Medicare Supplement Insurance Plan K is one of 10 different standardized Medigap plan types. Learn about Plan K benefits and costs.
Medicare Supplement Insurance, also called Medigap, is a type of private insurance that is used together with your Original Medicare coverage (Medicare Part A and Part B) to help cover certain Medicare out-of-pocket expenses, such as copays and deductibles.
Medigap Plan K is one of the 10 Medigap plans available in most states, which include Plan A, B, C, D, F, G, K, L, M and N. Each type of Medigap plan offers a different combination of standardized benefits.
Let’s take a look at what Medicare Supplement Insurance Plan K covers and review the average cost of Medigap Plan K.
What does Medicare Supplement Plan K cost?
It’s important to note that Medigap Plan K premiums may vary based on factors such as age, gender, your health, how your insurance carrier rates (prices) its plans and where you live.
A licensed insurance agent can help you compare Medigap Plan K options that may be available where you live.
* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020,... you may still be able to enroll in Plan F or Plan C as long as they are available in your area.
1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2 Plan K has an out-of-pocket yearly limit of $6,220 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3 Plan L has an out-of-pocket yearly limit of $3,110 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.+ Read more
Medicare Supplement Insurance Plan K provides 100 percent coverage for the following benefit area:
Medicare Part A coinsurance and hospital costs
If you are admitted to a hospital for inpatient treatment, Medicare Part A helps cover your hospital costs once you reach your Medicare Part A deductible, which is $1,484 per benefit period in 2021.
For the first 60 days of your hospital stay, you aren’t required to pay any Part A coinsurance.
But beginning on day 61 of your stay, you’re required to make a Medicare Part A coinsurance payment of $371 per day through day 90. After your 90th day in the hospital, you must pay $742 per day for up to 60 more days. Beyond that, you are responsible for all costs.
These coinsurance costs can add up quickly. Medigap Plan K covers 100 percent of your Part A coinsurance costs.
Medicare Supplement Plan K provides partial coverage for the following five benefit areas:
Medicare Part B coinsurance or copayment
Medicare Part B helps cover costs for things like doctor’s appointments, medical devices and preventive care.
After you meet your Medicare Part B deductible (which is $203 per year in 2021), you are typically responsible for a coinsurance or copay of 20 percent of the Medicare-approved amount for covered services.
For example, if you suffer a foot injury and need to use a wheelchair, Part B will help cover 80 percent of the cost of your wheelchair (after you meet your Part B deductible). For illustration purposes, if it costs $800 to buy the wheelchair and Medicare Part B covers it as durable medical equipment (DME), your Part B coinsurance cost would be $160.
Medigap Plan K would cover 50 percent of your $160 Part B coinsurance, which means you would pay $80, and your plan would pay $80.
First three pints of blood
Original Medicare does not cover the cost of the first three pints of blood you might need for a blood transfusion. A pint of blood can potentially cost hundreds of dollars.2
Medicare Supplement Insurance Plan K covers 50 percent of the cost for your first three pints of blood.
Part A hospice care coinsurance or copayment
Medicare Part A requires a copayment for prescription drugs used during hospice care. You might also be charged a 5 percent coinsurance for inpatient respite care costs.
Medigap Plan K covers 50 percent of your Medicare Part A hospice care coinsurance or copayments.
Skilled nursing facility care coinsurance
Medicare Part A requires a coinsurance payment of $185.50 per day in 2021 for inpatient skilled nursing facility stays longer than 20 days. You are responsible for all costs after day 101 of an inpatient skilled nursing facility stay.
Medigap Plan K covers 50 percent of your skilled nursing facility care coinsurance costs.
Medicare Part A deductible
As mentioned above, the Medicare Part A deductible is $1,484 per benefit period in 2021.
The Medicare Part A deductible is not annual — you could potentially need to meet this deductible more than once in a given year.
Medigap Plan K covers 50 percent of the Medicare Part A deductible.
What you need to know about Medigap Plan K
There are a few things to know about Medicare Supplement Insurance Plan K, beyond what it covers.
Medigap Plan K offers a standardized yearly out-of-pocket limit
Medicare Supplement Insurance Plan K offers n annual out-of-pocket spending limit of $6,220 in 2021.
After you meet your yearly out-of-pocket yearly limit and yearly Part B deductible, Plan K pays 100 percent of covered services for the rest of the calendar year.
Medigap Plan K vs. Medicare Advantage plans
Medigap plans and Medicare Advantage plans are very different things. You cannot have a Medicare Supplement Insurance (Medigap) plan and a Medicare Advantage plan at the same time.
Medicare Advantage plans provide all the same benefits as Original Medicare. Many Medicare Advantage plans also offer benefits that Original Medicare doesn’t cover, such as coverage for prescription drugs, dental, vision, hearing and more.
Medicare Supplement Insurance does not offer any medical benefits or coverage for prescription drugs and other services. Medigap plans only cover certain Medicare Part A and Part B out-of-pocket costs as outlined above.
Medicare Supplement Insurance Plan K doesn’t cover everything
Medicare Supplement Insurance Plan K does not offer any coverage for the following Medicare costs:
Other Medicare Supplement Insurance plans may cover some or all of the benefits listed above, either partially or in full. Medicare Supplement Insurance Plan F, for example, covers all of them.
Learn More About Medicare Supplement Insurance
Medicare Supplement Insurance Plan K may or may not be right for your health care needs. Research all of the plans available where you live and speak with a licensed insurance agent to evaluate your needs.
1 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.
2 Fisher, Miles. Your blood could be worth a lot. You should give it away for free. (July 5, 2017). Chicago Tribune. Retrieved from www.chicagotribune.com/news/opinion/commentary/ct-blood-donation-money-20170705-story.html.
Plan F and Plan G are the most comprehensive Medicare Supplement Insurance plans available. Discover the key differences between Medicare Supplement Insurance Plan F and the Medigap plan that may soon become the most popular Medigap plan, Medigap Plan G. Read more
You can change your Medigap plan any time, but you may have to go through medical underwriting unless you have a guaranteed issue right, depending on what state you live in. Learn about switching Medigap plans with the help of a licensed insurance agent. Read more
Use this Medicare Supplement Insurance plans comparison chart to compare your potential 2021 coverage options and find the right Medigap plan for your needs. Compare Plan F, Plan G and other Medigap Plans. Read more