According to a report from AHIP’s Center for Policy and Research, there was a 28% increase in enrollment for Medicare Plan K from 2014 to 2015. This particular Medicare Supplement not only covers the Part A hospital deductible but also provides coverage for approximately 50% of the other gaps in Medicare. The rise in enrollment can be attributed to the growing interest among consumers in plans that offer lower premiums while requiring them to share in more of the cost-sharing.
Medicare Supplement Plan K provides the same fundamental benefits as other Supplements, but at a more affordable premium. This plan covers preventive care services and extends your hospital stay by an additional year. However, you will share the cost with the insurance carrier for certain expenses such as the Part A deductible. Additionally, you are responsible for paying the Part B deductible and any excess charges.
Moreover, Medicare Plan K includes an out-of-pocket maximum limit on your expenses. For example, if you have a year with numerous medical treatments and reach the maximum spending limit, your Medigap K policy will step in to cover all remaining costs for that year.
Medicare Supplement Plan K Maximum Out-of-Pocket limit.
Medigap Plan K has a cap of $7,060 for the year 2024, meaning that is the most you would pay in a single calendar year. This cap functions similarly to the out-of-pocket maximums found in employer group health insurance plans you may have had in the past. Your insurance provider will monitor your out-of-pocket expenses throughout the year. If you happen to exceed the cap amount, your insurance policy is required to cover 100% of any additional expenses incurred beyond that point.
Frequently Asked Questions
How does Plan K work?
Plan K provides coverage for a wide range of medical expenses, but there are a few exceptions. Specifically, it does not cover the Part B deductible, Part B excess charges, and foreign travel emergency coverage. However, it does offer coverage for other important aspects. For instance, Medicare Plan K will cover 50% of the costs after Medicare for Part B coinsurance, blood, hospice coinsurance, skilled nursing facility coinsurance, and the Part A deductible. This means that you and the plan will share the costs equally after Medicare has made its payment.
What is covered under Plan K?
Plan K provides coverage for 50% of the coinsurance for Part B, the deductible for Part A, the first three pints of blood, as well as coinsurance for hospice and skilled nursing facility services. Additionally, it offers comprehensive coverage for all hospital costs under Part A once Medicare has made its payment.
Is Plan K available in my state?
Contact our team to learn more about the availability of Plan K in your area, as it may be an option for you. The availability of this plan depends on your zip code and the carriers offered in your state. Call us now for detailed information on the Medicare Supplement plans available in your area.
Takeaways
Medigap Plan K typically offers a lower monthly premium due to only covering 50% of the cost of most Medicare services. While the maximum out-of-pocket limit helps limit your costs, it is important to note that this limit may vary annually. Once you reach this limit, your expenses will be fully covered for the remainder of the year.
Mario Arce
I have been working with Medicare clients since 2016. I serve California members in San Bernardino & Riverside county.
