Medigap Plan C — not to be confused with Medicare Part C (Medicare Advantage) — covers nearly all of Original Medicare’s coinsurance requirements, besides Medicare Part B’s excess charges (if that’s not restricted in your state).
Medigap Plan C is also known as Medicare Supplement Insurance Plan C.
Medigap Plan C Coverage
Medicare Supplement Insurance Plan C usually covers the following:
- Medicare Part A hospice care copayments
- Medicare Part B copayments
- Medicare Part A hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are depleted
- Medicare Part A deductible
- Medicare Part B deductible
- First three pints of blood for a medical procedure
- Skilled Nursing Facility care coinsurance
- Foreign travel emergency (80% of approved costs up to plan limits)
What Medigap Plan C Doesn’t Cover
Medigap Plan C doesn’t cover Medicare Part B excess charges. These are doctor costs that can legally expand outside of what Medicare approves for the service payment amount. When excess charges arise, the rest of the cost is put on the patient’s account. For example, a doctor may be permitted to bill up to 15% above the Medicare-approved amount in certain cases.
Medigap Plan C Costs
Since Medigap plans are sold by private insurance carriers, the premiums may vary. However, each Medigap Plan C policy must have the same basic benefits.
When to Enroll in Medigap Plan C
If you register during your six-month Open Enrollment Period (OEP), most of the time the insurance carrier has to accept your application. In most cases, they can’t charge you extra if you’re in poor health, and they can’t enforce a waiting period even if you have a prior health condition.
Your Medigap OEP begins the month that you’re at least 65 and enrolled in Medicare Part B. You’re required to live within the plan’s service area.
If you apply outside your OEP, the insurer may have you go through medical underwriting and may not accept you as a member. However, in some cases you may have a guaranteed issue right to enroll in a Medigap Plan C policy.
Cornerstone Senior Advisors Can Help
Availability and plan costs may differ. If you’re looking to compare Medigap policies that are available in your area, Cornerstone Senior Advisors can help. Call (316) 260-3331 to learn more!