The Medicare Supplement Plan C (Medigap Plan C) is one of the more popular Medigap Plans. Original Medicare does not provide coverage for all healthcare, which is one reason that many Medicare beneficiaries search for other options, including Medigap Plans. Gaining an understanding of Medigap Plans, including what each plan covers, such as Medigap Plan C, is an important step before you purchase any optional Medicare Supplement plans.
What is Medicare Part C? (Don’t confuse it with Medicare Plan C)
Medicare Part C is a popular Medicare plan commonly called Medicare Advantage plans for several reasons:
- If you decide to join a Medicare Advantage plan, that plan provides all of your Medicare Part A, or hospital insurance coverage, along with your Medicare Part B, or outpatient doctor medical insurance coverage.
- Medicare Advantage plans may provide extra coverage that is not offered by Original Medicare, such as dental and vision coverage or coverage for hearing aids and wellness programs. Some plans provide prescription drug coverage.
- Although Medicare Advantage plans are sold by private insurance companies, Medicare must approve the companies that sell Advantage plans. The companies are also required to follow the rules set by Medicare.
- Medicare Advantage providers sell their policies with other rules that each person abides by when they have the Medicare Part C Plan. The insurance companies can charge different out-of-pocket costs. They may have strict rules for how individuals get their services. One example is that you may have to get a referral to see a specialist.
Medicare Part C is not the same as Medigap Plan C.
What is Medigap Plan C?
Medicare indicates that the Medicare Supplement plans cover the gap between what Original Medicare covers and the out-of-pocket charges paid by Medicare beneficiaries. One of these plans is Medigap Plan C.
Medigap Plan C is a popular plan because it offers comprehensive coverage for individuals who decided to choose this option for their Medicare Supplement Plan. Medigap plans pay some remaining health care costs, such as coinsurance, copayments and deductibles. Medicare pays their share, then the Medigap plan pays its share of the cost of your healthcare.
Medigap Plan C covers 100% of the Medicare Part A coinsurance and hospital costs, up to an additional 365 days after Medicare benefits are used by the Medicare beneficiary. Some other Medigap Plan C coverage benefits include:
- Part B coinsurance or copayment.
- First three pints of blood.
- Part A hospice care copayment or coinsurance.
- Part A deductible.
- Skilled nursing care coinsurance.
- 80% of foreign travel emergency care.
Is It True that New Medicare Beneficiaries Cannot Enroll in Medigap Plan C?
Yes, it is true that new enrollees cannot enroll in the Medicare Supplement Plan C. There were recent changes to Medigap, the changes to Medigap plans came about because of legislation passed in 2015, which was to take effect in January 2020.
The legislation, called the Medicare Access and CHIP Reauthorization Act, included a rule that Medigap plans were no longer allowed to cover the Medicare Part B deductible. Medigap Plan C provided coverage for the Part B deductible, so it was discontinued in 2020. The Medigap Plan F also provided Part B deductible coverage, and was discontinued along with Plan C.
What Does the Discontinuation of Plan C Mean for Medicare Beneficiaries?
If you were enrolled in Medigap Plan C prior to the 2020 changes you are still allowed to keep your Medicare Supplement Plan C coverage.
If you are new to Medicare beginning in 2021, you cannot purchase Medigap Plan C. There are several other Medigap plans available for those who are new to Medicare and who want to purchase an optional Medicare Supplement plan.
- What is Medicare Part C?, HHS.
- What’s Medicare Supplement Insurance (Medigap)?, Medicare.
- Choosing a Medigap Policy, Medicare.