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Medigap - Plan K
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Important Points
Plan K is one of the ten uniform Medigap plans available.
Plan K offers 50% coverage on most Medicare benefits, but also has a maximum out-of-pocket limit to cap your annual costs.
Plan K does not cover the Part B deductible, Part B excess charges, or foreign travel emergency.
Medigap Plan K covers the Part A hospital deductible as well as about 50% of the other gaps in Original Medicare. Lately enrollments in Medigap Plan K have been increasing, likely because consumers are becoming more interested in plans that offer lower premiums if they share in some of the costs.
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Medigap Benefits - Plan K
Medicare Part A Coinsurance & Hospital Costs
(Up to an additional 365 days after Medicare benefits are used)
50%
Medicare Part B Coinsurance or Copayment
50%
Blood (First 3 Pints)
50%
Part A Hospice Care Coinsurance or Copayment
50%
Skilled Nursing Facility Coinsurance
50%
Medicare Part A Deductible
Medicare Part B Deductible
Medicare Part B Excess Charges
Foreign Travel Emergency (up to plan limits)
Plan K - Fewer Benefits for Lower Premiums
Medigap Plan K offers the same basic benefits as other Medigap plans, but with lower premiums. For instance, Plan K will still cover preventive care services and give you an extra 365 days in the hospital. In exchange for the lower premiums, you split the cost-sharing with the insurance company on certain things like the Part A deductible. You also agree to pay the Part B deductible and any excess charges.
Medigap Plan K includes a cap on your spending called an out-of-pocket maximum. As an example, let's say you have a year in which you have a lot of medical treatments. If your out-of-pocket spending reaches the maximum limit, then your Medigap Plan K policy will kick in to pay all costs for the remainder of that year.
Plan K - Maximum Out-of-Pocket
The cap on Medigap Plan K out-of-pocket spending is $7,060 in 2025, so that is the absolute maximum you would spend during the calendar year. This cap works much like any out-of-pocket maximums that you've had in the past on employer group health plans. Your insurance company will track exactly how much out-of-pocket spending you have done for that year. If, for any reason, you spend more than the cap, then the insurance company must cover 100% for the remainder of the year.
Common Questions
How does Medigap Plan K work?
The only benefits that Plan K does not cover are the Part B deductible, Part B excess charges, and foreign travel emergency coverage. Medigap Plan K will only cover 50% of the costs after Medicare for Part B coinsurance, blood, hospice coinsurance, skilled nursing facility coinsurance, and the Part A deductible. So once Medicare pays, you and your plan will split the remaining costs equally.
What is covered by Plan K?
Plan K pays 50% of the Part B coinsurance, Part A deductible, first three pints of blood, and hospice and skilled nursing facility coinsurance. However, it will cover all Part A hospital costs after Medicare pays.
Is Plan K available in my state?
Plan K may be available to you. Availability depends on your zip code and the companies offering it in your state. Give our team a call for more information on Medigap plans that are available in your area.
Quotes for Medigap Plan K
Getting a quote for Medigap Plan K is not always easy for people since not every Medigap insurance company offers it. At Mohring Insurance Services LLC, we know which companies in your state offer this plan. We can easily pull rates for you so that you won't have to hunt through 30 insurance companies to find the 2 or 3 that might be offering this particular option.
Since only a few companies offer Medigap Plan K, we can help you get quotes from the companies that do. Contact Mohring Insurance Services LLC online to request a quote!
Key Points
Plan K usually has a lower monthly premium, but only covers 50% of the cost of most Medicare services.
The maximum out-of-pocket limit on Plan K helps to cap your costs, but this limit does change each year.
Once you hit the maximum out-of-pocket cap, your cost will be covered 100% for the rest of the year.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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Rates are reviewed periodically and are subject to change in your state.
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Medicare beneficiaries may also enroll in Medicare plans through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.