Medigap Insurance Plan C is a great coverage to purchase because it covers nearly all of the out-of-pocket deductibles, coinsurance and copays that are not covered by Original Medicare and therefore become gaps in your healthcare coverage that you would usually be required to pay. The only real exception to this is the fact that Medigap Plan C doesn’t cover the Medicare Part B excess charges that the government allows a provider to charge a medicare beneficiary.
Excess charges are surcharges that your doctor can charge above and beyond what Medicare will normally reimburse the provider. They’re limited to no more than 15% beyond what Medicare pays. Most doctors that you see do not charge excess charges because they have accept the Medicare fee schedule. However some providers may not accept the Medicare fee schedule and choose to bill up to 15% beyond the standard rate but few rarely do. If this possibility of potential excess charges beyond what Medicare normally allows a provider to charge concerns you, then you better option would be to buy a Medigap Plan F or Plan G instead of a Medicare Supplemental Plan C. Both Plan F and Plan G cover all the allowed excess charges, so you ever have to worry about coming out of pocket to cover those expenses.
You can read more about excess charges and how they are assessed here.
Consider this scenario: Flora purchases a Meidicare Supplement or Medigap Plan C insurance policy. Most of her doctors are participating Medicare doctors so Flora usually owes absolutely nothing when she receives medical care. Flora twists her ankle while jogging one day. At first she tries to shake it off but then she notices swelling, so she visits an urgent care clinic for an outpatient X-ray and exam. The clinic that she visits does not accept the standard Medicare assignment rates, but chooses to bill an excess charge to patients. The fee for her X-ray is normally only $50.00 but at this clinic there is an additional 15% excess charge, bringing the cost to a total of $57.50. Since Flora’s Medicare Supplemental Plan C does not cover any excess charges, Flora will owe the $7.50 difference to the medical facility.
Medicare Supplement Plan C is one of 10 different medicare supplement options available to you. (Medicare Part C, on the other hand, refers to Medicare Advantage insurance plans. These are not supplements and work very differently than medigaps or medicare supplements.) If you decide stay in Original Medicare and purchase a Plan C, you will enjoy the freedom of access to top medical physicians and hospitals. Medical providers prefer their patients obtain remain in Original Medicare because it allows the patient and the doctor to stay in full control of your medical care. You”ll not need authorizations for approved medicare services that you and your doctor have already agreed upon. You will simply be able to schedule the procedure or service and get the medical care that you need. You can also be assured that your supplemental policy is going to cover things like your inpatient and outpatient deductibles. This has made Medicare Supplemental Plan C a very popular choice among medicare beneficiaries.
Medicare Supplemental Plan C has benefits that are very similar to a Plan F supplement. The main difference is the coverage for excess charges that was outlined above. So, if not having the coverage for excess charges is worrisome to you, then you should allay your fears and purchase policy that covers these costs like a Medicare Supplement Plan F or G. You can receive quotes for Plan F or Plan G in order to make a fair comparison. You will find that in many areas the prices are almost the same, making it a very cost effective way to buy the richer coverage that appeals to you.
There are literally dozens of private insurer’s that offer supplement policies in every state. These insurance companies have often been in operation for decades and offer great coverage. Some of these companies will be the large brand name insurance carriers that you’ll easily recognize. You have may have even enjoyed insurance benefits from them during your working years through your former employer health plan. They are like household names and offer competitive rates as well.
However, there are quite a few not so well-known private insurer’s that too have a solid financial rating that offer medicare supplements in your state. You should get a quote from them as well because they may provide greater savings and still give you exactly the same benefits of the blue chip insurance carrier.
Do you need help comparing prices for different insurance carriers? Contact our insurance specialist and get a medicare coverage helpline review of companies offering the best coverage at the lowest prices. Call us today at 1-866-936-3831.