Medigap Plan K Supplement Insurance

Medigap Plan K is a Medicare Supplement insurance plan that helps you pay for out-of-pocket costs associated with Original Medicare — Medicare Part A and Part B.

While most Medigap plans cover 100% of most costs, you will still have to pay some out-of-pocket costs under Plan K until you meet your Part B deductible and your plan’s maximum out-of-pocket (MOOP) limit for the year – $6,940 in 2023.

As an example of how Plan K would work, here’s how it would cover your Medicare Part B medical insurance coinsurance payment. If you had a $100 medical bill from an office visit with your doctor, Part B would pay $80. You would have to pay the remaining $20.

With Medigap Plan K, the plan would pay $10 and you would pay the other $10.

There are some out-of-pocket costs that Medigap Plan K does not cover.

Medigap Plan K does not cover prescription drugs or dental, vision and hearing care. No Medigap plans cover these costs.

If you want help paying for prescriptions, you can purchase a Medicare Part D prescription drug plan from a private insurer. You can also purchase a Medicare Advantage plan — most contain Medicare Part D benefits. Medicare Advantage plans may also cover dental, vision and hearing care.

Medicare Plan K policies are sold by private insurers. Monthly premium costs vary from company to company and depending on where you live. Plan K premiums are in addition to monthly premiums you have to pay for Original Medicare and optional Medicare Plan D prescription drug coverage.

Your monthly premiums for Medigap Plan K and other Medicare coverage — Medicare Part A, Part B and Part D — do not apply to your maximum out-of-pocket limit.

Medigap Plan K is similar to Plan L. When comparing Medigap plans, note that the key difference is that Plan L provides more benefits and a lower maximum out-of-pocket limit. Where Plan K covers 50% of some out-of-pocket costs, Medigap Plan L covers 75% until you meet the Plan L MOOP – $3,470 in 2023.

Either Medigap Plan K or Plan L may be a good fit if you prefer coverage similar to an employer health insurance plan and are not bothered by out-of-pocket costs.

They may also be right for you if you live in a state that doesn’t allow Medicare Part B excess charges, are in relatively good health, don’t have serious health problems and seldom have to visit a doctor.