Medicare Supplement (Medigap) Plan K helps cover some of your health insurance costs. The cost for Medigap Plan K varies based on where you live, when you enroll, and your health.
Medicare Supplement Plan K is designed to help with some of the out-of-pocket costs that come with Original Medicare coverage. It’s one of two Medicare supplement plans that offer a yearly out-of-pocket limit.
Also known as Medigap, Medicare supplement plans range in their coverage and costs.
Keep reading to learn more about the cost and coverage for Medicare Supplement Plan K.
Monthly premiums for Medicare Supplement Plan K vary according to where you live and other factors, such as:
- your age
- your gender
- when you buy your plan
- tobacco use
- health status
The table below provides cost ranges in a few cities across the United States for 2024:
| City | Monthly premium |
|---|---|
| New York, NY | $99 to $225 |
| Charlotte, NC | $54 to $208 |
| Topeka, KS | $58 to $217 |
| Las Vegas, NV | $67 to $216 |
| Seattle, WA | $81 to $121 |
You can use this online tool to look for Medigap plans and their costs in your area.
Plan K monthly premiums
If you enroll in a Medigap plan, you’ll have to pay a monthly premium. This will be in addition to your Medicare Part B monthly premium. Because private insurance companies sell Medigap policies, monthly premiums will vary by policy. Companies can choose to set their premiums in a variety of ways.
The three main ways they set premiums are:
- Community rated: Everyone with the policy pays the same monthly premium, regardless of their age.
- Issue-age rated: Monthly premiums are set based on how old you are when you purchase your policy. Individuals who buy at a younger age will have lower monthly premiums.
- Attained-age rated: Monthly premiums are set based on your current age. Because of this, your premiums will increase as you get older.
Plan K deductibles
While Plan K covers the Medicare Part A deductible, it doesn’t cover the Medicare Part B deductible. Medigap policies, including Plan K, typically don’t have their own deductible.
Plan K copays and coinsurance
Plan K covers copays and coinsurance associated with Medicare parts A and B. If you have a Plan K policy, you won’t be responsible for these costs.
Plan K out-of-pocket costs
There are some things that Medigap typically doesn’t cover, although this can vary by policy. When a service isn’t covered, you’ll need to pay the cost out of pocket.
Some examples of services that often aren’t covered in Medigap policies are:
- long-term care
- dental care
- vision, including eyeglasses
- hearing aids
- private nursing care
Plan K is one of the only Medigap plans that limits the amount you’ll spend per year out of your own pocket.
The out-of-pocket limit for Medicare Plan K is $7,060 in 2024. This means that once you pay your yearly Part B deductible and meet the Plan K yearly limit, the Medigap policy will pay 100% of Medicare-approved services for the remainder of the calendar year.
The Centers for Medicare & Medicaid Services (CMS) requires that insurance companies offer standardized Medigap plans. This means that Plan K offers the same coverage in Tennessee as it does in California.
Medicare requires Medigap plans to be standardized. This means they cover the same features throughout the country. Examples of what Plan K covers include:
- Part A coinsurance and hospital costs for up to 365 days after a person uses up their Medicare benefits
- 50% of the Part A deductible
- 50% of the costs of a person’s first 3 pints of blood
- 50% of Part A hospice care coinsurance or copayments
- 50% of the coinsurance for skilled nursing facility care
- 50% of a person’s Part B coinsurance or copayments
Plan K does not pay for some aspects that other Medigap policies may. Examples include the Part B deductible, Part B excess charges, and foreign travel exchange.
Does Medicare Supplement Plan K cover prescription drugs?
Medicare Supplement Plan K does not cover prescription drugs. You can enroll in Medicare Part D for prescription drug coverage.
You must have Original Medicare to purchase a Medicare supplement plan. Insurance companies can’t offer Medicare supplement plans to those with Medicare Advantage.
If you have Original Medicare Part A and Part B, you can enroll in a Medigap plan. In addition to the premium you pay for Part B, you will pay a monthly premium for Medigap. You can’t share a policy with your spouse — you must each have your own policy.
The ideal time to apply for Medigap Plan K is during your Medigap initial enrollment period. This window begins on the first day your Part B coverage is effective and lasts for 6 months.
During your Medigap initial enrollment window, insurance companies can’t base your costs on preexisting conditions, and a company can’t refuse to offer you a policy. Otherwise, you can purchase a policy anytime, but the insurance company may require a medical examination first, and they can refuse to cover you.
After this window, there may be times when you have “guaranteed issue” rights to purchase a policy. This could include if you lost coverage from your previous health plan. However, at this time, you may have to answer questions about your health history that could increase the plan’s cost.
Medicare doesn’t require insurance companies to offer every plan. However, if an insurance company chooses to sell Medigap policies, it must offer at least Plan A.
If you wish to purchase a Medigap plan, you have several options:
- Visit Medicare.gov and search for available Medigap plans in your state or by ZIP code.
- Call your State Health Insurance Assistance Program. Also known as SHIP, this agency helps people with counseling for available plans in your area.
- Call or visit an insurance agent with an insurance company you’d like a quote from for a Medigap policy.
When it comes to Medigap policies, it pays to shop around. Because the coverage is the same, trying to get a lower cost policy can be helpful. Remember to ask how the insurance company prices the policy. If the policy is age-based, you may need to consider how your costs could change as you get older.
Medicare Plan K is one Medicare supplement plan option. The cost can vary based on location, when you enroll, how the insurance company prices its policies, and more.
If you are interested in Medigap Plan K, it pays to shop around online, by phone, or in person.