Medicare Supplement Insurance, also called Medigap, is a type of private insurance that is used together with your Original Medicare coverage (Medicare Part A and Part B) to help cover certain Medicare out-of-pocket expenses, such as copays and deductibles.
Medigap Plan C is one of the 10 Medigap plans available in most states, which include Plan A, B, C, D, F, G, K, L, M and N. Each type of Medigap plan offers a different combination of standardized benefits.
Let’s take a look at what Medicare Supplement Insurance Plan C covers and review the average cost of Medigap Plan C.
The average premium cost for Medicare Supplement Insurance Plan C in 2018 was $189.88 per month.1
It’s important to note that Medigap plan costs may vary based on factors such as age, gender, your health, how your insurance carrier rates (prices) its plans, and where you live. The average cost listed above includes Medigap Plan C options that may offer lower premiums than what is listed, as well as some plans with higher premium costs.
You can use the Medigap plans comparison chart below to compare Medigap Plan C benefits to what is covered by other Medigap plans.
|Medicare Supplement Benefits||A||B||C||D||F1||G||K2||L3||M||N4|
|Part A co-insurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Medicare Supplement Insurance Plan C provides 100 percent coverage for each of the following seven benefit areas:
If you are admitted to a hospital for inpatient treatment, Medicare Part A helps cover your hospital costs once you reach your Medicare Part A deductible, which is $1,364 per benefit period in 2019.
For the first 60 days of your hospital stay, you aren’t required to pay any Part A coinsurance.
But beginning on day 61 of your stay, you’re required to make a Medicare Part A coinsurance payment of $341 per day through day 90. After your 90th day in the hospital, you must pay $682 per day for up to 60 more days. Beyond that, you are responsible for all costs.
These coinsurance costs can add up quickly. Medigap Plan C covers 100 percent of your Part A coinsurance costs.
Medicare Part B helps cover costs for things like doctor’s appointments, medical devices and preventive care.
After you meet your Medicare Part B deductible (which is $185 per year in 2019), you are typically responsible for a coinsurance or copay of 20 percent of the Medicare-approved amount for covered services.
For example, if you suffer a foot injury and need to use a wheelchair, Part B will help cover 80 percent of the cost of your wheelchair (after you meet your Part B deductible). For illustration purposes, if it costs $800 to buy the wheelchair and Medicare Part B covers it as durable medical equipment (DME), your Part B coinsurance cost would be $160.
Medigap Plan C would fully cover your $160 Part B coinsurance.
Original Medicare does not cover the cost of the first three pints of blood you might need for a blood transfusion. A pint of blood can potentially cost hundreds of dollars.2
Medicare Supplement Insurance Plan C covers 100 percent of the cost for your first three pints of blood.
Medicare Part A requires a copayment for prescription drugs used during hospice care. You might also be charged a 5 percent coinsurance for inpatient respite care costs.
Medigap Plan C covers 100 percent of your Medicare Part A hospice care coinsurance or copayments.
Medicare Part A requires a coinsurance payment of $170.50 per day in 2019 for inpatient skilled nursing facility stays longer than 20 days. You are responsible for all costs after day 101 of an inpatient skilled nursing facility stay.
Medigap Plan C covers 100 percent of your skilled nursing facility care coinsurance costs.
As mentioned above, the Medicare Part A deductible is $1,364 per benefit period in 2019.
The Medicare Part A deductible is not annual — you could potentially need to meet this deductible more than once in a given year.
Medigap Plan C covers 100 percent of the Medicare Part A deductible.
As mentioned above, the Medicare Part B deductible is $185 per year in 2019.
Medigap Plan C covers 100 percent of the Medicare Part B deductible.
Medicare Supplement Plan C provides partial coverage for the following benefit:
In most cases, Original Medicare does not provide coverage for emergency medical care received outside of the U.S.
Medigap Plan C covers 80 percent of emergency medical care received abroad.
There are a few things to know about Medicare Supplement Insurance Plan C, beyond what it covers.
The basic benefits that are covered by Medigap Plan C are the same, no matter where the plan is sold, or by which carrier.
Medicare Supplement Insurance Plan C could sometimes be mistaken for Medicare Part C. But these are actually two very different things.
Medicare Part C is another name for the Medicare Advantage program.
Medicare Advantage plans provide all the same benefits as Original Medicare. Many Medicare Advantage plans also offer benefits that Original Medicare doesn’t cover, such as coverage for prescription drugs, dental, vision, hearing and more.
Medigap Plan C helps cover some of the out-of-pocket Medicare costs listed above.
Medicare Supplement Insurance does not offer any medical benefits or coverage for prescription drugs and other services. Medigap plans only cover certain Medicare Part A and Part B out-of-pocket costs as outlined above.
Medigap plans and Medicare Advantage plans are very different things. You cannot have a Medicare Supplement Insurance (Medigap) plan and a Medicare Advantage plan at the same time.
Medicare Supplement Insurance Plan C does not offer any coverage for Medicare Part B excess charges.
Doctors who do not accept Medicare assignment reserve the right to charge up to 15 percent more than the Medicare-approved amount for services and items they provide. These costs are called excess charges.
Other Medicare Supplement Insurance plans may cover some or all of the benefits listed above, either partially or in full. Medicare Supplement Insurance Plan F, for example, covers all of them, including Medicare excess charges.
Medicare Supplement Insurance Plan F offers more standardized benefits than the other current Medicare Supplement plans. Because of a new federal law, Plan F and Plan C won’t be available for Medicare beneficiaries who became eligible on or after January 1, 2020.
If you already have Plan C or Plan F before 2020, you will be able to keep your plan. If you become eligible for Medicare before 2020, you may still be able to buy either Plan C or Plan F after January 1, 2020, if either is available where you live.
Medicare Supplement Insurance Plan C may or may not be right for your health care needs. Research all of the plans available where you live and speak with a licensed insurance agent to evaluate your needs.
Compare Medigap plans in your areaVisit MedicareSupplement.com
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1 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.
2 Fisher, Miles. Your blood could be worth a lot. You should give it away for free. (July 5, 2017). Chicago Tribune. Retrieved from www.chicagotribune.com/news/opinion/commentary/ct-blood-donation-money-20170705-story.html.
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