Medicare Plans by Turning 65 Solutions


Medicare Supplement (Medigap) Plan K

Medigap Plan K is one of three cost-sharing plans on the market, alongside plan L and Plan N. In comparison to other cost-sharing plans, this plan has the lowest share percentage. Therefore, this Medigap policy covers only 50% of deductibles and coinsurance expenses.

What Does Medigap Plan K Cover?

ecause it is a cost-sharing plan, it has the maximum out-pocket limit beneficiaries can spend before the provider starts to cover all the costs for the rest of the year. The MOOP is 6940$ in 2023. Original Medicare, on the other hand, does not offer this benefit.

These are the benefits this Medigap policy includes by percentage:

  • 100% Medicare Part A coinsurance hospital costs up to additional 365 days after Medicare benefits are exhausted
  • 100% part B preventive care coinsurance
  • 50% Medicare Part A deductible (1660$ in 2023)
  • 50% Medicare Part B copayment/coinsurance
  • 50%Medicare Part A hospice care copay/coinsurance
  • 50%Skilled nursing facility care coinsurance
  • 50% First three pints of blood for an approved medical procedure

Plan K does not cover Part B’s deductible, excess charges, or a foreign travel emergency. Part B deductible cost is 226$ in 2023, and Part B excess charges can happen if you go to a doctor or a hospital which don’t accept Medicare Assignment. This means that they can charge you up to 15% more than the Medicare-approved amount for provided service.

What makes Plan K a popular choice is the lower premiums. If you do not visit the doctor’s office or hospital frequently, it might be wise to share some of the medical expenses so you save on monthly premiums. The monthly premium for this plan can be from 40$ to 100$ each month.

Turning 65 Solutions can assess your situation and offer you a plan that fits your budget and healthcare needs.

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What Is the Out-Of-Pocket Maximum for Medigap Plan K?

In 2023, the maximum out-of-pocket limit for Medigap Plan K is $6940. You will not have to pay more than this out of your own pocket for Medicare-related things in a single year. If you happen to reach this limit, your Medicare Supplement must cover all of your Medicare-related expenses for the remainder of the year.

Due to this maximum, plenty of Medicare beneficiaries will accept the lower premiums offered by Plan K. They know that if they ever have a major health problem, there is a limit to how much they have to pay out-of-pocket.

Because it is a cost-sharing plan it may be a good option in combination with Original Medicare (Parts A and B) because it helps reduce half of the responsibility costs that are left off, with a lower price of a monthly premium.

However, if you are interested in Medigap cost-sharing. plans, but, want a plan that has coverage with more percentage, you can consider Plan L as another great option because it covers 75% of mentioned services which is 25% higher in comparison to plan K.


Get Your Medicare Supplement Insurance Quote

Private insurance companies like Turning 65 Solutions have experienced agents which can help you find the best Medigap policies that suit your budget and need. If you are interested in Medigap Plan K or another Medicare Supplement Insurance plan, we can help you find a great rate and offer advice so you feel at ease with your decision. Call 830-217-6711.