Last updated on May 23rd, 2022

Are you looking to lower your out-of-pocket costs? Medicare Supplement Plan K may be the plan for you as the plan helps reduce out-of-pocket costs from Original Medicare.

Below we review Medicare Supplement Plan K, its benefits, and how to know if Plan K is right for you.

What is Medicare Supplement Plan K?

Medicare Supplement Plan K, also known as Medigap Plan K, is one of 12 standardized Medicare Supplement (Medigap) Plans available to Medicare beneficiaries. Medicare Supplement plans help cover the gaps in Original Medicare coverage and reduce the out-of-pocket spending for Medicare beneficiaries. Medicare Supplement Plan K is one of the most affordable Medigap plans in terms of monthly premium.

When you enroll in a Medicare Supplement plan, you have the freedom to visit any doctor or hospital that accepts Original Medicare regardless of the carrier you choose to enroll with. This is a major perk of a Medicare Supplement plan because you are not restricted by a network of doctors.

Medicare Supplement Plan K is available in 47 of 50 states nationwide. Due to the plan having standardized benefits, you will receive the exact same coverage benefits no matter which state you use your plan in, including the three states where the plan is not available.

What Does Medicare Supplement Plan K Cover?

Original Medicare, consisting of Medicare Part A and Medicare Part B, does not cover 100% of your healthcare costs. Medicare Supplement Plan K offers several benefits to help reduce your out-of-pocket costs after Original Medicare pays their portion of coverage.

Medicare Supplement Plan K benefits include:

  • 100% Medicare Part A hospital coinsurance
  • 100% Medicare Part B preventive care coinsurance
  • 50% Medicare Part B coinsurance
  • 50% Hospice coinsurance
  • 50% Skilled nursing care coinsurance
  • 50% Medicare Part A deductible
 

What is not Covered by Medicare Supplement Plan K?

Medicare Supplement Plan K does cover several benefits to help cut costs for Medicare beneficiaries. However, not every benefit is covered by this Medicare Supplement plan.

Medicare Supplement Plan K does not cover:

  • Half of the Medicare Part B coinsurance
  • Half of the Medicare Part A hospice coinsurance
  • Half of the Medicare Part A skilled nursing coinsurance
  • Half of the Medicare Part A deductible
  • Dental, Vision, or Hearing benefits
  • Prescription drug coverage
 

It is possible for a Medicare Supplement Plan K policy holder to enroll in an additional plan to cover dental, vision, and hearing benefits as well as a Medicare Part D plan for prescription drug benefits.

Medicare Supplement Plan K Costs

Medicare Supplement Plan K premium costs vary based on where you live, how old you are, and whether you are male or female. On average, Medicare Supplement Plan K costs anywhere for $40-$100 per month. However, this can vary.

When it comes to out-of-pocket costs, Medicare Supplement Plan K may be higher than other Medicare Supplement Plans. This is because Medicare Supplement Plan K only covers 50% of the major costs associated with Original Medicare. So, you will be responsible for the other half.

Unlike Original Medicare, Medicare Supplement Plan K has a cap on out-of-pocket costs. In 2022, the maximum out-of-pocket limit for Medicare Supplement Plan K is $6,620. Once your costs exceed this amount, Medicare Supplement Plan K covers the remainder of your Medicare-covered costs for the calendar year. This cap is helpful for beneficiaries to have predictable annual healthcare costs.  

Each year, Medicare Supplement Plan K’s maximum out-of-pocket changes based on the annual price increases for Original Medicare. Information will be sent to policy holders each fall for updated costs for the following year.

To estimate if Medicare Supplement Plan K is the right plan for you, it is important to budget your yearly maximum out-of-pocket costs and compare that to how often you see a doctor or require healthcare services. When considering the lower premium, if you find that you will only need a portion of your healthcare costs covered, Medicare Supplement Plan K might be right for you.

You may also consider Medicare Supplement Plan L. Plan L is like Medicare Supplement Plan K with a lower maximum out-of-pocket. If you require health services a little more frequent, Plan L might be the better plan for your needs.

How to Enroll in Medicare Supplement Plan K

The best time to enroll in Medicare Supplement Plan K is during your Medicare Supplement Open Enrollment Period. If you enroll during this time, you can choose any Medicare Supplement plan you wish without going through medical underwriting.

You can still enroll in a Medicare Supplement plan outside of this enrollment period, but you may be subject to medical underwriting. This means a carrier can deny you coverage for any reason. So, it is important to enroll in a plan when you first become eligible to avoid the risk of being denied coverage.

Additionally, if you decide Medicare Supplement Plan K is right for you, it is important to work with an agent who has access to several carriers to ensure you are with a reputable carrier at a low rate for your area. Since Medicare Supplement benefits are standardized, enrolling with the right carrier is just as important as finding the right plan.

Sources:

  1. Compare Medigap Policies, Medicare. Accessed May 2022.
    https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
  2. Medigap Plan K and L, CMS. Accessed May 2022.
    https://www.cms.gov/Medicare/Health-Plans/Medigap/KandL