Original Medicare does not pay for all healthcare costs. To fill this coverage gap, a person may buy a Medigap supplement insurance plan.
Private companies sell supplement insurance plans, which help pay for deductibles, copayments, and coinsurance. One supplement insurance plan is Plan K.
In comparison with other Medigap plans, Plan K does not provide as much coverage. However, the monthly premiums are lower, and it is one of only two plans that put a cap on yearly healthcare costs.
Below, we discuss the benefits and costs of Plan K and compare it with other Medigap plans. Then, we look at how and when to enroll.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
As with other Medigap plans, Plan K benefits are standard across all of the states in the country. The only exceptions are Wisconsin, Massachusetts, and Minnesota, which standardize the plans in different ways.
Plan K does cover:
- 100% of Part A coinsurance up to 1 year after a person uses up their Medicare benefits
- 50% of Part A deductible
- 50% of Part A hospice care copayments or coinsurance
- 50% of skilled nursing facility coinsurance
- 50% of Part B copayments or coinsurance
- 50% of the first 3 pints of blood
In addition to these benefits, Plan K limits out-of-pocket costs to $5,880 per year.
Plan K does not cover:
- Part B deductible
- Part B excess charges, which are the amounts that providers charge over and above Medicare-approved amounts
- emergency medical care in a foreign country
- prescription drugs
- vision care
- dental care
- hearing aids
- private duty nursing
The costs of Plan K include:
- monthly Plan K premiums, which vary widely among locations and companies
- Medicare Part B monthly premiums of $144.60
- Medicare Part B yearly deductible of $198
After a person pays the above three costs, they do not owe anything once their healthcare expenses reach the $5,880 yearly cap.
Plan K provides less coverage than other Medigap plans. Several Medigap options provide 100% coverage in areas where Plan K provides only 50%. However, plans that offer more coverage have higher monthly premiums.
Also, Plan K does not cover emergency healthcare costs that a person may encounter in a foreign country. Some Medigap plans do provide this coverage.
An additional difference is that Plan K is one of two Medigap plans that set a limit on yearly costs. The other Medigap plan with this feature is Plan L, which has a yearly cap of $2,940. These limits may give a person peace of mind if they are concerned about the possibility of unexpected healthcare costs.
A person with Original Medicare is eligible to purchase Plan K or any of the nine other Medigap supplement insurance plans.
Find a plan
The coverage, prices, and features of Medigap plans differ, so people may wish to compare all of the options before selecting one. This chart shows the coverage of all 10 plans for easy comparison.
Once a person decides on their preferred coverage, the next step involves using this search tool to find Medigap plans available in their area. After deciding on a plan, a person may compare the prices of different companies.
Once they have made a choice, the person can contact the company offering the plan and fill out an application.
Payment methods vary, but they may include money order, check, and bank draft. Some companies may also accept payment through automatic debit from a credit card or checking account.
During this period, someone with preexisting health conditions can purchase a policy at the same price as an individual with good health.
However, if they apply after the Open Enrollment Period, they may encounter problems. A company may charge the person higher premiums due to their health issues or refuse their application.
Medicare Supplement Plan K, as with other Medigap plans, helps pay healthcare costs that Parts A and B do not cover. These include deductibles, copayments, and coinsurance.
In comparison with other Medigap plans, Plan K provides less coverage, but this makes the monthly premiums lower. The plan also has a $5,880 cap on yearly healthcare costs, which may protect a person from unexpected healthcare expenses.
If a person is interested in Plan K, they may wish to compare the prices of the available plans before buying. The premiums that different companies charge for the same plan can vary widely.