Medigap Plan C was a standardized Medicare Supplement insurance plan that provided a comprehensive set of benefits to help cover out-of-pocket costs not covered by Original Medicare (Part A and Part B). This plan typically included coverage for Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayments, and the first three pints of blood needed for a medical procedure.
In addition to these basic benefits, Medigap Plan C also offered coverage for the Medicare Part A deductible, skilled nursing facility coinsurance, and even coverage for emergency medical care during foreign travel. However, it did not include coverage for the Medicare Part B deductible or excess charges.
It's important to note that while Medigap Plan C provided comprehensive coverage, it was discontinued for new enrollees after January 1, 2020. This change was due to the Medicare Access and CHIP Reauthorization Act (MACRA), which eliminated Medigap plans that covered the Part B deductible for newly eligible beneficiaries.
If you are considering a Medigap plan, we recommend exploring other available plans such as Medigap Plan G or Plan N, which may offer similar coverage options. It's always best to review and compare the available plans to find the one that best suits your healthcare needs and budget.
Below is a comprehensive list of the covered services provided by Medicare Supplement Plan C, which include benefits under Medicare Part A, Medicare Part B, and other areas:
Service | Who pays what? |
---|---|
First 60 days | Medicare pays: All cost but $1,632 Plan pays: $1,632 (Part A Deductible) Member pays: Nothing |
61st thru 90th day | Medicare pays: All cost but $408/day Plan pays: $408/day Member pays: Nothing |
91st day and after (While using 60 lifetime reserve days) | Medicare pays: All cost but $816/day
Plan pays: $816/day Member pays: Nothing |
Once lifetime reserve days are used; additional 365 days | Medicare pays: Nothing Plan pays: 100% of Medicare-eligible expenses Member pays: Nothing |
Beyond the additional 365 days | Medicare pays: Nothing
Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First 20 days | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
21st thru 100th day | Medicare pays: All but $204/day Plan pays: Up to $204/day Member pays: Nothing |
101st day and after | Medicare pays: Nothing Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: Nothing Plan pays: All cost Member pays: Nothing |
Additional amount | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
Hospice Care | Medicare pays: All but very limited
copayment/ coinsurance for outpatient drugs and inpatient respite care Plan pays: Medicare copayment and coinsurance Member pays: Nothing |
Service | Who pays what? |
---|---|
Part B Deductible | Medicare pays: Nothing Plan pays: $240 (Part B Deductible) Member pays: Nothing |
Part B Coinsurance | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Part B Excess Charges
(above Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
Test for diagnostic lab services | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Additional amount (First $240 of
Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays: $240 (Part B deductible) |
Remainder of Medicare approved amounts | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who pays what? |
---|---|
Medically necessary skilled care
services and medical supplies/ Durable medical equipment (First $240 of Medicare approved amounts) | Medicare pays: Nothing Plan pays: $240 (Part B deductible) Member pays: Nothing |
61st thru 90th day | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who pays what? |
---|---|
First $250 each calendar
year/Remainder of charges | Medicare pays: Nothing (exccept under limited circumstances) Plan pays: $0/80% to a lifetime maximum of $50,000 Member pays: $250/20% and amounts over the $50,000 lifetime maximum |
Medicare Part C, also known as Medicare Advantage, and Medicare Supplement (Medigap) Plan C are not identical. Medicare Part C refers to Medicare Advantage plans that offer comprehensive coverage, including medical and outpatient services. On the other hand, Medicare Supplement Plan C is an insurance policy designed to supplement Original Medicare (Parts A and B) and provides additional coverage beyond what Original Medicare offers.
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