Medigap Plan C provides comprehensive coverage to help fill the gaps in Original Medicare. It typically covers:
Keep in mind that Medigap Plan C does not cover prescription drugs, dental, vision, or hearing services
Medigap Plan C offers comprehensive coverage, including Medicare Part A coinsurance, Part B coinsurance or copayments, first three pints of blood, Part A hospice care coinsurance, skilled nursing facility care coinsurance, Medicare Part A deductible, Medicare Part B excess charges, and foreign travel emergency care
Medigap Plan C does not cover Medicare Part B deductible or prescription drugs.
Medicare excess charges are additional costs that beneficiaries may have to pay if they receive medical services from healthcare providers who do not accept Medicare assignment.
These charges occur when the provider’s fee exceeds the Medicare-approved amount for a particular service or procedure. Medicare excess charges typically amount to 15% more than the Medicare-approved rate, and beneficiaries are responsible for paying this difference out of pocket.
It’s important for beneficiaries to confirm whether their healthcare providers accept Medicare assignment to avoid excess charges and minimize out-of-pocket expenses.
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Enrolling in Medigap Plan C is a straightforward process once you become eligible for Medicare. To qualify for a Medigap plan, you must be enrolled in both Medicare Part A and Part B.
Most individuals become eligible for Medicare when they turn 65, but those under 65 with certain disabilities may also qualify. After determining that you are eligible and have chosen Medigap Plan C as your preferred option, the next step is to enroll during your Medigap Open Enrollment Period.
This enrollment window begins on the first day of the month in which you are both 65 or older and enrolled in Medicare Part B and lasts for six months. During this time, you have a “guaranteed issue” right to purchase any Medigap policy sold in your state, regardless of your health status.
You can apply directly through the insurance company offering the Medigap Plan C policy or seek assistance from a licensed insurance agent.
If you apply for Medigap coverage outside of your Medigap Open Enrollment Period, you may be subject to medical underwriting, where the insurance company considers your health status when determining acceptance and premium rates.
Once approved, you will receive confirmation of your enrollment in Medigap Plan C, providing you with additional coverage to help cover out-of-pocket costs not covered by Original Medicare
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