Medicare Supplement Plan C: What It Covers and Who Can Buy It

Medicare Supplement Plan C is one of the most comprehensive Medigap policies available, but it comes with a major catch: you can only buy it if you became eligible for Medicare before January 1, 2020.

If you meet that requirement, Plan C covers almost every gap in Traditional Medicare (Parts A and B), leaving you with very few out-of-pocket medical bills. If you became eligible for Medicare on or after January 1, 2020, federal law prohibits you from buying Plan C. Instead, you would look at Plan G or Plan N.

Benefits are standardized by federal law. That means a Plan C from one insurance company provides the exact same medical coverage as a Plan C from any other company. The only difference is the price they charge and their history of rate increases.

What Plan C Covers

When you use Traditional Medicare, the government pays its share of your approved medical bills, and your Medigap plan steps in to pay the rest. Plan C covers:

• Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
• Medicare Part B coinsurance or copayment (typically 20% of the Medicare-approved amount for doctor visits and outpatient care).
• Blood (first 3 pints).
• Part A hospice care coinsurance or copayment.
• Skilled nursing facility care coinsurance.
• Medicare Part A deductible (the amount you pay when admitted to the hospital).
• Medicare Part B deductible (the annual amount you pay before Medicare Part B starts paying).
• Foreign travel emergency (80% of approved costs up to plan limits).

What Plan C Does Not Cover

Plan C covers almost everything, but there is one specific gap it leaves open: Medicare Part B excess charges.

If you see a doctor who does not accept "Medicare assignment" (meaning they don't accept the Medicare-approved amount as full payment), they are legally allowed to charge up to 15% more than the approved amount. You would be responsible for paying that 15% difference out of your own pocket. If you want a plan that covers excess charges, you would need to look at Plan F (if eligible) or Plan G.

Like all modern Medigap plans, Plan C also does not cover prescription drugs, routine dental, vision, or hearing care.

The Medicare Module: Two Paths, Not Two Products

When you are setting up your Medicare, remember that Medigap vs. Medicare Advantage is a rigged comparison. The real choice is Traditional Medicare (A+B) vs. Medicare Advantage.

The supplement decision comes AFTER you choose Traditional Medicare. It's a component of the Traditional path, not an alternative to Advantage. If you choose the Traditional path, a supplement like Plan C fills the gaps by law, allowing you to see any doctor in the country who accepts Medicare, with no network restrictions and no prior authorizations.

Plan C vs. Plan F

Plan C and Plan F are nearly identical. Both require you to have been eligible for Medicare before 2020. The only difference is that Plan F covers Part B excess charges, while Plan C does not. Because of this small difference, Plan C premiums are sometimes slightly lower than Plan F premiums, but you take on the risk of excess charges if you see certain doctors.

Plan C vs. Plan G

If you are new to Medicare (eligible on or after January 1, 2020), you cannot buy Plan C. Your closest alternative is Plan G. Plan G covers everything Plan C covers, PLUS it covers Part B excess charges. The only thing Plan G does not cover is the annual Part B deductible. You pay that small deductible once a year, and then Plan G covers 100% of your approved gaps.

You've worked hard to build your life, and you deserve to protect what you've earned. If you're eligible for Plan C and want to see how the numbers stack up against other options, we can help. We're licensed in all 50 states and we sit on your side of the table. We'll walk you through every option and compare the rates in your zip code - free, with no obligation.