Plans C & F (Eligible Before 2020): Medigap Plans Explained

Plans C and F are two of the standardized Medigap plans. Medigap is private insurance that may help pay some costs Original Medicare does not cover, such as certain deductibles, copayments and coinsurance. Plan F is known for covering a broad set of those cost-sharing items. Plan C is similar in many ways but is a different plan.

High-deductible Plan F works like Plan F once you meet a yearly deductible set by the plan. Before that, you pay certain costs yourself. Because it is a separate version, it is worth understanding how it differs from regular Plan F.

Here is the key rule. Plans C and F, including high-deductible F, are available only to people who became eligible for Medicare before January 1, 2020. People newly eligible after that date can buy Plans A, B, D, G, K, L, M and N, plus high-deductible Plan G. Plans E, H, I and J were discontinued and are not sold today, even though people still search for Plan H. Massachusetts, Minnesota and Wisconsin standardize Medigap differently, so confirm details for your state.

Many people who qualify have traditionally kept Plan F or Plan C for years. They often value having a plan whose cost-sharing is largely handled, which can make medical bills feel more predictable. Medigap plans are generally guaranteed renewable, which means the plan is typically kept as long as premiums are paid, though you should confirm the terms of your own policy.

A common question is Plan F versus Plan G. The two are similar in many ways, and the differences are usually in which cost-sharing items each one covers. Some people compare the plans side by side, looking at monthly premiums and the cost-sharing items each plan does or does not cover. Others consider switching plans over time. Plan G is open to people newly eligible, while Plan F is not.

Another traditional approach is comparing Medigap with Medicare Advantage. Medigap lets you see any provider nationwide that accepts Medicare, with no network or referrals, and offers predictable cost-sharing. The trade-offs are that monthly premiums are generally higher, medical underwriting may apply outside open enrollment or guaranteed issue, drugs need a separate Part D plan, and routine dental, vision and hearing are not included. Medicare Advantage often has lower premiums, an annual out-of-pocket maximum, extra benefits and drug coverage in many plans. Its trade-offs include networks, prior authorization and copays. Neither is wrong; they suit different needs.

A Medigap agent may help you sort out whether you qualify for Plan C or Plan F based on when you became eligible for Medicare. That date matters. An agent may also explain which carriers in your state sell these plans, and how the rules work where you live.

In a conversation, an agent will generally ask about your health needs, your doctors, how you use care, and how you feel about monthly premiums versus cost-sharing. Many people find it helpful to bring their current plan details, a list of medications and questions about whether switching could involve medical underwriting.

Good questions to ask include: Am I eligible for Plan F or Plan C? How does my current plan compare with Plan G? What happens if I change plans? Could I be asked health questions? How might premiums change over time? An agent may help you think these through, but no outcome is guaranteed. Call 1-800-MEDIGAP for more information.