Medicare Supplement Insurance (Medigap) Plan Details


Supplement Plan C

(This plan is no longer available for people who turned 65 years old after 1/1/2020)


Monthly Premium


Covered Benefits
  • Skilled nursing facility
  • Part A deductible
  • Part B deductible
  • Part B excess charges
  • Foreign travel emergency


*Monthly costs shown do not include the standard Part B premium. 2021 Medicare Part B premium is $148.50 per month.

Coverage Overview

Part A - Hospital - Deductible


(what you pay)
Part B - Medical - Deductible


(what you pay)
Part B - Medical - Coinsurance


(what you pay)

Coverage Details

Part A Coinsurance

(what you pay)

Hospital stays
Days 1-60: $0
Days 61-90: $0
Days 91-150: $0 while using your 60 lifetime reserve days
Additional 365 days: $0 for Medicare-eligible services
After the additional 365 days: All costs
Skilled nursing facility (for Medicare-covered stays)
Day 1-20: $0
Days 21-100: $0
After 100 days: All costs
Blood (during a hospital stay)
First 3 pints: $0
After 3 pints: $0
Hospice care

Part B Coinsurance

(what you pay)

Covered Part B services
First: $0
Then: $0
Preventive services
$0 Generally for most preventive services Medicare covers
Part B excess charges
All costs
Blood (outside a hospital stay)
First 3 pints: $0
After 3 pints: $0
Tests for diagnostic services

Home Healthcare - Part A & B Services

(what you pay)

Home health care (for Medicare-approved services)
Durable medical equipment (covered by Medicare)
First: $0
Then: $0

Extra Benefits

(what you pay)

Foreign travel emergency
First: $250
Then: 20% and amounts over the $50,000 lifetime maximum

Insurance Companies Offering This Plan


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