Medicare Supplement Plan C
Medicare Supplement (Medigap) Plan C is no longer available to new Medicare enrollees — you had to be eligible before January 1, 2020 to buy Plan C. But people already enrolled in Medigap Plan C before that date can keep their policy.
What Is Medicare Supplement Plan C?
Medicare Supplement Plan C — also known as Medigap Plan C — was a Medigap plan that covered a majority of your out-of-pocket expenses if you had Original Medicare. The only thing it did not cover was excess charges — what doctors could charge you over and above what Medicare approved for a medical service.
Medigap Plan C was discontinued effective January 1, 2020. Anyone who had a Plan C policy before then is able to keep it. But no one who became eligible for Medicare after that date is eligible to purchase a Medigap Plan C policy.
If you became eligible for Medicare on that date, you may still be eligible to purchase a Medigap Plan C policy in some cases. You would have to check with an insurer that sells Medigap policies.
Though no longer available to newly eligible Medicare enrollees, there are still eight other standardized Medicare Supplement plans available in most states. It’s wise to compare Medigap plans available in your state before deciding on which one may be the best fit for your health and financial situation.
What’s the Difference Between Medicare Part C and Medigap Plan C?
Medigap Plan C should not be confused with Medicare Part C — better known as Medicare Advantage. These are two different and distinct health insurance policies.
- Medicare Part C
- Medicare Part C is best known as Medicare Advantage. Medicare Advantage plans are sold by private insurers and replace Original Medicare — Medicare Part A and Part B. Original Medicare is federal health insurance administered by the United States government. Medicare Advantage plans are available for purchase. They cover everything Original Medicare covers in addition to benefits such as prescription drug coverage and hearing, dental and vision benefits.
- Medigap (Medicare Supplement) Plan C
Medigap Plan C was a Medigap policy sold by private insurers to cover most out-of-pocket expenses related to Original Medicare.
Medigap plans — such as Medicare Supplement Plan C — were designed to fill the out-of-pocket cost “gaps” you have with Original Medicare. You can buy a Medigap plan if you have Original Medicare, but you cannot have both a Medigap plan and a Medicare Advantage plan at the same time.
What Does Medigap Plan C Cover?
For those who purchased a Medigap Plan C policy before they were discontinued, their policy still covers nearly every out-of-pocket cost associated with Original Medicare.
- Medicare Part A coinsurance and costs for 365 days after your Medicare benefits are exhausted
- Medicare Part A hospital insurance deductible
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part B medical insurance deductible
- Medicare Part B coinsurance (typically 20 percent of Medicare approved cost of services, items or tests)
- Medicare Part B copayment (a fixed dollar amount usually set by a health care provider)
- The first three pints of blood necessary for a medical procedure each calendar year
- Skilled nursing facility care coinsurance
Medigap Plan C also covered 80 percent of the foreign travel emergency cost — up to your plan’s limits — if you needed medical care while traveling outside the United States.
The only out-of-pocket expense that Medigap Plan C does not cover is your excess charge. This is the maximum amount a doctor can charge you. It’s currently set at 15 percent above the Medicare-approved cost for services.
Medigap Plan C policies were popular in states that did not allow excess charges.
What Is the Difference Between Medigap Plan C and Plan F?
Medigap Plan C and Medigap Plan F are similar Medicare Supplement insurance plans. The only difference is that Plan F covered the excess charge, whereas Plan C did not.
Both Medigap Plan C and Plan F were discontinued at the same time to discourage people from making unnecessary visits to doctors’ offices.
These were the only two Medicare Supplement plans that covered the Medicare Part B deductible. It was believed that if new Medicare enrollees were required to pay out of pocket until they met their Part B deductible — $233 in 2022 — people would not visit a doctor for minor problems.
5 Cited Research Articles
- U.S. Centers for Medicare & Medicare Services. (2020). Medicare & You 2021. Download. Retrieved from https://www.medicare.gov/sites/default/files/2020-12/10050-Medicare-and-You_0.pdf
- Bunis, D. (2020, July 6). Medigap Plans Help Bridge Gap of Original Medicare Costs. Retrieved from https://www.aarp.org/health/medicare-insurance/info-2017/choosing-right-medigap-plan.html
- U.S. Centers for Medicare & Medicare Services. (2020, February). Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf
- U.S. Centers for Medicare & Medicare Services. (n.d.). How to Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
- U.S. Centers for Medicare & Medicare Services. (n.d.). What’s Medicare Supplement Insurance (Medigap)? Retrieved from https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap