Why Choose Medigap Plan C

  • It is the 2nd most comprehensive plan, second only to Medigap Plan F.
  • It gives you predictable out of pocket expenses. You can essentially budget for health care at the start of the year by simply multiplying the premium by 12.
  • You can go to any doctor or hospital - there are no networks. A standardized Medicare supplement Plan C can be used anywhere that takes Medicare.
  • Coverage and claim payments are standardized. All companies pay claims through the Medicare "crossover" system.
  • It is easy to compare "like" plans. When comparing plans, a Plan C with one company is the exact same coverage as a Plan C with another company.
  • Benefits will never change on Plan C unless you change insurance. It, like all Medicare Supplement plans, is "guaranteed renewable" and is a contract. Once you sign up for a Plan C, the contracted benefits will stay the same.
  • Plan C is offered on a Federally-mandated "Guaranteed Issue" basis in some situations (i.e. losing employer coverage, losing Advantage plan coverage, etc.).

 

Medigap Plan C

Medigap Plan C is the 2nd most comprehensive Medigap plan available. There are a total of 10 standardized plans, which all companies can offer. Most companies do not offer all 10, and many companies choose to offer either Plan C or Plan F, which is the top level of coverage. This is because the two plans are extremely similar, with only one benefit difference. Plan F pays everything that Medicare Parts A & B do not cover, so that you do not have any out of pocket costs. Plan C does the same thing, except that it does not cover the Medicare Part B Excess charges. Excess charges are very rare and only occur when a doctor does not accept Medicare "assignment" (the Medicare-approved amount for a service or procedure). Because the plans are this similar, there is typically not a lot of difference in price. When deciding between the two, it is advisable to obtain a Medigap Plan F comparison.

Medigap Plan C has been a fairly popular plan, where it is offered. However, many companies do not offer this plan at all. Out of the ones that do, they typically just offer C (and not F). Overall, though, it is usually a good option for someone who wants comprehensive coverage with little, or in most cases NO, out of pocket expenses.

What Does Plan C cover?

Before you start comparing rates and companies that offer Plan C, you must first understand what the plans cover to make sure that Plan C is the right option for you. Because it is one of the top Medicare Supplement coverage plans available, it is a great starting point when you are considering the plans. From there, you can see what benefits you need, or can live without, and look at other plan options as well. Here is a list of benefits that are included on the Medigap Plan C:

  • Basic Benefits, including 100% Part B coinsurance. Basic Benefits also encompasses Part A coinsurance (the 20% that Medicare doesn't cover), plus coverage for an additional 365 days after Medicare benefits end.
  • Blood - Plan C covers the first three pints of blood each calendar year.
  • Hospice - Plan C covers the Medicare Part A coinsurance (20% that Medicare doesn't pay) for these services.
  • Skilled nursing facility coinsurance. The plan covers the 20% that Medicare doesn't pay for a skilled nursing facility.
  • The Medicare Part A deductible. For 2013, this deductible is $1,184/benefit period. The Plan C covers this deductible.
  • The Medicare Part B deductible. For 2013, this deductible is $147/year. The plan also covers this deductible.
  • Foreign Travel Emergency. Plan C covers medically necessary emergency care services beginning during the first 60 days of each trip outside the USA. There is a separate $250 deductible on these charges and a $50,000 lifetime limit.

How Does Medigap Plan C Work?

The Medigap Plan C is a standardized Medicare Supplement plan. As such, it works just like all Medicare Supplement plans do. First and foremost, benefits are provided through the private company, as a supplemental (or secondary) to Medicare. A Medigap Plan C will automatically pay claims through the Medicare "crossover" system for Medicare-covered services. Because of the comprehensive coverage offered under this plan, you will not be subject to the Medicare co-pays, deductibles, and coinsurance. The only thing that Plan C does NOT cover are Part B excess charges. These are very rare and only occur when a doctor does not accept Medicare "assignment". If you are considering Plan C, it is advisable to check with your primary doctor to see if he or she accepts "assignment". Approximately 99.5% of doctors do, but with one simple phone call, you confirm this for peace of mind. NOTE: PA and OH prohibit doctors that take Medicare from charging more than the "Medicare-approved" amount ("Part B Excess Charges"). So, if you are in one of those states, 'C' should be the same as 'F' for the purposes of any in-state doctor visits.

