Understanding Medicare can be confusing, especially when trying to decipher the different Medigap plans. One frequently asked question revolves around Plan C: What does it actually cover? While Plan C isn’t available to those newly eligible for Medicare on or after January 1, 2020, it’s still important to understand its coverage if you were eligible before that date.
Below is a breakdown of what Medicare Supplement Plan C typically covers:
- Part A Deductible: Covers the deductible for inpatient hospital stays under Medicare Part A.
- Part B Deductible: Pays for the deductible for doctor visits and outpatient care under Medicare Part B.
- Part A Coinsurance and Hospital Costs: Covers coinsurance for inpatient hospital stays and extends hospital benefits for up to an additional 365 days after Medicare benefits are exhausted.
- Part B Coinsurance and Copayments: Covers the 20% coinsurance or copayments for Medicare Part B services (doctor visits, outpatient care, etc.).
- First Three Pints of Blood: Covers the cost of the first three pints of blood needed in a medical procedure.
- Skilled Nursing Facility Care Coinsurance: Pays the coinsurance for skilled nursing facility (SNF) care.
- Hospice Care Coinsurance or Copayment: Covers the coinsurance or copayment for hospice care.
- Foreign Travel Emergency Care: Covers 80% of the costs for emergency healthcare received while traveling outside the U.S. (up to plan limits).
Important Considerations:
- Because Plan C covers the Part B deductible, which is no longer allowed for new Medicare beneficiaries after 2020, the plan is not offered to those newly eligible.
- If you were eligible for Medicare before 2020 and have Plan C, you can generally keep it. However, your premiums may change.
- Alternatives like Plan D or Plan G are available to those newly eligible for Medicare and offer very similar coverage without the Part B deductible.
Consult with a licensed insurance agent or Medicare specialist to determine the best Medigap plan for your individual needs and circumstances. They can provide personalized guidance based on your healthcare requirements and budget.
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