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Understanding Medicare Supplement Insurance Plan C

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You have several choices to consider when shopping for Medicare supplement insurance coverage. Plan C is popular as it covers almost all of the gaps associated with Original Medicare Parts A and B. It can be a good alternative to Plan F if you desire slightly lower premiums and wish to maintain comprehensive overall coverage.

Plan C is just like Plan F in every way except that it does not cover “Part B Excess Charges.” The only two plans that cover Part B Excess Charges are Plans F and G. As these charges are very rare, most consumers are comfortable with Plan C.

Compare Plan C Medicare Supplement Insurance Benefits And Gaps

Benefits A B C D F G K L M N
Part A Hospital Coinsurance
Lifetime Reserve Days
365 More Hospital Days
Parts A and B Blood 50% 75%
Part B Coinsurance 50% 75%
Part A Hospice Coinsurance 50% 75%
Skilled Nursing Coinsurance 50% 75%
Part A Deductible
$1,288 in 2016
50% 75% 50%
Part B Deductible
$166 in 2016
Part B Excess
Foreign Travel Emergency
Preventive Care Coinsurance
Out of Pocket Limit $4,960 $2,480

By viewing the outline of coverage above, you can see that Plan F is the most comprehensive coverage available. Plans C and G are the next best options as they both have only one gap. Plan C is usually more expensive than Plan G, but less than Plan F.

What Are Medicare Part B Excess Charges?

These are charges that medical facilities and practitioners charge above and beyond what Medicare part B approves. They are usually a percentage of the total medical bill and can be as high as 15% of the total cost.

An excess charge on a costly Medicare Part B approved expense could be significant if the doctor or hospital does not accept Medicare assignment. Most medical professionals accept Medicare assignment so it is rare for consumers to run into these charges where they are allowed.

Are There Advantages to Medicare Plan C Insurance?

It depends on what state you live in and where you spend the most time. Considering that some states do not allow for Part B Excess (Ohio is a good example) then it can be a moot point. Consumers who spend time in multiple states or travel often might feel better with a supplement that covers this gap.

When comparing monthly rates for Plan C, consumers will find that it is usually only a couple of dollars less per month than Plan F. In other words, it’s not much savings. (Premiums for Plan G can be $15-$20 less per – so it is sometimes a better value overall.)

As mentioned, most doctors and hospitals (and some states) simply do not allow for Part B excess charges. In that way, Plan C and Plan F are nearly identical. However, most consumers feel better knowing these charges will be covered – especially if the cost is only a couple of dollars more per month for Plan F.

Select Plan C Medigap Insurance Network Policies

Medicare supplement Select Plans are those that use a pre-approved network of doctors and hospitals for routine care. They offer lower premiums than traditional coverage as the insurance company has negotiated lower prices within the network.

Like all network driven insurance coverage, the risk to the insured is if they receive non-emergency care outside of the approved network.  AARP (through Unitedhealthcare) and Anthem BCBS are two companies offering Select Plan C, but traditional non-network plans are more often purchased by seniors. It’s important to make sure you understand any limitations with a Select supplemental plan before purchase.

What Is The Future Of Medicare Supplement Insurance Coverage?

Health care reform did not eliminate Medicare Advantage plans as some predicted. In fact, these policies are seeing increased enrollment. Some supplemental plans will be phased out in 2020, however. New legislation states that all plans covering the Part B deductible will be eliminated. This includes Plans F and C as well as their Select and High Deductible versions.

This development will increase the demand for Plans G and N in our opinion as the 2020 gets closer. Most consumers do not want to own a plan that no longer accepts new members. When no new members can be accepted, rates will sometimes rise more dramatically.

Summary And Quote Request

In summary, Plan C offers negligible savings over Plan F in most cases. If you are deciding between the two, it might be wise to purchase Plan F and know that Part B excess charges are covered. With these two plans leaving the market, you might also consider Plans G & N.

Hyers and Associates, Inc. is a full service Medicare supplement insurance brokerage. We offer the direct rates from several highly-rated insurance carriers. We also help educate our clients about supplemental policy trends now and in the future.

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Category: Medicare Supplements