It is important to understand that Plan C is different from the part of Medicare called Part C. Many people get confused between the "parts" of Medicare and the supplement "plans". PART C is a part of Medicare that replaces Medicare A & B - it is known as Medicare Advantage. These plans are privatized insurance plans that take the place of Medicare. If you have a Medicare Advantage, you cannot have a supplement. These plans have a system of co-pays and deductibles and doctor networks that you would need to use in order to have coverage.

Where Can I View the Benefits of Plan C?

The standardized plans chart is the Federally-published and mandated chart that all companies must go by. You can view it here: Medigap Coverage chart.
On this chart, you can see exactly what each plan covers, and you can compare easily between plans. As you can see, Plan C covers everything except the Part B excess charges, which are discussed above.


Frequently Asked Questions about Plan C

While benefits are Federally-standardized and specifically spelled out in the Medigap coverage chart, some people do still have questions about how the plan works or what it covers. It can be helpful to get a Medigap Plan F comparison to aid in understanding how this plan works and what it costs. Here are some of the most frequently asked questions about this plan:

  • When can you enroll in a Medigap Plan C?

    There are no enrollment periods for Medicare Supplement plans. You can enroll in any Medicare Supplement plan at any time; however, there are certain times that are better than others for doing so. First and foremost, the "open enrollment" period that everyone is given surrounding their 65th birthday or their enrollment in Medicare Part B. This is, without a doubt, the optimal time to enroll in a Medicare supplement plan, and when you are in this period, it is very important to take advantage of it as it can be your only chance to get a supplement plan. This period lasts for 6 months and begins on the first day of the month that they are both age 65 and enrolled in Medicare Part B. The second time that you should know about, as far as signing up for a Medicare Supplement plan, is "Guaranteed Issue". These are periods that apply if you are in a certain situation, such as leaving/losing employer coverage, losing a Medicare Advantage plan coverage, or leaving a plan's service area. For more specifics and to find out if you are in one of these periods, please contact us using our website - Medicare Supplement.

  • If coverage is the same, why are rates so different?
  • This is the most common question we get when looking at Medicare supplement plans. Just like anything else on the free market, Medicare Supplement plan C is priced completely by the company selling it. They can set the rates however low or high they want. Now, that said, state departments of insurance do have to approve rates before they are offered to the public, but these rates are set entirely by the insurance companies. One factor that impacts this is that different companies target different areas, different plans and different age groups. Moreover, different companies have varying amount of administrative or overhead costs, and this most certainly has some influence on how they set rates. Lastly, some companies do not "have" to be competitively priced to acquire customers, simply because so many people do not "shop" for their supplemental plan or compare other options. While there will be some companies that you have heard of and some that you have not, that will have competitive pricing, the most important thing is to base your decision primarily on price. Everything else is standardized. There is absolutely no reason to pay more for the same thing, unless you just have the extra money to do so.

  • How Can I Compare Rates from Multiple Companies for Plan C?
  • You can certainly call the insurance companies directly and set up appointments to discuss their plans (most companies don't give out rates over the phone or publish their rates online). However, comparing rates does not have to be that hard. No matter who it is, it is highly advisable to use an independent agent or broker. This way, you can compare all rates in a centralized place in an unbiased way. Also, it does not cost you anything to do this. The costs for agents are built into the premiums that you would pay anyway. You can compare Medigap Plan C quotes on our website by clicking the link. This way, you can compare multiple quotes from the top companies for your area, in a centralized, unbiased place. It would also be helpful, to aid in your comparison of Plan C, to obtain a Medigap Plan F comparison.

To get a rate quote comparison from us, simply request the information online using: Medicare Supplement Quotes. We can provide the information you are seeking so you can compare multiple quotes in a centralized place.