What Is Medicare Supplement Plan K? How Much Does It Cost?
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Medicare Plan K is a cheaper Medicare supplement plan meant to fill in coverage gaps in traditional Original Medicare. Plan K primarily helps to cover some of the costs associated with Medicare Parts A and B, as well as additional medical services.
The average monthly cost of a Medicare Plan K plan is $77 per month.
How much does Medicare Plan K cost?
Medicare Plan K premiums average $77 a month but may vary depending on location, current health status, age and gender.
Plan K’s monthly premiums are cheaper than many of the other Medigap policies. The low monthly premiums make Plan K an attractive option for those on a budget. However, the plan’s coverage is not as extensive as some others — Medicare Plan K only pays 50% for certain out-of-pocket expenses. That's why comparing Medigap costs versus coverage can help you find the right balance between monthly premiums and medical expenses.
What is Medicare Plan K?
Medicare Plan K is a Medicare Supplement policy that fills in coverage gaps that exist in traditional Medicare. Supplement plans make it easier for beneficiaries to meet their overall medical expenses.
Medicare Plan K only covers 50% of costs for many services until the beneficiary meets the Plan’s out-of-pocket limit, which is $6,940 in 2023. After a beneficiary meets the threshold, the plan pays 100% of medical costs for the rest of the calendar year. It is important to note that Medicare excess charges do not count toward the yearly out-of-pocket limit, but the Medicare deductible of $226 does count toward that limit.
Like other Medigap supplement policies, Medicare Plan K has several distinguishing characteristics setting it apart from other supplemental policies. It does not, for example, cover the Medicare Part B deductible, which is $226 a year in 2023. Medicare Plan K also does not cover foreign travel emergencies or Medicare excess charges — the amount Medicare allows a provider to charge over and above what it reimburses.
Example of how Plan K works:
One of the benefits of Plan K is that it covers 50% of Part B medical coinsurance. Coinsurance is the percentage of your medical bill you have to pay before your insurance covers the rest. So, with Part B's 20% coinsurance, you would have to pay $2,000 of a $10,000 medical bill before Part B covers the remaining $8,000, as long as you've met your Part B deductible.
With Plan K, you would only have to cover $1,000 of the coinsurance, and Plan K would handle the remaining $1,000, assuming you haven’t met your out-of-pocket max. This means you'd only be paying $1,000 of a $10,000 medical bill.
What does Plan K cover?
It is important to remember that Medicare supplement plans augment and do not replace Medicare, serving as true supplemental policies. Original Medicare provides coverage to disabled individuals as well as people 65 and older. The original program is broken into parts — Part A pays for inpatient and hospital care while Part B covers outpatient medical services. Together, the two parts pay for about 80% of medical costs, creating gaps in coverage filled by supplement Medigap insurance policies.
Here's a breakdown of what Plan K Covers:
Medicare Plan K benefits | Covered? |
---|---|
Medicare Part A coinsurance and hospital care | 100% |
Medicare Part B coinsurance | 50% |
Blood (first 3 pints) | 50% |
Part A hospice care coinsurance and copay | 50% |
Skilled nursing home coinsurance | 50% |
Medicare Part A deductible | 50% |
Medicare Part B deductible | |
Medicare Part B excess charges | |
Foreign travel emergency |
Medicare beneficiaries receiving skilled nursing care under Medicare’s Part A benefit do not pay anything for the first 20 days. But after the 20th day, Medicare charges $200 daily. With Plan K, the beneficiary is responsible for half of that amount. Plan K will also cover 50% of the $1,600 deductible for Medicare Part A.
What doesn't Plan K cover?
Plan K does not cover the Medicare Part B deductible, which is currently $226 for the year, or any Part B excess charges. It also does not cover foreign travel emergencies. Medicare Plan K, like other Medigap plans, does not cover eye exams, vision care, dental care, hearing aids or long-term care.
When and where to buy Medigap Plan K
Medicare Supplement plans, including Plan K, can be purchased at any time, and are not restricted to the open enrollment period each year. While you can purchase Medicare Supplement plans at any time, making such adjustments is ideal during your guaranteed issue period, which ensures you'll receive the best rates and won't be denied coverage.
Plan K is offered through private health insurance companies such as UnitedHealthcare. Insurance carriers selling Plan K policies vary from state to state. It is important to compare rates among various providers to get the best Medicare rate possible, and to find out which companies provide plans that best meet their needs for the best possible rate.
Does Medicare supplement Plan K cover SilverSneakers?
Some Plan K plans may also cover the SilverSneakers program, which encourages older adults to participate in physical activities that promote a healthier lifestyle. With this arrangement, your insurer pays for a basic membership at any gym in the SilverSneakers network. Coverage of the SilverSneakers program depends on whether the insurer offers SilverSneakers as part of Plan K. This may depend on where you purchased Plan K and where you live. You can check whether you’re eligible for a SilverSneakers policy at its website.
Are Medicare Plan K premiums tax-deductible?
Like other Medigap policies, Medigap Plan K premiums are considered health expenses, making them tax-deductible on a federal tax return. If you spend more than 10% of your adjusted gross income on eligible medical expenses, then itemizing may help you save.
Plan K vs. Plan L
Medicare Plan K is sometimes compared to Medicare Plan L, and the two plans share some commonalities. Both plans, for example, pay a percentage of certain services, and both have annual out-of-pocket limits. Like Plan K, Plan L does not cover the Medicare Part B deductible, foreign travel emergencies or Medicare excess charges. The major differences between Plan K and Plan L are costs and how much the plans cover.
Medicare supplement plan | Plan K | Plan L |
---|---|---|
Medicare Part A coinsurance and hospital care | ||
Medicare Part B coinsurance | 50% | 75% |
Blood (first 3 pints) | 50% | 75% |
Part A hospice care coinsurance and copay | 50% | 75% |
Skilled nursing home coinsurance | 50% | 75% |
Medicare Part A deductible | 50% | 75% |
Medicare Part B deductible | ||
Medicare Part B excess charges | ||
Foreign travel emergency |
Frequently asked questions
What does Medicare Supplement Plan K cover?
Plan K helps to expand your coverage under other Medicare Parts. Notably, it covers Medicare Part A coinsurance and hospital care, and 50% of Medicare Part B coinsurance. You can read more about what Plan K covers here.
When and where can I sign up for Medigap Plan K?
Medigap Plan K can be purchased anytime, but it's recommended to do so during your guaranteed issue period to receive the best rates and avoid being denied coverage.
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