Medigap Plan C

Plan C is a popular Medigap Plan due to its “First Dollar Coverage” but Plan C will be discontinued for new Medicare enrollees only after Jan. 1, 2020

Plan C 2019 Medigap Plan Comparison Chart

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Plan N 2019 Medigap Plan Comparison Chart
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Maybe you’ve heard some information about Medigap Plan C from friends & family but what exactly are Plan C anyway & how does it fit within Medicare Insurance benefits? We consolidated & simplified all the important details for you by answering common questions to help save you time, money & energy!

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2019 Medigap Plan

Last Updated: 10/2/2019

What is Medigap Plan C?

Plan C is a popular Medigap Plan because of its “First-Dollar Coverage” which according to Investopedia, “…is an insurance policy feature that provides full coverage for the entire value of a loss without a deductible” (Investopedia, First Dollar) Basically, it pays for all the Part B Deductible of Original Medicare Insurance. Plan C should not be confused with “Part C” because these are separate programs (Read More..). The only other Medigap Plans that offer first-dollar benefits are Plan F & High-Deductible Plan F which, like Plan C, will be discontinued for new Medicare enrollees after January 1, 2020. In short, if you turned 65 before 2020, you still have the grandfathered plan available to enroll in after 2020.

Did you know, Plan C also includes all the benefits of its predecessor plan, Plan B, with the addition of;

  1. Skilled Nursing Facility Care Coinsurance Coverage AND
  2. Foreign Travel Emergency Coverage (up to plan limits) with a $250 deductible.

No wonder Plan C is a popular choice for senior clients enrolled before Jan. 1, 2020 due to its comprehensive benefits.

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Why is Medigap Plan C going away in 2020?

The reason Plan C is going away is because congress identified a financial issue with both patient care providers and patients “misusing” the Medicare Insurance. As you could probably imagine, an unrestricted use of medical care without cost to patients increases its unnecessary usage while incentivising doctors to over bill Medicare for services rendered. Furthermore, congress issued, H.R.2 – Medicare Access and CHIP Reauthorization Act of 2015, to curb the expense.

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What does Medigap Plan C cover?

Plan C covers;

  • 100% Medicare Part A coinsurance.
  • 100% Medicare Part B coinsurance.
  • 100% first three (3) pints of blood.
  • 100% Part A hospice coinsurance
  • 100% Skilled Nursing Facility Care coinsurance.
  • 100% Part A deductible.
  • 100% Part B deductible.
  • 80% Foreign Travel Emergency.

The National Association of Insurance Commissioners (NAIC), standardized all Medigap Plans which must adhere to the following guidelines;

  • Must cover costs for both Original Medicare Part A & Part B.
  • Must reflect statutory changes in Medicare.
  • Cannot deny preexisting conditions after a policy has been active for 6-months.
  • Must include a 30-day look back period.

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What does Medigap Plan C not cover?

Medigap Plan C does not cover the following items which are included in other Medigap Plans;

  • No Medicare Part B excess charges.

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How do I compare Medigap Plan C?

Comparing Medigap policies can be confusing and time consuming when vetting multiple carriers. It takes more than reading a 2019 Medigap PDF Guide to get the FAQs! Simplify the process by speaking with a Bridge Agent who can answer your questions & run all your Medigap comparisons for you at no cost.

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2019 Medigap Guide

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Is Medigap Plan C worth buying?

Plan C is one of the most popular Medigap Plan options among seniors clients because of its comprehensive coverage compared to plans such as Plan A & Plan B. We recommend speaking with a Bridge Agent to review your options and get a comparison quote to fit your needs. In order to review your Medicare Options and get a comparison quote, consult with a dedicated, Bridge Agent standing-by to help serve you!

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How much does Medigap Plan C cost?

As with all Medigap Plans, since they are federally standardized the only differentiating factor is based on the price you pay. Since Medigap plans vary in price, availability and carrier, you would need to speak with licensed, agent for Medigap Plan C quotes.

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How do I enroll in Medigap Plan C?

Enrolling in Plan C is a simple process. Once you have enrolled in Original Medicare, you can contact a Bridge Agent to find the best plans in your service area.

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What is the difference between Part C and Plan C?

Most people can get confused between the two since they have very similar names but Parts and Medigap Plans are not the same! Medicare Part C is called, “Medicare Advantage” which like an HMO/PPO health insurance. Enrollees of Part C opt out of Original Medicare a government insurance for 100% private insurance. Unlike Part C, (Plan C) works “with” Original Medicare as a “supplemental insurance” which covers the services depicted above. To better help clarify the confusion, refer to the page, ‘Medicare Options Redefined

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How does Medigap Plan C compare with Part C Medicare Advantage (MA)?

