Medigap Plan K – Medicare Supplement

Medigap Plans
Part A Hospital Coinsurance Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
365 Hospital Reserve Days Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Benefit for Blood Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Hospice coinsurance Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled Nursing Facility No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess No No No No Yes Yes No No No No
Foreign Travel Benefit No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit N/A N/A N/A N/A N/A N/A $4,940 $2,470 N/A N/A

Plan K utilizes different cost-sharing for items and services than most of the supplement plans. Instead of paying all of your costs, the plan will pay a percentage. You will have to pay some out-of-pocket costs for some covered services, also known as a deductible, until you meet the yearly cap for out of pocket spending. Once you meet the limit, the Medigap policy plan pays 100 percent of Medicare-approved costs, such as the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year.

Charges from your doctor that exceed Medicare-approved amounts, called “excess charges” aren’t covered and don’t count toward the out of pocket limit. You will be responsible for paying these excess charges. The maximum amount that you are responsible for paying yourself can also increase each year due to inflation.

Plan K is a good option if you prefer a lower premium and also have low medical expenses but still want a fair amount of coverage for a wide variety of services.

Medicare Supplement Plan K requires you to pay an out-of-pocket deductible. Benefits will begin after the $ 4,620 limit has been reached. Specifically included with Plan K benefits, Part A coinsurance and all costs after the hospital benefits are exhausted are covered 100%. Coinsurance for Part B preventative care is also covered for 50% of the Medicare-approved amount. The copay or coinsurance for Part B health care is covered 50% for services other than preventative. Also covered at 50% are hospice care, the Part A deductible, and skilled nursing facility services. Blood coverage is also covered at 50% after the first 3 pints.

There are services and benefits not covered under Plan K. The deductible for your Part B coverage is not covered. Any excess charges that Medicare does not subsidize, as explained above, are also your responsibility. Emergency travel abroad coverage is not included with this plan, so be aware of this when traveling. Benefits for home health care recovery are also not included in Plan K.

Not all providers offer all of the Medicare Supplement Plans. It can also be difficult to determine which plan is right for you. Our trained specialists can help you find the plan that best fits your needs and budget. Most insurance carriers offer a variety of plans, so our specialists can help you shop around for the best price.

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