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Medigap Plan K Coverage

by: Leandro Mueller

Medicare only covers 80% of your healthcare expenses. Usually, you are responsible for paying for the remaining twenty percent. However, that will not be the case if you have a Medicare supplement plan (Medigap).

Medigap Plan K is just one of the ten standardized plans of Medigap (other states, such as Massachusetts, Wisconsin, and Minnesota, have their own standardized plans). Compared to other Medigap plans, it provides very basic coverage at a much lower premium.

 

What does Medigap Plan K cover?

Medigap Plan K covers 50% of most of its benefits except for Medicare Part A as it covers this benefit in full.

Here’s a table showing the benefits of a Medicare supplement plan K:

Plan K supplement list of benefits
 

What it does not cover?

If you have Medicare supplement plan K, you’ll have to pay for the Part B deductible, Part B excess charges because this plan doesn’t cover those expenses. Also, you will be responsible for any healthcare expenses incurred during your foreign trips.

You’ll have Medicare Part B excess charges if a doctor charges you more than the Medicare-approved amount. Doctors who do not accept assignment from Medicare can add up to 15% of the Medicare rate for a particular service.

Let say you go to a doctor who does not accept Medicare assignment and charges you a $100 for a test he performed. Medicare will only cover 80% of the amount of the test which is $80 and you will pay the remaining 20% which is $20. Since the doctor does not accept Medicare assignment, he can have an additional 15% over the rate of the test. In this case, you will pay a total of $35 out-of-pocket expenses.

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What is Medigap Plan K out of pocket maximum?

Medicare Supplement Plan K has an out-of-pocket annual limit. This means that the policy will 100% cover for Medicare-approved costs once a beneficiary reaches the cap for out-of-pocket expenses.

Medigap Plan K includes a yearly out-of-pocket cost limit of $5,560 for 2019. After you have reached and paid for the yearly out-of-pocket expenses, Medigap Plan K may then cover your Medicare-approved expenses for the rest of the year.

This is important to take note because Medicare does not have a cap or limit on healthcare out-of-pocket expenses. This feature of Medigap Plan K is helpful if you don’t want to face skyrocketing out-of-pocket healthcare expenses. It may come in handy if you are someone with a chronic illness and requires ongoing medical attention.

 

How much is the monthly premium for Plan K?

The average monthly premium for Medigap insurance plan K is $129.

Medicare supplement costs may vary across the different location and insurance company that sells the plan. Age, the time when it is bought and the rating system used by the insurance provider can also affect the premiums.

 

Is Medicare supplement plan K right for me?

Each of every person’s needs is different. That is why you need to compare Medicare supplement plans first before deciding which one to purchase. In this case, you might be contemplating about Medigap Plan K. In this plan, you have to consider the out-of-pocket expenses vs. your medical needs.

Start off by estimating how much you spend on seeing your doctor and other medical services. If you find that you don’t need that much help from a supplemental insurance plan, then Plan K may be right for you. But if you estimate is the opposite, then you may want to consider other types of Medigap plans.

Depending on the plan that you choose, you may have to pay for deductibles and other payables before you receive the benefits. Get your Medicare supplement quotes now and let a licensed insurance agent provide you with the detailed coverage and costs.

 

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This website is for informational purposes only. Nothing should be used to replace any expert or professional medical advice.