Medigap Plans F, K and L
Plan F
Medigap Plan F is the only one that will pay the difference between Medicare approved costs and what your doctor or healthcare provider customarily charges. Under all other plans even with supplemental coverage, they will only pay for covered medical expenses, either those covered by Original Medicare, or through the supplemental plan, up to the amount approved by Medicare.
By most accounts Plan F is the most complete coverage you can purchase. Because the plan covers costs over and above Medicare-approved amounts, with Plan F it will be unlikely that you will ever have to go out-of-pocket at all for any hospital care and/or doctor's visits. Plan F has all of the same basic benefits as Plan C:
- Hospitalization: pays Part A coinsurance plus coverage for 365 additional days after Medicare benefits end
- Medical Expenses: pays Part B coinsurance - generally 20 percent of Medicare-approved expenses – or copayments for hospital outpatient services
- Blood: pays for the first three pints of blood each year
- Skilled nursing facility care
- Medicare Part A deductible for hospitalization
- Medicare Part B deductible for medical and hospital outpatient expenses
With that added benefit of covering Medicare Part B excess charges.
Plans K and L
Before the introduction of new plans M and N, in June 2010, Plans K and L were designed to be lower cost Medigap alternatives. The plans cover similar expenses to Plans C and F, however they only pay for some, not all of the covered expense. This is how Plans K and L keep their premiums so low. You can save money on a monthly basis with these plans, but understand, they only cover a percentage of the expense not covered by Original Medicare.
The two plans basically cover the same "gap" expenses, the only difference between the two plans are the percentage they pay, and the relative premium. Both plans have a "cap" on the out of pocket cost you can incur in a given year. In both plans once the cap is reached, 100% of covered expenses will be paid. Plan K pays 50% of covered expenses with annual out of pocket cap currently of around $4500.00 dollars. (The cap adjusts annually for inflation) Plan L pays 75% until the cap, currently about 2500.00, is reached.