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Medicare Supplement Plan C: What Is Covered?

There are many Medicare supplement plans available. One of those is Plan C, also known as Medigap Plan C. This supplement plan covers costs that Original Medicare leaves behind. These costs include skilled nursing facilities and deductibles. Medigap plans do not cover all healthcare costs, and beneficiaries are responsible for any charges left over after Original Medicare and Medigap. Read on to see if Medicare Supplement Plan C is right for you.

Key takeaways:

What is Medicare Supplement Plan C?

Medicare Supplement Plan C is one of the most comprehensive Medigap plans available. The only Medicare supplement plan that provides more coverage is Medicare Part F, which is also no longer available for purchase by anyone new to Medicare. Having Medicare Plan C coverage can save consumers money as it provides more coverage than Original Medicare does with low to no monthly premiums. Medigap plans are standardized, and while the cost of the premiums is dependent on multiple factors, coverage remains the same.

To purchase a Medigap plan, you must first be enrolled in Original Medicare. Each policy only covers one person and is automatically renewed if premiums are paid. Per Medicare guidelines, a Medigap policy can only be canceled if the premium is not paid, if you were not truthful on your application, or if the company you purchased your plan through goes bankrupt.

How does Medigap Plan C work?

Medigap plans are Medicare supplement plans that “fill in the gaps” of Medicare coverage. Medicare A/B does not cover all healthcare costs, such as deductibles, co-insurance, and excess charges. Purchasing Medigap Plan C can help with these costs. Medigap plans are not the same as Medicare Advantage and you cannot have them both. If you purchase an MA plan, it becomes your primary insurance whereas Medigap plans are supplemental to Original Medicare. Like MA plans, Medigap plans are purchased through a private company and come with monthly premiums.

What does Medicare Supplement Plan C cover?

Medigap plans are standardized. This means that no matter what insurance company offers the plan, the benefits must remain the same. Not only does Medigap Plan C cover everything that Original Medicare does, but it also offers the following benefits:

  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible
  • 80% of foreign travel exchange
  • No out-of-pocket limit

If you purchased your Medigap Plan C before 2005, you may receive prescription drug coverage with it. In these cases, the insurance company you purchased your plan through must send you an annual notice informing you if your prescriptions are creditable. After 2005, a Medicare Supplement Plan D will need to be purchased for prescription drug coverage.

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Services not covered by Medicare Supplement Plan C

Medigap plans do not cover all healthcare costs. Medicare Supplement Plan C does not cover Medicare Part B excess charges. This charge occurs if your medical provider charges you more than what is approved by Medicare. They also only provide 80% coverage for foreign travel emergencies. This is the cost of healthcare should you need it while traveling abroad. Travelers insurance should be purchased for any travel outside the country. Clinical trials, prescription drugs, dental, vision, hospice services, and cosmetic procedures are also not covered by Medigap Plan C.

Should I consider choosing Medicare Supplement Plan C?

One of the biggest things to consider when choosing Medicare Supplement Plan C is cost. While there is a monthly premium for Medicare Supplement Plan C, the cost of the premium may be lower than the cost of not having a supplement plan. Someone in need of skilled nursing facility care can also greatly benefit from having this supplement plan as it covers the cost of that care.

When deciding on a supplement plan, it’s important to remember that no Medicare Supplement Plan covers all healthcare costs. Speak with your insurance broker to help decide what plan is right for you.

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