EmblemHealth Medicare Supplement Insurance Plan C (PLH-5374 MSC)

Plan at a Glance

  • Hospitalization - EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare benefits end.
  • Medical Expenses - EmblemHealth pays Part B coinsurance* (generally 20% of Medicare-approved expenses).
  • Blood - First three pints of blood each year.
  • Hospice - Part A coinsurance
  • Coinsurance for skilled nursing facility care.
  • Part A inpatient deductible** per benefit period: $1,340 in 2018.
  • Part B annual deductible: $183 in 2018.
  • Emergency care rendered during the first 60 days of foreign travel.

* Coinsurance is the portion or percentage of the cost of a Medicare covered service that you are responsible to pay.

** Part A inpatient deductible is the dollar amount of costs for covered services you would be expected to pay for Medicare Part A hospitalization services, including semi-private room and board, general nursing and miscellaneous services and supplies during the first 60 days of a covered admission.

Basic Benefits

Benefit Chart of Medicare Supplement Plans

When Benefits Begin

Coverage begins on the effective date of the contract as shown on the contract schedule page, which is sent to you upon receipt of your initial payment. For open enrollment applications approved between the first and 15th of the month, coverage will begin on the first day of the following calendar month. For open enrollment applications approved after the 15th of the month, coverage will begin on the first day of the second month after approval. A waiting period of six months is required for pre-existing conditions. The waiting period applies to conditions for which medical advice or medical treatment was recommended by or received from a physician within six months of your effective date of coverage. However, the six-month waiting period may be reduced if you are replacing an existing plan. Your EmblemHealth Medicare Supplement contract will describe the circumstances under which your EmblemHealth Medicare Supplement plan’s waiting period may be reduced by the period of time you have been covered under your existing plan.