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). This plan still requires you to pay part of your health care costs, therefore keeping the premium more manageable.
Remember Medicare Plan K 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 $1,364*||You pay 50%|
|Hospital days 61-90||You pay $335 per day per day||You pay $0, after Part A deductible|
|Hospital Days 91-150||You pay $670 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 $170.50 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 $185||You pay $185|
|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
Get quote: Click here to see prices for 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 ($1,364).
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