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Medigap Plan K

Medigap Plan K provides many of the benefits that Medicare Supplement plans can offer using a cost-sharing format. It also has an out-of-pocket maximum, or a limit on how much spending you will have to do if you enroll in this plan.

What does Medigap Plan K cover?

If you enroll in Medigap Plan K, you will receive 100% coverage for

  • Medicare Part A coinsurance payments for inpatient hospital care up to an additional year after your Medicare benefits have been expended
  • Part B preventive care coinsurance 
  • Foreign travel emergency expenses (up to your plan’s limit)

Additionally, your Medigap plan will cover 50% of the following expenses

  • Part B coinsurance and copays
  • Skilled Nursing Facility (SNF) and Part A Hospice Care coinsurance and copays
  • Part A deductible ($1,484 in 2021)
  • First three pints of blood for a medical procedure 

The only expenses that aren’t covered at all by Plan K are your Part B deductible and Part B excess charges*

Plan K does come with an out-of-pocket maximum, which puts a cap on Medicare spending that you will have to do each year. However, the coverage offered by Plan K isn’t as extensive as what you would get with Plan F or Plan G

Plan K isn’t available in all states, and not all insurance providers offer it. Plus, its premiums may not be low enough to justify choosing this plan. Consequently, it is a relatively unpopular Medicare Supplement plan, with on average only 1% of Medigap enrollees choosing Plan K. 

*Excess charges are incurred when a medical provider doesn’t “accept assignment” or, in other words, charges more than the Medicare-approved amount that corresponds to their services.

What is the Plan K out-of-pocket maximum?

The limit on spending that you have to do with Plan K is set at $6,220 for 2021. Once you have spent that amount of money on Medicare costs, your plan will pay 100% of the remaining eligible expenses for the rest of the year. 

Just be aware that out-of-pocket (OOP) limits increase annually, so the maximum when you enroll in the plan will not be the same the following year or years down the road. 

If you think that Plan K could be a good fit for you, or you simply want to consult your Medicare Supplement Insurance options, reach out to a licensed insurance agent here at Medicare Plans Direct.

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