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Medigap Plan K

Medigap Plan K is a type of cost-sharing plan that offers benefits like other Medigap plans but with a lower monthly premium. This plan can help reduce costs for Medicare beneficiaries since Parts A and B do not cover all costs in full. Despite the lower premium, Medigap Plan K provides the same basic benefits as other Medicare Supplement insurance plans. However, in exchange for the lower premium, cost-sharing plans cover less of the coinsurance and copayments than other Medicare Supplement insurance plans. It’s worth noting that there is a maximum out-of-pocket cost every year, providing added security for plan members.

Medigap Plan K Coverage Details

Medigap Plan K provides coverage for certain benefits in full, while others are covered at 50% of the cost. This includes coverage for the Part A coinsurance and foreign travel emergencies. Plan K also covers 100% of the Part B coinsurance for preventive services. However, it does not cover the Part B deductible or the Part B excess charges. It’s worth noting that excess charges are uncommon and if you live in a state that doesn’t allow them, this won’t be 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

The premiums for Medigap Plan K vary based on various factors such as age, gender, tobacco use, the state of coverage, and the chosen insurance carrier. On average, the monthly cost for Plan K ranges from $40 to $100, and premiums are generally higher in states with a higher cost of living. Compared to Plan L, Plan K offers a lower monthly premium, but it comes with higher coinsurance amounts and an annual out-of-pocket limit.

Plan K Out-of-Pocket Maximum

Medigap Plan K is one of the two plans that provide a maximum out-of-pocket (MOOP) limit. In 2023, the MOOP limit for Plan K is $6,940, and this amount typically increases annually. Once the MOOP limit is reached, Plan K covers 100% of the covered services for the remainder of the year.

To enroll in Medigap Plan K, you must first be enrolled in Original Medicare (Part A and Part B). The Medigap open enrollment period, which lasts for six months and begins after your Part B becomes effective, is the best time to enroll in Plan K. Keep in mind that eligibility requirements may vary by state, and individual factors such as age, gender, and tobacco use can affect the monthly premiums.

Alternatives to Plan K

Medigap Plan L and Plan M are two cost-sharing plans that could be a viable option for those who need more coverage than Plan K. These plans have higher monthly premiums than Plan K, but also offer more coverage and have fewer cost-sharing requirements. When deciding between these plans, individuals must determine which factor is more important to them. It’s essential to explore all available Medigap plans to compare the options and choose the one that best meets your needs.

How to Compare

Medigap Plan K Rates

To receive an accurate quote for a Medigap plan, it’s best to consult a licensed Medicare agent rather than searching online or contacting individual insurance carriers. With our services, we can compare premiums across various carriers to ensure that you receive the best rate for your needs. However, we’ll need to collect some personal information and health history to provide accurate quotes. Our services come at no additional cost to you, and if you choose to enroll in a Medigap plan through us, we offer unlimited support. You can count on us to assist you with any issues or concerns you have about your coverage.

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