Medigap Plan C is one of the most comprehensive Medicare Supplement plans available, covering both Part A and Part B deductibles. However, it's only available to people who were eligible for Medicare before January 1, 2020. Here's what Plan C covers and what alternatives are available if you're newly eligible.
Medigap Plan C is a Medicare Supplement Insurance policy that covers almost all of Original Medicare's out-of-pocket costs, including the Part B deductible. It's also known as Medicare Supplement Insurance Plan C.
Important: Don't confuse Medigap Plan C with Medicare Part C (Medicare Advantage). These are entirely different types of coverage. Medicare Part C is an alternative way to receive your Medicare benefits through a private insurance company. Medigap Plan C is supplemental insurance that works alongside Original Medicare to help cover your out-of-pocket costs.
Medigap Plan C is no longer available to people who became eligible for Medicare on or after January 1, 2020.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA), which prohibited Medigap plans from covering the Medicare Part B deductible for newly eligible beneficiaries starting in 2020. Because Plan C covers the Part B deductible, it can no longer be sold to new Medicare enrollees.
You CAN still buy Plan C if:
You were eligible for Medicare before January 1, 2020, even if you didn't enroll at that time
You currently have Plan C and want to continue renewing it
You CANNOT buy Plan C if:
You turned 65 on or after January 1, 2020
You became eligible for Medicare due to disability or ESRD on or after January 1, 2020
If you're newly eligible for Medicare and looking for comprehensive Medigap coverage, see the "Alternatives to Plan C" section below.
Plan C is one of the most comprehensive Medigap plans available. It covers nearly all out-of-pocket costs associated with Original Medicare, providing 100% coverage for:
Medicare Part A (Hospital Insurance):
Part A deductible: $1,676 per benefit period in 2025 ($1,736 in 2026)
Part A coinsurance and hospital costs: Coverage for up to 365 additional days after you've exhausted your Original Medicare hospital benefits
Hospice care coinsurance: Your share of the expenses for hospice care, including drugs for pain management and respite care
Medicare Part B (Medical Insurance):
Part B deductible: $257 in 2025 ($283 in 2026)
Part B coinsurance: The 20% coinsurance for doctor visits, outpatient services, lab work, and other Part B services
Additional Benefits:
Skilled nursing facility coinsurance: $209.50/day in 2025 ($217/day in 2026) for days 21-100 of a covered stay
First three pints of blood: Covers the blood that Medicare doesn't pay for each year
Foreign travel emergency care: 80% of approved costs for emergency medical care outside the U.S., up to plan limits (typically after a $250 deductible and up to a lifetime maximum of $50,000)
Despite being one of the most comprehensive Medigap plans, Plan C does NOT cover:
Medicare Part B Excess Charges:
If a doctor or healthcare provider doesn't "accept Medicare assignment," they can charge up to 15% more than the Medicare-approved amount. These additional charges are called Part B excess charges, and Plan C doesn't cover them.
How excess charges work: Medicare assignment is the amount Medicare has approved for a particular service. Most doctors (about 95%) accept Medicare assignment and agree to charge only the approved amount. However, doctors who don't accept assignment can charge you up to 15% more. For example, if Medicare approves $300 for a procedure, a non-participating provider could charge you up to $345—and you'd owe that extra $45.
Note: Eight states have banned Part B excess charges: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. If you live in one of these states and receive care from local providers, excess charges aren't a concern. However, if you travel or receive care in other states, you could still face these charges.
Prescription Drugs:
No Medigap plan covers prescription drugs. If you need prescription drug coverage, you'll need to enroll in a separate Medicare Part D plan.
Plan C vs. Plan F:
Plan F is the only Medigap plan that covers more than Plan C. It includes everything in Plan C, plus coverage for Part B excess charges. Like Plan C, Plan F is no longer available to people who became eligible for Medicare on or after January 1, 2020.
Plan C vs. Plan D:
Plan D covers everything Plan C covers except the Part B deductible. Plan D is available to everyone and may have lower premiums than Plan C.
Plan C vs. Plan G:
Plan G covers everything Plan C covers except the Part B deductible, but Plan G also covers Part B excess charges (which Plan C doesn't). Plan G is the most popular Medigap plan for people who became eligible for Medicare in 2020 or later.
If you became eligible for Medicare on or after January 1, 2020, you cannot purchase Plan C or Plan F. However, several other Medigap plans offer comprehensive coverage:
Plan G (Most Popular Alternative):
Plan G covers everything except the Part B deductible ($257 in 2025, $283 in 2026). It also covers Part B excess charges, which Plan C doesn't. For many people, Plan G is the best choice because the premium savings compared to Plan C/F often exceed the Part B deductible you pay out-of-pocket.
High-Deductible Plan G:
Some states offer a high-deductible version of Plan G. You pay a higher deductible ($2,870 in 2025, $2,950 in 2026) before the plan pays anything, but premiums are much lower. This option can make sense if you're healthy and want to minimize monthly costs while still having protection against large medical expenses.
Plan N:
Plan N has lower premiums than Plan G but requires you to pay copays of up to $20 for office visits and up to $50 for emergency room visits that don't result in admission. Plan N doesn't cover Part B excess charges. It's a good middle-ground option if you're comfortable with some cost-sharing.
Plan D:
Plan D provides similar coverage to Plan C minus the Part B deductible, but it also doesn't cover Part B excess charges. If you want coverage similar to Plan C and excess charges aren't a concern, Plan D may be a good fit.
Medigap Plan C premiums vary based on several factors:
Your age: Premiums typically increase as you get older
Where you live: Premiums vary by state, county, and even zip code
The insurance company: Different insurers charge different amounts for the same standardized plan
Tobacco use and health history: May affect premiums depending on when you enroll
Plan C premiums are higher than Plans D, G, or N because they cover more benefits, including both the Part A and Part B deductibles. However, the exact premium will depend on your location and the insurance company you choose.
Important: Because Medigap plans are standardized, Plan C benefits are identical regardless of which insurance company sells the policy. The only differences between companies are price and customer service—so it pays to compare quotes from multiple insurers.
Medigap Open Enrollment Period:
The best time to enroll in any Medigap plan is during your Medigap Open Enrollment Period. This one-time, six-month window begins when you're both 65 or older AND enrolled in Medicare Part B. During this period:
Insurance companies cannot deny you coverage based on health conditions
You cannot be charged higher premiums due to pre-existing conditions
There are no waiting periods for coverage to begin
You have guaranteed issue rights to any Medigap plan available in your state (for which you're eligible)
Important: There is no annual open enrollment period for Medigap plans. Your initial six-month window is your best (and often only) opportunity to enroll without medical underwriting. If you miss it, insurance companies can deny you coverage or charge higher premiums based on your health.
For Plan C specifically: Remember that you can only purchase Plan C if you were eligible for Medicare before January 1, 2020. If you qualify, you can enroll during your Medigap Open Enrollment Period or if you have guaranteed issue rights.
Choosing the right Medigap plan can be confusing—especially with Plan C and Plan F no longer available to newly eligible beneficiaries. Our experienced and local health insurance agents can help you understand your options and find the best plan for your needs.
Common questions we answer:
What's the difference between Medicare Part C (Advantage) and Medigap?
Am I eligible for Plan C, or should I consider Plan G or Plan N?
How do I compare premiums from different insurance companies?
Should I choose Medigap or Medicare Advantage?
Do I need to worry about Part B excess charges in North Carolina?