Medicare Supplement Plan C | Medigap Plan C | Coverage & Details

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Medicare Supplement Plan C
Medicare Supplement Plan C is almost identical to the most comprehensive and popular Medicare Supplement Plan F. The only difference in coverage between the Supplement Plan F and Plan C is that Medicare Plan C does not include Medicare excess charge coverage.

Some insurance companies decide to promote Supplement Plan C and others decide to promote Plan F--they are so similar, they are basically interchangeable. Excess charge coverage is not a significant benefit, and you can read about what is Medicare excess charge on the page by clicking the link.

When you purchase Medicare Supplement Plan C, you are purchasing a very comprehensive Medigap Plan. Plan C covers all the major gaps left by Medicare, meaning that you will not have any co-pays, deductibles, or network of doctors to follow. The only thing Medicare Supplemental Plan C does not cover (neither does any Medicare Supplement Plan) is Dental, Prescription Drugs, and Vision/Hearing. Besides that, you should have most or all of your health insurance needs met, having peace-of-mind that you will not have large out-of-pocket expenses should you need medical services.

As with all Medigap plans, it is of utmost importance that you shop around for price quotes to make sure you have the lowest cost Plan C available. You can contact a broker (like us), and we will relieve that burden for you by shopping the rates of ALL companies and helping you enroll in the plan that you choose.

Also, keep in mind, purchasing a toy with all the "bells and whistles" is not necessarily the cheapest plan, so if you are watching your budget more closely, you may also want to keep in mind Medicare Supplement Plan G or Plan N.

Medigap Plan C | Part A Coverage MEDICARE (PART A) - HOSPITAL SERVICES - PER BENEFIT PERIOD
* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
HOSPITALIZATION: Semi-private room and board, general nursing and miscellaneous services and supplies.
Services		Medicare Pays	Plan Pays	You Pay
First 60 days		All but $1,184	$1,184 (Part A Deductible)	$0
61st through 90th day		All but $296 a day	$296 a day	$0
91st day and after:
While using 60 lifetime reserve days		All but $592 a day	$592 a day	$0
Once lifetime reserve days are used:
Additional 365 days		$0	100% of Medicare Eligible Expenses	$0**
Beyond the Additional 365 days		$0	$0	All Costs
SKILLED NURSING FACILITY CARE: You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital.
Services	Medicare Pays		Plan Pays	You Pay
First 20 days	All approved amounts		$0	$0
21st through 100th day	All but $148 a day		Up to $148 a day	$0
101st day and after	$0		$0	All costs
BLOOD:
Services	Medicare Pays		Plan Pays	You Pay
First 3 pints	$0		3 pints	$0
Additional amounts	100%		$0	$0
HOSPICE CARE: You must meet Medicare's requirements including a doctor's certification of terminal illness.
Services	Medicare Pays		Plan Pays	You Pay
Hospice care	All but very limited copayment / coinsurance for out-patient drugs and inpatient respite care		Medicare copayment / coinsurance	$0
**NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy's "Core Benefits." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

Medigap Plan C | Part B Coverage MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR
Once you have been billed $147 of Medicare-Approved amounts for covered services your Medicare Part B Deductible will have been met for the calendar year.
MEDICAL EXPENSES: In or Out of the Hospital and Outpatient Hospital Treatment, such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment.
Services	Medicare Pays	Plan Pays	You Pay
First $147 of Medicare Approved Amounts	$0	$147 (Part B Deductible)	$0
Remainder of Medicare Approved Amounts	Generally 80%	Generally 20%	$0
Part B Excess Charges (Above Medicare Approved Amounts)	$0	$0	All costs
BLOOD:
Services	Medicare Pays	Plan Pays	You Pay
First 3 pints	$0	All costs	$0
Next $147 of Medicare Approved Amounts	$0	$147 (Part B Deductible)	$0
Remainder of Medicare Approved Amounts	80%	20%	$0
CLINICAL LABORATORY SERVICES:
Services	Medicare Pays	Plan Pays	You Pay
Tests for Diagnostic Services	100%	$0	$0

 

MEDICARE PARTS  A & B
HOME HEALTH CARE: Medicare Approved Services.
Services	Medicare Pays	Plan Pays	You Pay
Medically necessary skilled care services and medical supplies	100%	$0	$0
Durable medical equipment:
First $147 of Medicare Approved Amounts	$0	$147 (Part B Deductible)	$0
Remainder of Medicare Approved Amounts	80%	20%	$0

 

OTHER BENEFITS - NOT COVERED BY MEDICARE
FOREIGN TRAVEL: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA. (Canada & Mexico only.)
Services	Medicare Pays	Plan Pays	You Pay
First $250 each calendar year	$0	$0	$250
Remainder of charges	$0	80% to a lifetime maximum of $50,000	20% and amounts over the $50,000 lifetime maximum

 

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