Medicare Supplement Plan K is one of two Medigap plans, along with Plan L, that offer a yearly out-of-pocket limit.
Medicare supplemental insurance, or Medigap, helps cover some healthcare costs often left over from Medicare Parts A and B.
Keep reading to learn more about Medigap Part K, what it covers, and who might benefit from it.
The following chart summarizes Medicare Supplement Plan K coverage. You can compare this to other Medigap plans on Medicare.gov.
| Part A coinsurance and hospital costs | yes |
| Part B coinsurance or copayment | 50% |
| Blood (first 3 pints) | 50% |
| Part A hospice care coinsurance or copayment | 50% |
| Skilled nursing facility care coinsurance | 50% |
| Part A deductible | 50% |
| Part B deductible | no |
| Part B excess charge | no |
| Foreign travel emergency (up to plan limits) | no |
Whether or not Plan K is right for you depends on your needs. Along with Plan L, Plan K is one of two Medigap plans that have an annual out-of-pocket limit.
Generally, a plan with a yearly out-of-pocket limit may be beneficial if you:
- have a chronic health condition with high costs for ongoing medical care
- want to be prepared for potentially expensive, unexpected medical emergencies
When you enroll in Plan K, you will have to pay a monthly premium. How much you will pay depends on your specific plan and the company that offers it in your area. This cost may also depend on factors like your age or sex or on health factors such as whether or not you smoke.
That said, Plan K covers only 50% of most out-of-pocket costs, and its yearly maximum out-of-pocket is $7,060 in 2024.
Once you reach this amount in your healthcare expenses, Medigap will cover 100% of all covered services for the rest of the year.
If you’re eligible for Original Medicare, you have the option to enroll in Plan K or any of the other nine Medigap supplement insurance plans
You can enroll in Medicare when you turn 65, or if you have specific health conditions like end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), or receive Social Security Disability Insurance.
The best time to enroll is during the Open Enrollment Period, which starts 6 months after you turn 65 or become eligible for Medicare.
But to ensure that Plan K is the best option for you, start by comparing it to the other Medigap plan options. Once you’re sure which plan you want, you can use the Medicare search tool to find the options and costs in your area.
Note that Medigap plans are offered by private insurance companies, but not every state may offer Plan K. You can apply to the plan you want by filling out an application directly with the company.
Sometimes referred to as Medicare supplemental insurance, a Medigap policy helps cover healthcare costs that Original Medicare doesn’t cover. For a Medigap plan, you must:
- have Original Medicare, which is Medicare Part A (hospital insurance) and Medicare Part B (medical insurance)
- have your own Medigap policy (only one person per policy)
- pay a monthly premium in addition to your Medicare premiums
Medigap policies are sold by private insurance companies. These policies are standardized and follow federal and state laws.
In most states, they’re identified by the same letter, so Medicare Supplement Plan K will be the same across the country, except in the following states:
- Massachusetts
- Minnesota
- Wisconsin
You can only buy a Medigap policy if you have Original Medicare. Medigap and Medicare Advantage cannot be used together.
Medicare Supplement Plan K is a Medigap policy that helps cover healthcare costs leftover from Original Medicare. It’s one of the two plans that offer a yearly out-of-pocket limit.
If you feel that a Medigap policy is the right decision for your healthcare needs, be sure to consider all your policy options. Visit Medicare.gov to compare Medigap policies to find one that’s right for you.
Medicare plan options and costs are subject to change each year.