What Is Medigap Plan C? What You Need to Know
Medigap Plan C is one of 10 Medicare Supplement Insurance plans that assist with some out-of-pocket expenses not met by Original Medicare. Because it covers the Part B deductible, it’s not available to most new Medicare enrollees, but Plan D could be a good alternative.
How it works
After Medicare pays its approved amount, your Medigap coverage takes effect. These plans typically assist with copayments, coinsurance and some deductibles not covered under Original Medicare. You must be enrolled in Medicare Parts A and B to be eligible for a Medicare Supplement plan (it’s not available to Medicare Advantage enrollees).
Like Medigap Plan F, Plan C is no longer available to Medicare beneficiaries who became eligible on or after Jan. 1, 2020. If you already had Plan C before that date, you can keep your plan, and if you were eligible for Medicare before Jan. 1, 2020, but aren't yet enrolled, then you may still have the option to buy Plan C.
What Medigap Plan C covers
Medigap Plan C covers the following, according to Medicare.gov:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
Part A deductible.
Part A hospice care coinsurance or copayment.
Part B coinsurance or copayment.
Part B deductible. (Since 2020, new Medicare members can’t buy any plan that covers the Part B deductible. However, this coverage is available for Medicare beneficiaries currently enrolled in Medigap Plan C and Plan F.)
Skilled nursing facility care coinsurance.
Blood transfusion (first three pints).
Medically necessary emergency health care services for the first 60 days when traveling outside the U.S. Deductible and limitations apply.
What Medigap Plan C doesn't cover
The only benefit Medigap Plan C doesn’t cover that’s included in some other Medigap options is Medicare Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).
Additionally, Medigap Plan C doesn’t cover the following, nor do any Medigap plans sold to new Medicare members:
Prescription drugs.
Long-term care (like non-skilled care you get in a nursing home).
Dental care.
Vision care.
Private-duty nursing.
Medigap Plan C alternatives
If you aren't eligible for Medigap Plan C, but want similar benefits, Plan D is the closest option. Medigap Plan D covers all of the same benefits as Plan C except for the Part B deductible, since that coverage can’t be sold to new members anymore.
Compare Medicare Supplement plans' costs and coverage to see what might work for you.
All Medigap plans are sold by private health insurance companies. They're federally regulated and standardized across all states, except Massachusetts, Minnesota and Wisconsin.
To find out what Medigap Plan D or other alternatives would cost you, visit Medicare.gov.
The best time to enroll in Medigap is during your Medigap open enrollment period.