MEDICARE PART C

Medicare Part C

Since Medicare Part A and Part B roughly pay for around 75 percent of all your medical cost, you are now at a fork in the road.  You may stay only with Part A and Part B and pay the rest on your own, or you may have a “gap plan” (also called Part C) to cover the rest.  

Option 1: Medicare Advantage

  • Individuals who are entitled to benefits under Part A and enrolled under Part B are eligible to enroll in a Medicare Advantage plan.
  • All Medicare Advantage (MA) plans must cover all Part A and Part B benefits. Plan cost-sharing must be actuarially equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services.
  • Health Maintenance Organizations (HMOs) (some also include Part D)
  • Preferred Provider Organizations (PPOs) (some also include Part D)

Option 2: Medigap and Medicare Supplement Insurance

  • Medigap insurance is sold by private insurance companies to fill “gaps” in Original Medicare coverage. Medigap policies only work with Original Medicare.
  • Medigap insurance does not cover Medicare benefits, but works with Original Medicare coverage. Medigap covers Part A and Part B cost sharing (coinsurance, copayments, or deductibles) for beneficiaries in Original Medicare.
  • Some Medigap policies cover benefits not covered by Part A or Part B of Original Medicare, such as assistance with at-home recovery or extra days of coverage for inpatient care.
  • Medigap helps pay Part A and Part B coinsurance, copayments, and/or deductibles when Original Medicare determines that a benefit is medically necessary. Some Medigap plans also cover benefits not covered by Original Medicare.
  • Available in standardized benefit plans, identified by the letters A - L (different plans are offered in Massachusetts, Minnesota, and Wisconsin).
  • Turning age 65 and signing up for Part B triggers a six-month Medigap open enrollment period when Medigap plans must be issued, regardless of any pre-existing conditions.

Most Medigap plans pay for some or all of the following costs:

  • Part A Coinsurance and Hospital Benefits
  • Part A Deductible
  • Coverage for 365 Additional Hospital Days when Medicare coverage ends
  • Part B Coinsurance or Copayment
  • Part B Deductible
  • Part B Excess Charges
  • At-Home Recovery not covered by Medicare
  • Blood (First 3 pints)
  • Hospice Care Coinsurance
  • Preventive Care Coinsurance
  • Preventive Care not covered by Medicare (up to $120)
  • Skilled Nursing Facility Care Coinsurance

Medicare Supplement Chart for 2010

Medicare Supplement Chart

Good Neighbor Insurance will be able to provide, in most states, a Medical Supplement Plan that will fit your needs. In the Medicare Supplement Plans, you will have an array of options from Plan C to Plan N, with Plan F being the “best bang for your buck.” Please click on this form and fill out the needed information so we may provide you with a couple of Medicare Supplement Plans that will fit your needs.


Other Medicare Information

2009 Medicare Information

2008 Medicare Information

2007 Medicare Information

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