What is Medicare Supplement Plan C and where is it going?

Medicare Supplement Plan C is quite popular for beneficiaries on Social Security Disability (SSDI).

Plan C is one of the 10 standardized Medicare Supplement plan options available for purchase in most states.

The goal of Medicare Supplement (Medigap) insurance is to fill in some of the out-of-pocket costs left over after Original Medicare (Parts A & B) coverage. (For reference, ‘Medigap’ is another term often used for Medicare Supplement. We will use them interchangeably.)

The 10 standardized plans cover varying degrees of your Original Medicare deductibles, copays, and coinsurance. Medicare Supplement plans are labeled: A, B, C, D, F, high deductible F, G, high deductible G, K, L, M, N.

(Be careful not to confuse Medigap plans A, B, C and D with Medicare Parts A, B, C and D. They are different.)

Medigap plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Like all Medigap plans, Plan C will have the same benefits no matter which insurance carrier you buy your policy from. The only difference between a Plan C from Humana, a Plan C from Aetna, a Plan C from UnitedHealthcare AARP, or a Plan C from any other insurance carrier will be the price.

Medicare Supplement Plan C Popularity

Medicare Supplement Plan C is quite popular for beneficiaries on Social Security Disability (SSDI).

What is Different about Plan C

Plan C offers some of the most comprehensive coverage of all Medicare Supplement plans. Plan C covers everything besides Part B excess charges, which you may not be responsible for paying if your provider accepts assignment, meaning they do not charge more than the Medicare approved amount.

Medicare Supplement Plan C Premium 

Given that it has the most coverage, Plan C will likely be the most expensive Medicare Supplement option available to you. On the bright side, you know exactly what your medical expenses will cost you for the year.

Medicare Supplement Plan C plan offer coverage for:

  • Medicare Part A hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are exhausted
  • Medicare Part B coinsurance
  • First three pints of blood for a medical procedure
  • Medicare Part A hospice care coinsurance
  • Skilled Nursing Facility care coinsurance
  • Medicare Part A deductible ($1,364 for each benefit period you use in the year)
  • Medicare Part B deductible ($185 per year in 2019)
  • 80% of Foreign travel emergency coverage

Coinsurance is the amount left over after the 80% covered by Original Medicare

Medicare Supplement Plan C does not cover

What is happening to Plan C?

If you become eligible for Medicare Supplement after January 1, 2020, you will not be able to sign up for Medicare Supplement Plan C or Plan F

Passed in 2015, Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was bipartisan legislation to support the transition from volume-driven, fee for service (FFS) reimbursement model to a value-based system that rewards quality and value of care over volume of services provided. MACRA is eliminating plans that cover the Part B deductible.

Plan C and Plan F offer coverage for the Part B deductible. The primary reason policies have deductibles is to prevent you from going to the doctor for every little bump and bruise. Eliminating coverage Part B deductible will drive down care volume in favor or quality and value care.

We believe MACRA will lead to increased popularity of Medicare Supplement Plan G.

MACRA also removed Social Security Numbers from Medicare cards – everyone should have a new Medicare card by now.

Why else you might want a Medicare Supplement policy

Medicare Supplement Plan C is just one of the Medigap plans available. It’s important to compare Medigap plans and choose the option that’s best for your healthcare needs (now and down the road) and your budget.

Anyone who has Original Medicare (Parts A & B) is eligible to buy a Medigap plan. You cannot however buy a Medigap plan if you have a Medicare Advantage plan.

Beneficiaries who went without a Medicare Supplement plan spent an average of $5,374 on out-of-pocket costs in 2016, according to a study by the Commonwealth Fund, more than twice what those with a Supplement plan spent.

The best time to purchase a Medicare Supplement plan is during your personal initial enrollment period. Initial enrollment period is the first six months after you’re both 65 years old and enrolled in Medicare Part B. The typical enrollee will coordinate their Medigap policy to begin on the month they turn 65.

You can still buy a Plan C later, but you may have to go through medical underwriting. Underwriting could mean higher premiums or having a pre-existing condition not covered.

Medicare Part C

Medicare Part C is another name for Medicare Advantage. It is completely separate from Medicare Supplement Plan C. Why is it so confusing? We have no idea.

  • Medicare Part A is the hospital insurance portion of Original Medicare
  • Medicare Part B is the medical insurance portion of Original Medicare
  • Medicare Part C is Medicare Advantage. Medicare Advantage is an alternative to Original Medicare (Parts A & B) that is offered by private insurance companies
  • Medicare Part D is Prescription Drug Plans (PDP)
  • Medigap Plan C is one of the 10 standardized Medicare Supplement insurance plans

Medicare Advantage

You cannot have a Medicare Supplement Plan C with Medicare Advantage (Part C).

Medicare Advantage is a private alternative to replace Original Medicare (Parts A & B) and typically offers additional benefits. Medicare Advantage plans often limit your coverage to a particular network of healthcare providers. Plans that allow you to see out-of-network providers typically charge you more.

You must be enrolled in Medicare Parts A and Part B to be eligible to apply for a Medicare Advantage plan.

You may pay a premium for your Medicare Advantage plan, in addition to your Part B premium. To be clear, you will still need to pay your Part B premium.

Shop for Medicare Supplement Plan C

Look at Medicare Supplement Plan C prices with no obligation. Enter your zip code, birthdate, gender and tobacco status to get the most accurate prices. Or, shoot us an email at [email protected], or speak with a licensed insurance agent by calling 917-408-3690.

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