What Is Medigap Plan C?

A Medigap Plan C is a health insurance plan covering almost all of Original Medicare's coinsurance requirements, except for excess charges relating to Medicare Part B. Medigap Plan C is also known as Medicare Supplement Insurance Plan C.  As of January 1, 2020, Medigap plans sold to people new to Medicare can no longer cover the Medicare Part B deductible.  Because Medigap Plan C covers the Part B deductible, this plan is no longer available to people new to Medicare on or after January 1, 2020.

It's important to realize that Medigap Plan C is not Medicare Part C (Medicare Advantage). These are two unique plans with different levels of coverage included. 

Health Plans of NC, Kelly Quinn
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A Medigap Plan C is a health insurance plan covering almost all of Original Medicare's coinsurance requirements, except for excess charges relating to Medicare Part B. Medigap Plan C is also known as Medicare Supplement Insurance Plan C.  As of January 1, 2020, Medigap plans sold to people new to Medicare can no longer cover the Medicare Part B deductible.  Because Medigap Plan C covers the Part B deductible, this plan is no longer available to people new to Medicare on or after January 1, 2020.

It's important to realize that Medigap Plan C is not Medicare Part C (Medicare Advantage). These are two unique plans with different levels of coverage included. 

What Medigap Plan C covers

If you choose a Medicare Part C plan, it typically provides coverage for the following: 

Medicare Part A 

  • copayments for hospice care 

  • hospital coinsurance 

  • the hospital costs up to 365 days after you have depleted your Original Medicare benefits

  • deductible

Medicare Part B 

  • copayments 

  • deductible

In addition, Medigap Plan C covers you for foreign travel emergency medical costs (80% of approved costs up to plan limits). You also have coverage for the first three pints of blood required for medical procedures and coinsurance for skilled nursing facility care. 

Coverage for Medicare Part B excess

Medigap Plan C doesn't provide any coverage for Medicare Part B excess charges. To understand how Medicare Part B excess charges work, you need to understand Medicare assignment, which is the cost Medicare has approved for a particular health service. Any provider who is Medicare-approved accepts Medicare assignment.

Providers who don't accept Medicare assignments can charge more than what Medicare has approved for the Medicare service. Any costs above the Medicare-approved amount are your Part B excess, which you're responsible for paying. For example, some doctors may charge up to 20% above the approved Medicare amount. 

How much does Medigap Plan C cost?

Private insurance carriers sell Medigap plans. Therefore, your premium will vary depending on the insurance provider. However, your basic benefits must be the same for your Medigap Plan C policy, regardless of the insurance provider. 

Enrolling in Medigap Plan C

You can enroll in different Medigap plans offering various benefits during your Medicare Supplement Open Enrollment Period. This period lasts for six months and starts when you first enroll in Medicare Part B. Taking advantage of this enrollment period means that you can enroll in a plan no matter what your health status. You also won't have to undergo any waiting periods, and you won't face higher premiums even if you have any pre-existing health conditions. 

You do need to live within the plan's service area, so talking to a Medigap agent specializing in North Carolina is a great idea to ensure you're choosing the right strategy. It's also essential to enroll when you're eligible, as it's a one-off enrollment period. If you miss it, you won't be able to take advantage of these benefits again.

Need help choosing the right Medigap plan?

If you've got questions about Medigap plans and which one is suitable for you, our experienced and local health insurance agents can help. We often get asked questions like 'What is the difference between Medicare Part C and Medigap' and can help provide straightforward advice that’s right for you. 

We specialize in helping people living in North Carolina find the right health plan for their health needs and budget. If you want help to compare Medigap policies in your local area, get in touch with us today or compare plans online. 

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