Medicare Supplement Plan K is one of 10 different Medicare health insurance supplemental plans.
Plan K supplemental insurance plan is a cost-sharing plan that will split the medical cost between the insurance company and the individual beneficiary.
Although shared cost plans provide fewer benefits, they cost less than the broader coverage plans, which cost more for the additional coverage.
Medicare Supplement Plan K Benefits
If you are interested in a Medicare Supplemental Plan K and its benefits to lower your costs, keep in mind it doesn’t cover all of the gaps completely.
Other plans will give you a lot more coverage and offer you a greater overall value for the money.
Plan F and Plan G are both very popular plans, the top two plans in the market. Most additional benefits provided in Plan K are based on the individual beneficiary sharing the cost with the insurance company at rates as high as 50% for covered items.
Medicare Plan K might offer you some assistance in paying for the costs and medical expenses Medicare doesn’t cover; however, many of the costs are the responsibility of the insured to pay.
For some services, Plan K typically pays only half, until you’ve met an out-of-pocket maximum limit, leaving you to pay the balance.
Plan K won’t cover any excess charges, but depending on which state you live in, your state may enforce the Medicare Overcharge Measure (MOM law) then you do not need to worry about excess charges.
Plan K does not cover costs if you are outside the United States.
Outline of Coverage for Medicare Supplemental Plan K
Plan K coverage includes your Part A hospital coinsurance costs for up to 365 days once your regular Original Medicare benefits are used or completely exhausted.
Additionally, included in this coverage is your Part B coinsurance for preventive care.
Medicare Supplement Plan K covers 50% of your cost for the following:
- Copayments and coinsurance for Medicare Part B
- First 3 pints of blood when you need surgery
- Copayments and coinsurance for Part A hospice care
- Coinsurance use when you need skilled nursing facility care
- Deductible for Medicare Part A
Plan K Out of Pocket Maximum
Once your yearly limit for out-of-pocket expense has been met, then your Medigap plan will pay 100% of your covered services for the remainder of the calendar year.
Plan K Pros and Cons
Always factor in your cost for a plan and its potential benefits provided. The amount of cost saved when using a cost-sharing plan is attractive for anyone trying to save money.
Remember, other plans cost a little more each month in premiums but will pay for more benefits overall.
Both of the Medicare Supplemental plans, Plan K and Plan L, are cost-sharing plans. Use the chart below to compare Medigap Plan K to the other options available.
|Medigap Benefits||Medigap Plans|
|Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Part B coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes***|
|Blood (first 3 pints)||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A hospice care coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Skilled nursing facility care coinsurance||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 charge||No||No||No||No||Yes||Yes||No||No||No||No|
|Foreign travel exchange (up to plan limits)||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||$6,940 in 2023||$3,470 in 2023||N/A||N/A|