Medigap Plan K

Medigap Plan K provides partial coverage on many of the core benefits Original Medicare leaves out. It pays the Part A hospital deductible in full, for instance, and roughly 50% of the remaining gaps in Original Medicare. If you'd like a policy with lower premiums in exchange for more cost-sharing, Medigap Plan K is worth a look.

What Does Plan K Cover?

Plan K stands apart from the rest. It covers:

Medicare Part A coinsurance and hospital costs — plus an extra 365 days once your Medicare benefits are used up.
50% of the Part B copayment
50% of blood
50% of the Part A hospice care copayment
50% of the Part A deductible
50% of skilled nursing facility coinsurance

Which Costs Fall on You?

With Plan K, policyholders are on the hook for the Part B deductible ($203 in 2021), Part B excess charges, and foreign travel emergency care.

This policy still pays for preventative care services and grants you an additional year in the hospital. But you and the insurance company split the cost on certain items, such as the Part A deductible and the Part B copay.

Put simply, you receive fewer benefits in return for lower premiums.

It Comes with a Spending Cap

Plan K also features an out-of-pocket maximum — $6,220 in 2021. That means you won't pay more than this amount in any single calendar year. Should you somehow exceed the maximum, the policy then picks up 100% of the remaining costs beyond that point. So in a year loaded with medical treatments, this cap can prove genuinely valuable.

Who Qualifies and When to Sign Up

A few eligibility requirements apply when purchasing any Medigap plan:

You need Original Medicare Parts A and B, and you cannot hold both Medigap and Medicare Advantage at once.
A Medigap policy covers only one person. Your spouse would need to buy their own separate plan.
Insurers are not legally required to sell Medigap coverage to people under 65. If you're under 65 with Original Medicare, the plan you want may not be available to you.

If Plan K interests you, your first chance to enroll is during Medigap Initial Enrollment — a six-month window that opens when you turn 65 and sign up for Medicare Part B. Miss it and you might be unable to get your preferred plan, or it may cost more.

How Insurers Set Your Rate

Every Medigap policy carries a monthly premium, and the exact amount can vary by location, gender, and tobacco use. Insurers use three approaches to price their premiums:

Community rated — Every purchaser of the plan pays an identical monthly amount regardless of age.
Issue-age rated — Your premium depends on your age when you first bought the plan. Buying younger means a lower premium, and it won't rise just because you age.
Attained-age rated — Your premium reflects your CURRENT age, so it climbs as you grow older.

We're Here to Help!

Finding quotes for Plan K is trickier because fewer companies offer it. At Quottes, we know which carriers in your area sell Plan K. We can pull the rates for you so you don't have to burn hours tracking down the details. Call us at 941-894-6460 to get started.