Medigap Plan C may offer more comprehensive coverage when paired with Original Medicare and a Part D drug plan. In comparison, Plan C is a supplemental health insurance plan unlike Medicare Advantage (Part C) which is an ‘all encompassing health plan’. For example, Part C may contain a drug plan within it called MA-PD vs. PDPwhich is a stand alone drug plan. Comparing Medigap vs Medicare Advantage Plans can be difficult going at it alone. After all, they are similar in that both are considered private health plans but you cannot be enrolled in both Original Medicare and a Medicare Advantage at the same time. Read about comparing Original Medicare vs Medicare Advantage.

But wait…although, Medicare Advantage Plans are appealing based on price, they can also come with a few Medicare pitfalls that may have you reconsider the real “advantage”. For example;

  1. Prices have been historically unstable.
  2. Your coverage will change annually.
  3. You could be locked-in without the future option for a Medigap Plan
  4. You’re responsible for out-of-network, Physician costs.
  5. No coverage beyond your service area.
  6. Must use in-network providers.
  7. No travel coverage.
  8. May need a referral to see a specialist.

Additionally, If you have a MA plan and diagnosed with a critical illness such as cancer, heart attack or stroke, costs for treatment if the hospital is out-of-network may not be covered in your plan. The max out-of-pocket only applies to covered services and could require a specialist referral. People with MA plans, think they have more coverage than they actually do unlike Medigap plans, which is considered more comprehensive senior health coverage plan.

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CONSULTANT TIP

Starting January 1, 2020, Medigap plans for seniors new to Medicare will not be able to cover the Part B deductible. As such, Plans C & F will no longer be available to new Medicare enrollees on or after January 1, 2020.

How does Medigap Plan C work with Medicare Part D Prescription drug coverage?

Since Plan C is compatible with Original Medicare, enrollees who choose this plan will also need to enroll separately in a Part D drug plan. Enrollees have a guaranteed eligibility for a Part D plan when they enroll in Plan D (on-time). It’s best to avoid the Part D Enrollment Penalty by enrolling during your initial enrollment period (also known as, IEP). Did you know that drugs administered in a Hospital setting are generally covered under your Medicare Part A? For more information on enrollments, visit the Medicare Enrollment Periods page.

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How does Dental, Vision & Hearing Insurance (DVH) work with Medigap Plan C?

Plan C is compatible with DVH plans however since they are considered standalone plans, DVH’s would need to be purchased separately. By working with a Bridge Agent, we can help you find an affordable DVH insurance plan to fit your needs.

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How does Medigap Plan C work with a Critical Illness Insurance for cancer, heart-attack & stroke coverage (CHAS)?

Plan C is compatible with CHAS insurance / cancer plans however since they are considered standalone plans, they would need to be purchased separately. By working with a Bridge Agent, we can help you find an CHAS and/or affordable critical illness insurance plans to fit your needs.

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How does Medigap Plan C work with a Long Term Care Insurance (LTC)?

Medigap Plan C is compatible with LTC plans however, since they are considered standalone plans, they would need to be purchased separately. There is talk about developing a new Medigap plan to include LTC coverage. By working with a Bridge Agent, we can help you find an affordable LTC insurance plan to fit your needs(LTC).

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How does Plan C work with a Health Savings Account (HSA)?

Medigap Plan C, as with all Medigap Plans, are not considered a qualified expense to pay out of your Health Savings Account (HSA). However, your HSA can pay for Medicare Parts A, B, C & D. Once enrolled in Medicare, enrollees are no longer able to contribute to their Health Savings Account. However, the funds can be used to pay for qualified Medicare costs stated above. If one postpones Medicare enrollment they may still contribute to their Health Savings but enrolling late will also be subject to a Medicare Late Enrollment Penalty which is a percentage increase of costs per year. Speak with your Financial Advisor to determine what works best for you!

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In Conclusion

Plan C is limited plan since it will be discontinued come Jan. 1 2020 for new Medicare enrollees but still offered as a grandfathered plan to past enrollees. Also, Plan C offers first-dollar coverage on the Medicare Part B Deductible. The C Plan contains all of Plan B benefits + additional benefits. Plan C is one of the more popular senior insurance plans because of its comprehensive coverage compared to less popular Medigap Plans like A & B. Plan C is private insurance that “supplements” Original Medicare. The cost of Plan C is dependent upon carrier & availability. All carriers who sell Plan C must adhere to standardized federal guidelines. Comparing Medigap Policies can be confusing and time consuming! If you would like to speak with a licensed Bridge Agent about Plan C options, please contact us today for a free, no-obligation, comparison quote today!

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