Are you are new to Medicare? Are you are still researching how the federal government’s health care plan will impact your life after age 65? If you answered yes to either of these questions, you might want to familiarize yourself with Medicare Supplement Plan C. Medicare supplement plans do exactly what their name suggests — they supplement existing coverage from original Medicare Parts A and B in order to fill in the gaps that patients sometimes experience between the services they need and the coverage they’re given by Medicare. For this reason, Medicare Supplement Plans are also called Medigap Plans.
There are 10 different types of Medigap plans. These are administered by private insurance companies under guidelines provided to them by the United States government. Medicare Supplement Plan C (or Medigap Plan C, if you prefer) is one of the best supplement plans in terms of coverage. Of the 10 approved Medigap supplement plans, only Plan F offers more coverage than Plan C. However, Plan C typically covers all of your out-of-pocket health expenses as long as they are approved by Medicare.
What Plan C Covers
Before we get into the specifics of what Medigap Plan C covers, it is important to point out that Medigap Plan C is not the same as Medicare Part C (also known as Medicare Advantage). With that out of the way, let’s get into specifics.
Medicare Supplement Plan C covers:
- Medicare Part A hospital costs and co-insurance up to one year after Original Medicare (Part A or Part B) benefits are exhausted
- Medicare Part A hospice co-payments and co-insurance
- Medicare Part B co-payments and co-insurance
- the first three pints of blood for a medicinal procedure
- skilled nursing facility co-payments and co-insurance
- the Medicare Part A deductible
- the Medicare Part B deductible
- foreign travel emergency coverage up to 80% of the approved plan limit costs
Medicare Supplement Plan C (Medigap Plan C) does not cover Medicare Part B excess charges. Excess charges are doctor or specialist fees that may extend past the Medicare-approved amount for reimbursement or payment. If your doctor or specialist bills you for excess charges, the cost is your responsibility since Medicare will not cover them. Generally doctors are allowed to bill a percentage over the Medicare-approved amount for some services, so be sure to ask your doctor for a thorough explanation of costs and your payment responsibilities before you schedule a visit or a procedure.
What Plan C costs
How much will a plan cost? Medicare Supplement Plan C costs are beyond the scope of this document, simply because there are so many available plans sold by numerous third-party insurance companies. While each Plan C offering must meet federal standardization requirements, monthly premium costs may vary based on a number of factors including your location, your age and health conditions, your sex, and more. To help you discover which of these many plans is best for you, we can connect you with an insurance representative.
After you have selected an appropriate Medigap Plan C offering that meets your individual health care needs, you should enroll during the six month Open Enrollment Period. If you do so, the insurance company must accept your application and can not deny you coverage or charge you more for coverage even if you are already in poor health. They also cannot impose a waiting period before your coverage begins. The six month Open Enrollment Period begins on the first day of the month after you are at least 65 years old and enrolled in Medicare Part B. If you miss the open enrollment period, you may be subject to medical underwriting and the insurance company that administers the Plan C you have chosen may decline to offer you coverage. Speak with a local insurance provider to obtain pricing and availability information.
You may also want to contact Medicare directly if you have questions about how Medigap coverage functions with your existing Original Medicare or third-party insurance coverage. Dial 1-800-633-4227 for a Medicare representative. You can compare Medigap Plan C with other Medigap offerings by visiting our other articles.