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Medigap Plan K: Medicare Supplement Insurance
By Chris Gasparini
Chris Gasparini has been a licensed insurance agent since 2005. He enjoys helping Medicare beneficiaries navigate their options to find the best solution for their unique needs. Chris feels as though ...his work truly helps people. Because he represents multiple insurance companies and plan types, Chris is able to help Medicare beneficiaries find the most cost-effective plan. Every day, he leaves work knowing he did what was right for each and every client he serves.Read more
May 23, 2020
|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|
|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%|
2021 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 2021 is $6,220 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.
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