Medigap Plan K Supplement Insurance
Medigap Plan K is a Medicare Supplement plan that pays half of many Original Medicare out-of-pocket expenses until you hit your plan’s maximum out-of-pocket limit for the year. After reaching that limit, Medigap Plan K pays 100% of the Medicare-covered costs that Plan K covers.
- Written by Terry Turner
Senior Financial Writer and Financial Wellness Facilitator
Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
- Edited ByLee Williams
Senior Financial Editor
Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.Read More
- Financially Reviewed ByBrian Hickey, CLU®, CLTC®, FLMI
Brian Hickey, CLU®, CLTC®, FLMI
Vice President of Insuractive
Brian Hickey is vice president of Insuractive, an Omaha-based company providing direct-to-consumer Medicare plans, life insurance and wealth protection to individuals. With 24 years’ experiencein Medicare, long-term care, life insurance and wealth protection, Brian leads and develops Insuractive’s strategic initiatives with a focus on direct-to-consumeroptions for insurance information and solutions.Read More
- Published: July 2, 2021
- Updated: May 23, 2023
- 3 min read time
- This page features 9 Cited Research Articles
- Edited By
What Does Medigap Plan K Cover?
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.
- 100% of Medicare Part A coinsurance and hospital costs for an extra 365 days after your Original Medicare benefits are used up
50% of the following Medicare costs until you reach your MOOP each year:
- Medicare Part A deductible
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part B coinsurance or copayment
- First three pints of blood for medical procedures each year
- Skilled nursing facility care
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.
- Medicare Part B deductible – $226 in 2023
- Medicare Part B excess charges – charges over and above the Medicare-approved amount that your doctor is legally allowed to bill you for medical services
- Emergency medical care while traveling in a foreign country
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.
How Much Does Medigap Plan K Cost?
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.
- Monthly premiums – amount varies depending on location and plan administrator
- Medicare Part B hospital insurance deductible – up to $226 in 2023
- Medigap Part B excess charges – if you have any
- 100% of any medical care while traveling outside the United States
- Maximum out-of-pocket costs before Plan K provides full coverage – up to $6,940 in 2023
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.
What Is the Difference Between Medigap Plan K and Plan L?
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.
9 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2022, October). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/medicare/health-plans/medigap/kandl
- U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
- U.S. Centers for Medicare & Medicare Services. (2022, September). Welcome to Medicare. Download. Retrieved from https://www.medicare.gov/media/12116-Welcome-to-Medicare.pdf
- Bunis, D. (2022, May 11). Medigap Plans Help Bridge Gap of Original Medicare Costs. Retrieved from https://www.aarp.org/health/medicare-insurance/info-2017/choosing-right-medigap-plan.html
- U.S. Centers for Medicare & Medicare Services. (2022, March). Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://web.archive.org/web/20230314223405/https://www.medicare.gov/sites/default/files/2022-03/02110-medigap-guide-health-insurance.pdf
- U.S. Centers for Medicare & Medicare Services. (2021, December 1). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/Medicare/Health-Plans/Medigap/KandL
- U.S. Centers for Medicare & Medicare Services. (n.d.). How to Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
- U.S. Centers for Medicare & Medicare Services. (n.d.). What’s Medicare Supplement Insurance (Medigap)? Retrieved from https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap
- U.S. Centers for Medicare & Medicare Services. (n.d.). Medicare Costs at a Glance. Retrieved from https://www.medicare.gov/basics/costs/medicare-costs
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