Plan C covers everything except Part B excess. It's no longer available to anyone who became eligible for Medicare after January 1, 2020 - a MACRA rule change. Existing Plan C holders can keep their plans.
Best for
- Existing Plan C holders considering whether to keep their plan
Watch out for
Not available to new enrollees. Plan G is the modern equivalent.
What Plan C covers
- Part A coinsurance & 365 extra hospital daysCovered in full
- Part B coinsurance or copaymentCovered in full
- Blood (first 3 pints)Covered in full
- Part A hospice coinsurance / copayCovered in full
- Skilled nursing facility coinsuranceCovered in full
- Part A deductibleCovered in full
- Part B deductibleCovered in full
- Part B excess chargesNot covered
- Foreign travel emergency (up to plan limits)Covered in full
Compare to other Medigap plans
- Plan AThe minimum-coverage Medigap plan - basic benefits only.
- Plan BPlan A plus the Part A deductible.
- Plan DPlan G minus Part B excess. Modest savings, modest reduction in benefit.
- Plan FThe 'everything' plan - closed to newly eligible after Jan 1, 2020.
- Plan GToday's most popular Medigap plan - comprehensive coverage minus only Part B deductible.
- Plan KLower premium, partial coverage with out-of-pocket cap.
- Plan LLike Plan K but covers more - 75% of most cost-sharing.
- Plan MSplits the Part A deductible 50/50 between you and the plan.
- Plan NLower premium than Plan G in exchange for office and ER copays.
What Does Medigap Plan C Cover?
Plan C is one of the most complete letters ever standardized. It covers eight of the nine benefits on the Medigap chart. Only Part B excess charges are left out.
- Part A hospital coinsurance, plus 365 extra hospital days for life
- Part B coinsurance and copays on doctor visits and outpatient care
- The Part A hospital deductible, paid in full each benefit period
- Skilled nursing coinsurance for covered rehab stays
- The Part B deductible, paid for you each year
- The first three pints of blood and Part A hospice coinsurance
- Foreign travel emergency care, up to the limits in your policy
The one gap
Plan C does not pay Part B excess charges. Those apply only when a provider does not accept Medicare assignment. Most California doctors do accept it, so the exposure is limited for many people.
Why Is Plan C Closed to New Enrollees?
Congress passed a law that stopped new Medigap plans from paying the Part B deductible. The change took effect on January 1, 2020. Plan C and Plan F both pay that deductible, so both closed to newly eligible members.
Who can still hold or buy Plan C
You already own a Plan C policy
Your coverage continues as long as you pay the premium. Nothing about your benefits changes because of the law.
Eligible for Medicare before January 1, 2020
You may still be able to buy Plan C, even if you had not enrolled yet. Ask which carriers still offer it.
You became eligible after that date
Plan C is not available to you. Plan G is the closest modern equivalent, and Plan D is close behind it.
What a closed plan really means
No new members join a closed block of business. The group grows older together, claims rise, and premiums often climb faster than on open letters. Your benefits are safe. Your rate is the thing to watch.
Should You Keep Your Plan C?
There is no single answer, and anyone who gives you one quickly is guessing. The honest question is whether your premium still buys value compared with an open letter.
Reasons to stay
Keeping Plan C makes sense if:
- Your current rate is still competitive against open letters in your county.
- Your health would make underwriting a real risk right now.
- You value having the Part B deductible paid for you each year.
- Your carrier's recent increases have been steady rather than steep.
Reasons to shop
Look at other letters if:
- Your renewal notice has jumped noticeably two years in a row.
- An open letter would cover more for a similar monthly premium.
- You are in good health and your birthday window is coming up.
- You want Part B excess charges covered, which Plan C never includes.
Plan C or Plan G: How Do They Compare?
Plan G is the letter most Plan C holders end up comparing against. The trade is simple. You give up having the Part B deductible paid, and you gain Part B excess coverage.
Plan C vs Plan G
Medigap Plan C
Closed to newly eligible members. Pays the Part B deductible for you.
- Open to new enrollees
- No, closed since January 1, 2020
- Part A coinsurance and 365 extra days
- Covered in full
- Part A hospital deductible
- Covered in full
- Skilled nursing coinsurance
- Covered in full
- Part B deductible
- Covered in full
- Part B excess charges
- Not covered
- Foreign travel emergency
- Covered up to plan limits
- Typical premium
- Among the highest of any letter
- Membership trend
- A closed group that grows older each year
Medigap Plan G
Open to everyone. The most popular supplement sold today.
- Open to new enrollees
- Yes
- Part A coinsurance and 365 extra days
- Covered in full
- Part A hospital deductible
- Covered in full
- Skilled nursing coinsurance
- Covered in full
- Part B deductible
- You pay it each year
- Part B excess charges
- Covered in full
- Foreign travel emergency
- Covered up to plan limits
- Typical premium
- Lower than Plan C in most counties
- Membership trend
- Growing, with new members joining
The Part B deductible is a modest yearly amount set by Medicare. If the premium savings on Plan G outrun it, the math favors moving. We run that comparison with your real numbers.
Can the Birthday Rule Move You Off Plan C?
California's birthday rule is the friendliest exit a Plan C holder has. It lets you switch supplements once a year with no health questions asked.
How the window works
- 01
It opens 30 days before your birthday
The window runs 60 days in total and closes 30 days after your birthday.
- 02
It applies to supplement holders only
You must already have a Medigap policy in force. Plan C qualifies you to use the window.
- 03
You may move to equal or lesser benefits
Carriers rank the letters when they apply this rule. We confirm which letters a given company will accept before you apply.
- 04
Your health does not matter
The new carrier cannot ask health questions or charge you more because of your history.
Trial rights and guaranteed issue
If you dropped a supplement to try Medicare Advantage for the first time, you have twelve months to return. If your old policy is gone, you choose from a guaranteed list of letters.
That list includes Plan C only for people who were eligible for Medicare before January 1, 2020. Everyone else is pointed to Plan D and Plan G instead.
What Happens If You Apply Outside a Protected Window?
Then the carrier decides based on your health. Leaving a closed plan can be a one way door, so this deserves careful thought before you sign anything.
- Health questions covering recent treatment, testing, and surgery
- A prescription database check that fills in what the form leaves out
- Attention to anything unresolved, such as a pending biopsy or a scheduled joint replacement
- Height and weight against the carrier's limits
- A phone interview if the file needs clarifying
Never cancel first
Your Plan C stays in force until a new policy is approved with a written effective date. If the new carrier declines you, you still have your coverage. We manage the timing so there is never a gap.
How Do You Decide Without Guessing?
A Plan C decision is really three questions. What are you paying now, what would an open letter cost, and can you qualify to move. We answer all three in one sitting.
What our review pulls together
Your current rate and its trend
We look at your last two renewal notices, not just this year's bill.
Live quotes from every licensed carrier
We are independent, so no company gets a head start in the comparison.
Your qualifying window
Birthday rule, trial right, or underwriting. The answer changes what is realistic.
The drug side of the ledger
Plan C includes no drug coverage. We check your Part D plan during the same visit.
We are an independent agency at 2135 N Pami Circle in Orange, and we meet in person, by video, or by phone. Book an annual review or call (714) 922-0043. There is no cost to you.