Medigap Plan K Overview
Medigap Plan K is one of the 10 federally standardized Medicare Supplement plans. Medigap Plan K fills in some of the gaps of Original Medicare (Part A and Part B) but still requires you to pay part of your healthcare costs, therefore keeping the premium more manageable.
Remember Medigap plans are designed to complement Original Medicare. Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you enroll in Medigap Plan K.
Medigap Plan K Benefit Details
|Benefits||Original Medicare Alone||Original Medicare With Medigap Plan K|
|Doctor Network||All Doctors that accept Medicare||All Doctors that accept Medicare|
|Part A Hospital Benefit Period Deductible||You pay $1,408*||You pay 50%|
|Hospital days 61-90||You pay $352 per day per day||You pay $0, after Part A deductible|
|Hospital Days 91-150||You pay $704 per day per day (lifetime reserve days)||You pay $0, after Part A deductible|
|Beyond Lifetime Reserve Days||You pay 100%||You pay $0 up to an additional 365 hospitalization days.|
|Skilled Nursing Facility Care Days 1-20||You pay $0 (Part A deductible applies)**||You pay $0, after Part A deductible|
|Skilled Nursing Facility Care Days 21-100||You pay $176 per day||You pay 50%, after Part A deductible|
|Hospice Respite Care||You pay 5%||You pay 2.5%|
|First 3 Pints of Blood||You pay 100%||You pay 50%, after Part B deductible|
|Additional Blood||You pay $0, Part B deductible applies||You pay $0, after Part B deductible|
|Part B Annual Deductible||You pay $198||You pay $198|
|Ambulance||You pay 20% (Part B deductible applies)||You pay 10%, after Part B deductible|
|Doctor’s Office Copays/Coinsurance||You pay 20% (Part B deductible applies)||You pay 10%, after Part B deductible|
|Durable Medical Equipment||You pay 20% (Part B deductible applies)||You pay 10%, after Part B deductible|
|Part B Excess Charges||You pay 100% (Part B deductible applies)||You pay 100% (Part B deductible applies)|
|Foreign Travel Emergency||You pay 100%||You pay 100%|
|Out-Patient Surgery||You pay 20% (Part B deductible applies)||You pay 10%, after Part B deductible|
|Urgent Care||You pay 20% (Part B deductible applies)||You pay 10%, after Part B deductible|
|Max Out of Pocket||No Max||$4940|
Next Steps for Medigap Plan K
The fine print of the Medigap Plan K Chart Above
*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,408).