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Medicare Basics

Medigap Plan K – Medicare Supplement

Benefits
Medigap Plans
A B C D F G K L M N
Part A Hospital Co-insurance Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
365 Hospital Reserve Days Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B co-insurance/co-payment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Blood Benefit (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Hospice coinsurance/co-pay Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled Nursing Facility 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 Benefit 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 $5,560 $2,780 N/A N/A

2019 Data – Table Source

What Is Medigap Plan K?

Plan K utilizes different cost-sharing for items and services than most of the supplement plans. Instead of paying all of your costs, the plan will pay a certain percentage until you meet the yearly cap for out-of-pocket spending. Once you meet the limit, the Medigap policy plan pays 100% of Medicare-approved costs, such as the Medicare Part B co- coinsurance, and the Medicare Part A deductible for the rest of the calendar year.

Specifically included with Plan K benefits are Part A coinsurance and the 365 hospital days after your Medicare benefits are used up. Plan K covers 50 percent of your out-of-pocket costs for Part B co-insurance, hospice care, the Part A deductible, and skilled nursing facility services. Blood coverage is also covered at 50% after the first 3 pints.

Your Medicare Part B deductible is not covered. Also, charges from your doctor that exceed Medicare-approved amounts, called “Part B excess charges,” aren’t covered and don’t count toward the out-of-pocket limit. Also not included in this plan is emergency travel abroad coverage, so be aware of this when traveling. Benefits for home healthcare recovery are also not included in Plan K.

The maximum amount that you are responsible for paying yourself (out-of-pocket limit) for 2019 is $5,560 and can increase each year due to inflation.

Plan K could be a good option if you prefer a lower premium and also have low medical expenses but still want a fair amount of coverage for a wide variety of services.

Not all insurance carriers offer all of the Medicare Supplement Plans. It can also be difficult to determine which plan is right for you. Our licensed sales agents can help you find the plan that best fits your needs and budget. Most insurance carriers offer a variety of plans, so our licensed sales agents can help you shop around for the plan that best meets your needs.