When navigating Medicare, it’s important to understand the difference between Medicare Plan C and Medicare Part C. While the terms may sound similar, they represent two very different things. Medicare Supplement Plan C (commonly called Medigap Plan C) is a supplemental insurance policy, while Medicare Part C refers to Medicare Advantage plans.
Medicare Supplement Plan C is one of the ten standardized Medigap plans that help cover some of the out-of-pocket costs not paid by Original Medicare. If you became eligible for Medicare before January 1, 2020, you may be eligible to purchase Plan C and take advantage of its extensive coverage.
What Does Medicare Supplement Plan C Cover?
Medigap Plan C is designed to fill nearly all the gaps in Original Medicare (Parts A and B). Here are some of the key benefits it provides:
- Part A Deductible: Covers the full cost of the Part A deductible, so you won’t have to pay out-of-pocket for hospital stays.
- Part B Deductible: Plan C pays your Part B deductible, which covers doctor visits and outpatient services.
- Coinsurance and Copayments: Plan C covers your Part A and Part B coinsurance, meaning you won’t have to worry about paying a percentage of the costs for covered services.
- Skilled Nursing Facility Care: If you need care in a skilled nursing facility, Plan C helps cover your share of the costs.
- Foreign Travel Emergencies: If you’re traveling outside the U.S., Plan C will help cover emergency medical care, making it a great option for frequent travelers.
The only gap that Medicare Supplement Plan C doesn’t cover is Part B excess charges. These are additional fees that some doctors charge above the Medicare-approved amount, which can be up to 15% more than what Medicare will reimburse. If avoiding these excess charges is important to you, you may want to consider Medigap Plan F or Plan G, both of which cover these charges.
Who is Eligible for Medicare Supplement Plan C?
Medigap Plan C is only available to people who became eligible for Medicare before January 1, 2020. This is because new Medicare enrollees after this date are no longer able to purchase plans that cover the Part B deductible, such as Plan C or Plan F. However, if you became Medicare-eligible before 2020, you can still apply for Plan C.
Understanding Plan C and Part C
It’s important to clarify that Medicare Plan C (Medigap) is not the same as Medicare Part C (Medicare Advantage). Medigap Plan C is supplemental insurance that works with Original Medicare, while Part C refers to Medicare Advantage, which is an alternative to Original Medicare. Medicare Advantage plans operate more like traditional health insurance and often have networks of providers. In contrast, Medigap Plan C allows you the freedom to see any doctor or visit any hospital that accepts Medicare.
Example: How It Works
To illustrate how Plan C works, consider this scenario:
Mike, a Medicare beneficiary, has Medigap Plan C. Most of Mike’s doctors accept Medicare assignment rates, meaning he typically owes nothing for his medical services. However, one day Mike injures his ankle and visits an urgent care clinic that doesn’t accept Medicare assignment. The clinic charges a 15% excess charge on top of the Medicare-approved amount for an X-ray. While Medicare would cover the standard $50 fee for the X-ray, the clinic charges $57.50 due to the excess charge. Since Plan C doesn’t cover excess charges, Mike will owe the $7.50 difference.
Should You Choose This Plan?
If you live in a state that doesn’t allow doctors to charge excess fees, Plan C can provide nearly the same level of coverage as Plan F, making it an attractive option. However, in areas where excess charges are allowed, you may want to consider comparing Plan C with other Medigap options, such as Plan G or Plan N, which might offer more comprehensive or cost-effective coverage based on your needs.
For those who are concerned about excess charges or prefer more robust coverage, Plan F or Plan G might be a better choice. In many cases, the difference in premiums between these plans is small, so it’s worth exploring all your options.
Comparing Medigap Plan C Rates
There are many insurance carriers that offer Medicare Supplement plans like Plan C. Some are well-known national brands, while others are smaller but equally reputable companies with solid financial ratings. You can often find significant savings by comparing quotes from different carriers.
At Medicare Mall, we help you compare prices from various insurance companies to find the most cost-effective option for your Medigap plan. Don’t miss out on the opportunity to save money while securing the coverage you need.
Still unsure if Medigap Plan C is right for you? Contact us at (817) 249-8600 for a FREE consultation. Our team is here to help you compare quotes, review your options, and find the plan that best fits your healthcare needs and budget.