There are ten different Medigap plans available to choose from, all with different coverage benefits and costs. For those looking for a low-cost Medigap plan, Medicare Supplement Plan K is a good option.

Medicare Supplement Plan K benefits

Medicare Supplement Plan K can help you pay for some of the copays, coinsurance, and deductible costs that are not included in your Original Medicare coverage. However, it is important to note that Medigap Plan K only covers a specified percentage of those out-of-pocket costs and not the entire amount.

Medicare Supplement Plan K coverage benefits include:

·        100% Part A coinsurance and hospital costs (coverage lasts up to 365 days after Medicare benefits are used up);

·        50% Part A deductible;

·        50% Part A hospice care coinsurance or copayment;

·        50% Part B coinsurance or copayment;

·        50% skilled nursing facility care coinsurance;

·        50% blood transfusion costs (first three pints).

If you enroll in Medigap Plan K, there is a limit on the out-of-pocket costs you can incur per benefit year. The MOOP for Medigap Plan K for 2023 is $7,060. Once you reach the MOOP, your plan will cover all the costs of covered services for the rest of the benefit year.

Keep in mind that the MOOP can change from year to year – for example, the MOOP for Plan K in 2023 was $6,940.

What Medigap Plan K doesn’t cover:

·        Part B excess charges;

·        Part B deductible;

·        Emergency care during foreign travel;

·        Prescription drugs;

·        Non-skilled long-term care;

·        Private-duty nursing;

·        Dental care;

·        Vision care.

Enrolling in Medicare Supplement Plan K

Medicare Supplement Plan K is a good option for Original Medicare beneficiaries who want a low-cost Medigap plan that shares in some of the out-of-pocket costs. Anyone with Original Medicare can enroll in Plan K. It is recommended that you enroll in a Medigap plan during your Medicare Supplement Open Enrollment Period.

The Open Enrollment Period is different for each Medicare beneficiary since it starts the month you turn 65 and are enrolled in Medicare Part B and runs for 6 months. For instance, if you turn 65 in June 2023 and enroll for Part B, your open enrollment period will run from June 2023 to November 2023.

If you enroll for a Medigap plan during the open enrolment period you are protected under guarantee issue rights. This means that insurers cannot deny you coverage or charge you higher rates regardless of your medical history.

If you miss the open enrollment period, you can still enroll in Plan K but insurers may deny you coverage based on your medical history, age, or other underwriting factors. You may also be required to pay higher premiums for coverage since you no longer have guarantee issue rights.

Medicare Supplement Plan K costs

On average Medicare supplement Plan K costs between $40 – $100 per month. Medicare supplement plans are sold by private Medicare-approved providers so costs can vary depending on your provider and factors like age.

You can use Medicare’s plan finder tool or Hella Health’s Personal Shopper to find and compare Medicare Supplement Plan K in your area.

Is Medicare Supplement Plan K right for you?

The right Medicare supplement plan for you will largely depend on your coverage needs and budget. Plan K is a good option if you are on a budget but still want a Medigap plan that will help to minimize your out-of-pocket costs under Original Medicare.

While Plan K only covers a percentage of your out-of-pocket costs, it does have a maximum out-of-pocket limit ($7,060 in 2024). Once you reach the out-of-pocket maximum, your plan will pay for covered services in full for the remainder of the plan year.

For those who are looking for more comprehensive coverage, Medigap plans like Plan F and G offer more coverage. You will have to pay more in premiums for these Medigap plans since on average they cost more than plan K.

Plan L is another good alternative to Plan K. It pays for a bigger percentage of your out-of-pocket costs and has a lower maximum out-of-pocket limit ($3,530 in 2024), so it may be more cost-effective compared to Plan K.

Medicare Supplement Plan K vs Plan L

Both Medicare Supplement Plan K and Plan L work on a cost-sharing basis where the plan covers a percentage of your out-of-pocket costs under Original Medicare. The main differences between Plan K and Plan L are in the percentage of costs covered by the plan and the maximum out-of-pocket cost limits.

Plan L Medigap offers the following coverage:

•       100% Part A coinsurance and hospital costs (coverage lasts up to 365 days after Medicare benefits are used up);

•       75% Part A deductible;

•       75% Part A hospice care coinsurance or copayment;

•       75% Part B coinsurance or copayment;

•       75% skilled nursing facility care coinsurance;

•       75% blood transfusion costs (first three pints);

Plan L covers up to 75% of your out-of-pocket costs while Plan K covers 50%. Plan L also has a lower MOOP limit ($3,530 in 2024) compared to Plan K which means that you will incur lower out-of-pocket costs under plan L.

Switching your Medicare Supplement Plan

If you are not happy with your coverage under a particular Medicare Supplement plan you have the option to either drop it or switch to a different plan.

When you first enroll in a Medigap plan, you will have a 30-day free look period during which you can choose to keep the plan or drop it. It is best to switch plans during the six-month open enrollment period to ensure that you are protected by Medicare protections. These protections ensure that you will not be denied coverage, required to pay higher rates, or subjected to a waiting period for pre-existing health conditions.

However, if you miss the open enrollment period you can still switch or drop your plan at any time during the benefit year by contacting your plan provider.

Questions about Medicare?

Shoot us an email at medicare@hihella.com.

Article updated on October 16, 2023