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Plan K

Medigap Plan K is a cost-sharing plan available to Medicare beneficiaries. It has benefits similar to other Medigap plans but has a lower monthly premium. Medicare Supplement Plan K can help you to reduce your costs because Part A and B don’t cover them in full.

With the benefit of a less costly monthly premium, Medigap Plan K provides the same basic benefits as other Medicare Supplement insurance plans. In exchange for the lower premium, these cost-sharing plan covers less of the coinsurance and copayments than other Medicare Supplement insurance plans. Keep in mind though that you will have the added security of a maximum out-of-pocket cost every year.

Coverage Benefits

Medigap Plan K

Medigap Plan K covers some benefits in full and others at 50%. It covers the Part A coinsurance, foreign travel emergencies, and the Part B coinsurance for preventive services at 100%.

Plan K does not cover the Part B deductible or the Part B excess charges. However, Part B excess charges are not common and if you live in a state that does not allow them, this is not an issue.

Medigap Plan K covers:

  • Part A coinsurance and up to an additional 365 days of hospital costs after Medicare benefits are exhausted
  • 50% of the Part B coinsurance/copayment
  • 50% of the first 3 pints of blood
  • 50% of the Part A hospice coinsurance/copayment
  • 50% of the Skilled nursing facility care coinsurance
  • 50% of the Part A deductible
  • $6220 out-of-pocket limit (in 2021), then Medigap pays 100%

Medigap Plan K Premiums

Individual premiums will vary based on which state the individual is seeking coverage in, which carrier they’re purchasing from, and also individual factors like gender, age, tobacco use, and a few other details. The average cost for Plan K ranges from $40-$100 each month. In general, Plan K premiums are higher in states who have a higher cost of living.

In comparison, Plan K offers a lower monthly premium than Plan L. At the same time, it offers higher coinsurance amounts and a higher annual out-of-pocket limit.

Plan K Out-of-Pocket Maximum

Plan K is one of two Medigap plans that offers a maximum out-of-pocket(MOOP) limit. In 2023, the MOOP limit will be $6940 and keep in mind this number typically increases each year. After the maximum has been met, Plan K will pay for 100% of covered services for the remainder of the year.

If you are enrolled in Original Medicare (Part A and Part B) then you are also qualified to enroll in Supplement Plan K. You can enroll in it during the Medigap open enrollment period which lasts for six months and starts after your Part B becomes effective.

Alternatives to Plan K

Plan L and Plan M are two cost-sharing plans that may be a good alternative to Plan K. They both offer more coverage and have less cost-sharing requirements, but the monthly premiums for both are typically higher than the Plan K premiums. Individuals will need to decide which factor is more important to them. You can look into all available Medigap plans to weigh out your options and find one which suits your best.

How to Compare

Medigap Plan K Rates

There is a lot of information about each plan online, but to get an accurate quote, you’ll need to enlist the help of a licensed Medicare agent. Instead of calling each insurance carrier to get a quote, we can compare premiums across many different carriers, ensuring that you enroll with one that gives you the best rate.

We’ll need to collect some information from you in order to provide quotes since your premium is based on your information and health history, but our services come at no additional cost to you! If you choose to enroll in a Medigap plan through our agency, we also offer unlimited support. If you have problems with your coverage or have questions about how your plan works, we will be here to help.

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Questions to be advised on:

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Any Medicare beneficiary who is already enrolled in Original Medicare – Parts A and B – is eligible to enroll in Plan K.
Many insurance carriers offer High Deductible Plan G as a Medicare supplement option. Each carrier may offer different plans in different states. No matter which carrier you enroll with, the plan’s benefits remain the same. The only difference will be the premium.
Plan K does not include routine eye exams or coverage for eyeglasses or contact lenses. Medigap plan holders should consider enrolling in a separate Dental, Vision, Hearing (DVH) plan.
Plan F will provide the most comprehensive coverage. However, that comes with a price as the premiums for Plan F will be much higher than those for Plan K. Also, Plan F is not available to anyone who turns 65 after January 1, 2020, so it is not an option available to everyone. Individuals who are eligible for both will need to weigh the difference in premiums versus the difference in coverage.
Plan K does not have a deductible in itself, but Plan K members do have to pay half of the Part A deductible and the entire Part B deductible. Deductibles for both of these can change each year.
Plan K is a great choice for individuals who are searching for a lower monthly premium. It does have some cost-sharing required, but also provides benefits for those who travel outside of the United States. While it is not the most comprehensive plan available, it still offers great benefits for the price.
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