Medigap Plan C is offered by most states, and like other supplement plans, covers basic benefits for medical and hospital expenses. Plan C is one of the most comprehensive Medicare supplement plans available, but it still has some limitations in coverage. This plan will help pay for many of your medical expenses, however, the coverage is limited to charges that are approved by Medicare. If your doctor accepts assignment, then he/she cannot bill you can excess charge (an amount up to 15% above and beyond the Medicare-approved amount).
If your doctor does not accept assignment (accepting the Medicare-approved amount for a given service), then he/she can bill you for an excess charge. As an example, if a doctor charges $400 for an office visit and Medicare says that $300 is a reasonable and customary charge for the service, the doctor can bill the patient up to $45 more for payment ($300 x 15% = $45).
Ideally, this plan will benefit people who want to be able to strongly predict what their monthly medical expenses will be.
Medigap Plan C covered benefits:
- Medicare Part A coinsurance plus coverage for 365 additional days after Medicare benefits are used up
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Part A hospice care coinsurance or copayment
- Part A hospitalization deductible
- Part B medical deductible
- Skilled nursing facility co-insurance
- Foreign travel emergency (up to plan limits)
Medigap Plan C benefits not covered:
- Medicare Part B excess charges
If you want a plan that includes everything above and also covers part B excess charges, Medigap Plan F may be a better alternative.