Starting January 1, 2020, some Medicare Supplement plans, also called Medigap plans, like Plan C will be discontinued. This means these plans are no longer offered to those who are eligible to enroll in Medicare beginning in 2020. Existing enrollees in a Medigap Plan C policy may be able to keep their Plan C benefits, but should be aware of any potential changes to Plan C and what their options are if they wish to change their coverage.
What Does Plan C Cover?
Most Medicare Supplement plans cover the same basic set of out-of-pocket expenses associated with Original Medicare, but to varying degrees that is reflected by the cost of the premium — more coverage usually means higher premiums.
Medicare Supplement Plan C enrollees have 100% coverage for the following:
- Coinsurance and hospital costs, up to 365 days more than Medicare’s maximum, with Part A services
- Coinsurance and copayments with Part B
- First 3 pints of blood during a transfusion
- Coinsurance or copayment for Part A hospice care
- Coinsurance at a skilled nursing facility
- Deductible with Part A
- Deductible with Part B
If you travel abroad, 80% of the costs during a medical emergency outside of the country are also covered. Plan C does not include any out-of-pocket limit to expenses.
Changes for Medicare Supplement Plan C in 2020?
Although Plan C is being discontinued at the beginning of 2020, this does not mean anyone already eligible for Plan C coverage will automatically lose access to this plan. Existing Plan C recipients can keep their coverage unless the insurance carriers that offer it leave their coverage area.
Only those who turn 65 in 2020 and beyond will be barred from enrolling in Plan C as new recipients. If you turned 65 prior to 2020, but did not choose to enroll in a Medigap plan like Plan C because you still had private insurance through an employer or union, you can still choose to enroll in Plan C when your private insurance coverage ends.
Keep in mind that although changes to what Plan C covers for eligible enrollees won’t change, the premiums for discontinued plans like Plan C may rise to compensate for the lack of new Medicare recipients. Without an influx of new recipients to help disperse the cost of care, it becomes more expensive for carriers to offer discontinued plans.
This may lead existing enrollees to shop around for more affordable care that offers similar benefits, but they may find some obstacles when looking at other Medigap plans, Medicare Advantage plans or Original Medicare benefits.
Can Plan C Enrollees Change Their Coverage?
In general, Medigap recipients can attempt to change their coverage options at any time — but unless they meet certain special circumstances that protect their guaranteed issue right, they may be denied or delayed coverage with other Medigap plans. They can also face higher premiums. This occurs when a recipient tries to enroll outside of the 6-month open enrollment period for Medigap, which begins the month they turn 65 and are enrolled in Medicare Part B.
Loss of private insurance, Medicare Advantage or Medigap coverage through no fault on the part of the recipient can make them eligible for guaranteed issue rights that then allow them to choose a Medigap plan without facing any penalties or delays. From there, recipients have a 30-day “free look” grace period where they can explore their new Medigap plan and save their spot on their former plan. Both plan premiums must be paid in order to use this grace period, however.
Medicare Part C vs. Medigap Plan C
Due to the letter-name standardization of Medigap plans, it’s easy to confuse Medicare Supplement Plan C with Medicare Part C, which refers to Medicare Advantage plans. These two types of plans are not the same. Medicare Advantage plans combine Original Medicare benefits with additional services, such as dental or vision care. Medigap Plan C extends or enhances existing Original Medicare benefits rather than offering anything not already covered by Original Medicare. You cannot be enrolled in Medicare Advantage and Medigap plans at the same time.
When Does Medicare Supplement Open Enrollment Occur?(Opens in a new browser tab)
Five Things Medicare May Not Cover(Opens in a new browser tab)