When it comes to choosing the right Medigap plan, beneficiaries have to negotiate a delicate balancing act. You obviously want to get as many benefits as possible for the lowest amount of cost-share you can afford. That’s where Medicare Supplement Plan K comes into play.

But you also have to consider that the more coverage you purchase, the more expensive your monthly premiums will be. Different Medigap plans employ different strategies to help beneficiaries like you find that balance between what you’re getting and what you’re paying for.

So let’s take a look at how Medicare Supplement Plan K does this, and why it may (or may not) be the right plan for you.

Medicare Supplement Plan K

There is one basic tenant which holds true in the insurance industry no matter what type of product you’re talking about: the more coverage you purchase, the more you pay in premiums.

For beneficiaries who want to pay less in premiums, Medigap Plan K offers them that opportunity. For a small monthly premium, Medigap Plan K provides:

  • 100% of your Medicare Part A coinsurance costs for up to 365 days after Medicare benefits run out (for inpatient hospital treatment only)
  • 50% of your Part B copay and/or co-insurance costs
  • 50% of the cost of your first 3 pints of blood should you require a blood transfusion while receiving inpatient hospital treatment
  • 50% of your Part A hospice care co-payments and/or co-insurance
  • 50% of your coinsurance costs for care in a skilled nursing facility
  • 50% of your Medicare Part A deductible

Unlike some other, more comprehensive plans, Medigap Plan K does not cover the following:

  • Your Medicare Part B deductible
  • Your Medicare Part B excess charges
  • Emergency Foreign Travel Assistance

Here’s What You Can Expect to Pay for Medigap Plan K

Most beneficiaries can get a Medigap Plan K for potentially less than $100 per month — but premiums will vary by state and zip code, so you’ll have to check with your insurance agent to make sure. In addition to that monthly premium, you should budget for the following costs:

Your Medicare Part A deductible

50% of the current Medicare Part A deductible is $778. Keep in mind that you must pay this amount at the beginning of every benefit period, which is not the same as paying annually.

Your Medicare Part B deductible

Currently, the annual Medicare Part B deductible is $233. Unlike the Medicare Part A deductible, you will only have to pay this amount once per year in order to get your doctor and outpatient care costs covered.

Medicare Part B Excess Charges

Certain doctors and facilities are allowed to charge up to 15% more than Medicare assignments. These costs may be difficult to avoid in an emergency situation, but outside of that, be sure to call ahead and see whether or not the doctors and facilities you need care from will apply excess charges before you go.

Foreign Travel Emergency Assistance

Unfortunately, Medicare Plan K does not cover medical emergencies should you travel abroad. Luckily, paying out-of-pocket for medical care in most foreign countries is still significantly less expensive than healthcare in the United States, so it’s unlikely to break your budget.

Out-of-Pocket Costs

In 2022, the cap on out-of-pocket costs for Medigap Plan K will be $6,620. After that, your insurance policy will cover 100% of the costs of your eligible benefits.

If you are newly retired and relatively healthy — meaning that you don’t anticipate needing much medical care or hospitalization — Plan K is an excellent choice for budget-conscious beneficiaries who want to use their retirement funds for other things.

If you think more frequent hospitalization, hospice care, or skilled nursing facility care are likely in your near future, Medigap Plan K may leave you with more out-of-pocket costs than you can handle.

Is Medigap Plan K Available in Every State?

Technically, no. There are three states in the U.S. that do not offer the 10 standardized Medicare supplement plans: Wisconsin, Massachusetts, and Minnesota. But some of the plans they do offer come with similar benefits. If you live in neither of these three states, it’s best to contact your insurance agent and/or your local CMS office for more details.

Who Is Medigap Plan K Meant For?

Medigap Plan K is a great way to save money on your healthcare costs if these apply to you:

  • Prefer not to travel abroad
  • Have a limited budget for your health care costs
  • Are newly retired and in relatively good health
  • Anticipate needing little to no emergency care in the near future
  • Think most of your medical needs will be covered by your Medicare Part B benefits
  • Live in a state which has outlawed Medicare Part B excess charges

If only one or two of these variables apply to you, you can consider purchasing a more comprehensive plan. Otherwise, you may face an insurmountable amount of out-of-pocket costs.

How to Enroll in Medicare Supplement Plan K

Our licensed agents are available to you at no cost. They can compare all Medigap plans with all carriers in your area to find you the best plan with the lowest premium. Give us a call, or use our online rate form to get started now.

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
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