Medigap Plan C is a supplemental insurance plan that covers a range of Medicare expenses. However, as of January 1, 2020, it’s no longer available to new Medicare enrollees.
Medigap plans went through several changes beginning in 2020. One of these changes was the removal of Medigap Plan C. If you were enrolled in Medigap Plan C before 2020, you can stay enrolled. And if you were eligible for Medicare before 2020, you can still enroll in Medigap Plan C in 2025.
Plan C is a popular Medigap plan because it offers coverage for many of Medicare’s costs, including the Part B deductibles. Although it’s no longer available to new Medicare enrollees, many other Medigap plans are available.
This article reviews why Plan C went away and which other Medigap plans may be a suitable replacement.
Medigap Plan C vs. Medicare Part C: What’s the difference?
Although they sound similar, Medicare Part C, also known as Medicare Advantage, is a completely separate program from Medigap Plan C (Medicare supplemental insurance).
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This ruling changed the law so that Medigap plans are not allowed to cover the Part B deductible. This rule went into effect on January 1, 2020.
Congress changed the law to discourage people from visiting a doctor’s office or hospital when it isn’t necessary. By requiring everyone to pay out of pocket for the Part B deductible, Congress hoped to cut down on visits for minor ailments that could be handled at home.
Plan C is one of two Medigap plan options that covered the Part B deductible (the other was Plan F). So, due to the new MACRA rule, Plan C can no longer be sold to new enrollees.
You can keep your Plan C if you already have it. As long as you were enrolled before December 31, 2019, you can continue using your plan. Unless the company you have decides to no longer offer your plan, you can keep it for as long as it makes sense for you.
If you became eligible for Medicare on or before December 31, 2019, you can also still enroll in Plan C.
The same rules apply to Plan F. If you already had it or were already enrolled in Medicare before 2020, Plan F will be available to you.
Plan C won’t be available to you if you’re newly eligible for Medicare in 2025.
You’ll still have many other options for Medigap plans that cover many of your Medicare expenses, but those plans cannot cover the Part B deductibles costs, per the new rule.
What Medigap Plan C covers
Plan C is very popular because of how comprehensive it is. Many Medicare cost-sharing fees are covered under the plan. In addition to coverage for the Part B deductible, Plan C covers:
- Medicare Part A deductible
- Medicare Part A coinsurance costs
- Medicare Part B coinsurance costs
- hospital coinsurance for up to 365 days
- the first three pints of blood needed for a procedure
- skilled nursing facility coinsurance
- hospice coinsurance
- emergency coverage in a foreign country
As you can see, nearly all costs that fall to Medicare beneficiaries are covered with Plan C. The only cost not covered by Plan C is what’s known as the Part B excess charges.
Excess charges are an amount above the Medicare-approved cost billed by a healthcare professional for a service. Because excess charges aren’t allowed in some states, Plan C is a great option.
Other available plans
A variety of Medigap plans are available. Popular choices include plans D, G, and N. They all offer similar coverage to plans C and F, with a few key differences:
- Plan D: This plan offers all of the coverage of Plan C except for the Part B deductible.
- Plan G: All costs except the Part B deductible are also covered under Plan G.
- Plan N: Under Plan N, almost all your costs are covered, with a few exceptions. The Part B deductible isn’t covered, and you’ll be responsible for some copayments. Under Plan N, you’ll pay up to $20 for some office visits and up to $50 for emergency room (ER) visits that don’t result in hospital admission.
The following chart compares the details of each of these plans more closely:
| Plan C | Plan D | Plan G | Plan N | |
|---|---|---|---|---|
| Part A deductible | yes | yes | yes | yes |
| Part B deductible | yes | no | no | no |
| Part A hospital coinsurance | yes (up to 365 days) | yes (up to 365 days) | yes (up to 365 days) | yes (up to 365 days) |
| Part A hospice coinsurance | yes | yes | yes | yes |
| Part A skilled nursing facility coinsurance | yes | yes | yes | yes |
| Part B coinsurance and copayments | yes | yes | yes | yes (with a $20 doctor visit copay and $50 ER copay) |
| Foreign travel coverage | 80% | 80% | 80% | 80% |
| Part B excess charges | no | no | yes | no |
Is there a cost difference between plans?
Plan C premiums tend to be slightly higher than monthly premiums for plans D, G, or N. Your costs will depend on where you live. The table below provides 2025 sample costs from around the country:
| City | Plan C | Plan D | Plan G | Plan N |
|---|---|---|---|---|
| Philadelphia, PA | $166-$872 | $155-$534 | $126-$1,094 | $95-$820 |
| San Antonio, TX | $156-$603 | $121-$531 | $98-$763 | $75-$584 |
| Columbus, OH | $142-$783 | $110-$559 | $105 to $706 | $80 to $528 |
| Denver, CO | $153-$1,117 | $144 to $515 | $122-$943 | $89 to $605 |
Depending on your state, you might have more than one Plan G option.
Some states offer high-deductible Plan G. While premium costs will be lower with a high-deductible plan, your deductible could be as high as a few thousand dollars before your Medigap coverage kicks in.
You can search for Medigap plans and plan costs in your area using this online tool.
Medigap plans can help you pay the costs associated with Medicare. There are 10 plans available, and Medicare requires them to be standardized, no matter which company offers them.
Plans offered to residents of Massachusetts, Minnesota, or Wisconsin are exceptions to this rule. These states have different rules for Medigap plans.
However, Medigap plans don’t make sense for everyone. Depending on your budget and healthcare needs, paying an additional deductible might not be worth the benefits.
Also, Medigap plans don’t offer prescription drugs and other supplemental coverage. For example, if you have a chronic condition that requires a prescription, you might be better off with a Medicare Advantage (Part C) plan or Medicare Part D plan.
On the other hand, if your doctor has recommended a procedure that will require a hospital stay, a Medigap plan that covers your Part A deductible and hospital coinsurance might be a smart move.
Medigap pros:
- nationwide coverage
- coverage for many Medicare costs
- additional 365 days of hospital coverage
- some plans offer coverage while traveling abroad
- some plans cover extras like fitness programs
- wide range of plans to choose from
Medigap cons:
- premium costs can be high
- prescription drug coverage is not included
- dental, vision, and other supplemental coverage is not included
You can shop for Medigap plans in your area using a tool on the Medicare website. This tool will show you the plans available in your area and their prices. You can use that tool to decide whether there is a plan that meets your needs and budgets.
For more help, you can contact your State Health Insurance Assistance Program (SHIP) to get advice for picking a plan in your state. You can also contact Medicare directly for answers to your questions by calling 800-633-4227. TTY users can call 877-486-2048.
Medigap Plan C is a popular supplement option because it covers so many of the out-of-pocket costs associated with Medicare.
However, starting on January 1, 2020, Plan C was discontinued due to a congressional ruling that Medigap plans can no longer cover the Medicare Part B deductibles.
If you already have Plan C, you can keep it and enroll in it if you were eligible for Medicare on or before December 31, 2019.
You can also enroll in similar plans without the Part B deductible coverage. Similar plans include Medigap plans D, G, and N.