and Medigap, you don’t have the option for Plan C available to you.
However, if you were eligible for Medicare before the cut-off date, you qualify for a Plan C policy.
A Medigap agent can assist you with understanding your “guaranteed issue rights” to a Plan C policy.
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What are the Best Alternatives to Medicare Supplement Plan C?
If you don’t qualify for Medigap Plan C, your next best option is Plan G. Plan G, which offers all the same benefits as Plan C and covers Part B excess charges.
However, Plan G doesn’t cover the Part B deductible. Plan G is available in a standard version and a high-deductible plan.
With the high-deductible version, your Part A deductible increases from $1,600 to $2,700 in 2023. However, you get a huge reduction in monthly premiums.
If you’re a healthy senior, you can benefit from the cost savings in Plan G while maintaining near-comprehensive medical emergency coverage.
Call Us to Learn More About Medicare Supplement Plan C
If you have questions surrounding Medicare supplement Plan C, call our team at 1-888-891-0229.
Our fully licensed agents offer a free consultation and quote on Plan C. If you’re eligible, we can explain your guaranteed issue rights to a Plan C policy.
If you can’t talk to us right now, leave your contact details on our web form, and we’ll get a Medigap professional to call you back. Or use the free tool on our site to get an automated quote on Plan C or any other Medigap policy.
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Frequently Asked Questions
What is Medicare Supplement Plan C?
Medicare Supplement Plan C is an insurance policy that helps cover the gaps in Original Medicare. It provides additional coverage for out-of-pocket costs such as deductibles, coinsurance, and copayments.
What does Medicare Supplement Plan C cover?
Medicare Supplement Plan C covers a range of benefits, including Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayments, and the Part A deductible. It also covers skilled nursing facility coinsurance and emergency medical care during travel abroad.
Is prescription drug coverage included in Medicare Supplement Plan C?
No, Medicare Supplement Plan C does not include prescription drug coverage. To obtain prescription drug coverage, you need to enroll in a separate Medicare Part D plan.
Can I see any doctor or specialist with Medicare Supplement Plan C?
Yes, Medicare Supplement Plan C allows you the flexibility to choose any doctor or specialist who accepts Medicare. There are no network restrictions, giving you the freedom to seek care from your preferred healthcare providers.
How does Medicare Supplement Plan C differ from Plan B?
Medicare Supplement Plan C offers the same benefits as Plan B but with additional coverage for the Part A deductible. This makes Plan C more comprehensive and can provide greater financial protection.
Are pre-existing conditions covered under Medicare Supplement Plan C?
Yes, Medicare Supplement Plan C covers pre-existing conditions. During the Medigap Open Enrollment Period, insurance companies cannot deny coverage or charge higher premiums based on pre-existing conditions.
Can I switch from Medicare Supplement Plan C to another plan?
Yes, you can switch from Medicare Supplement Plan C to a different plan at any time. However, you may need to go through medical underwriting, and approval is not guaranteed if you have pre-existing conditions.
How much does Medicare Supplement Plan C cost?
The cost of Medicare Supplement Plan C can vary based on factors such as your location, age, gender, and health status. It’s important to compare plans from different insurance companies to find the best rates and coverage that suit your needs.
Does Medicare Supplement Plan C cover medical expenses outside the United States?
Yes, Medicare Supplement Plan C provides coverage for emergency medical care during travel abroad. However, the coverage is limited, and it’s recommended to consider additional travel insurance for more comprehensive coverage.
Is Medicare Supplement Plan C the right choice for everyone?
Medicare Supplement Plan C may be a suitable choice for individuals who want comprehensive coverage, including coverage for the Part A deductible. However, it’s important to assess your healthcare needs, budget, and compare different Medigap plans to make an informed decision that best suits your situation.
Find the Right Medicare Plan for You
Discovering the best fitting Medicare plan doesn’t have to be confusing. Whether it’s a Medigap plan, or you have questions about Medicare Advantage or Medicare Part D, we can help.
Call us today at 1-888-891-0229 and one of our knowledgeable, licensed insurance agents will be happy to assist you!
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.