Medicare Supplement K: What You Need to Know

Medicare Supplements are products that help fill coverage gaps in Original Medicare. There are 10 plans currently on the market, one of which is Medicare Plan K.

Today, we’re going to take an in-depth look at Plan K and how it works. At the end, we'll share whether or not we recommend this plan for our clients.

Need Medicare or retirement planning help? The Senior Allies team specializes in Medicare health insurance as well as retirement planning. Call us today at 833-801-7999 for personalized help.

What is Plan K?

Plan K is one of the 10 Medicare Supplement plans currently available. Medicare Supplements are standardized in 47 states while Massachusetts, Minnesota and Wisconsin have different plan criteria.

All Medicare Supplement plans of the same letter name must offer the same benefits no matter which insurance company you buy it from.

Plan K is considered a lower premium plan. However, lower premiums translate directly into less coverage, as Plan K offers only 50% coverage in most areas and does not cover the Part B deductible.

This sets it apart from most other Medicare Supplements, and not necessarily in a good way.

How does Plan K work?

Like with other Medicare Supplements, you’ll have to enroll in Original Medicare Parts A and B before you can enroll in Plan K. Once enrolled, your Plan K coverage may look a little different than other Medicare Supplement plans.  

Plan K is one of two plans currently available that offer an out-of-pocket limit. After you reach that limit, your plan will pay for covered costs.

While that may sound good, it comes with a significant downside: You’re likely going to be paying more for your services up until that point.

Like other Medicare Supplements, Plan K helps bridge the approximately 20% gap in coverage left behind by Original Medicare. However, there are some things that Plan K doesn’t cover that other plans do, such as emergency care if traveling outside the US.  

What does Plan K cover?

Medicare Supplement Plan K covers 50% of the gap that Original Medicare leaves behind. Plan K covers the following:

• Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
• 50% of your Part A deductible
• 50% of your Part A hospice care coinsurance or copayment  
• 50% of your Part B coinsurance or copayment  
• 50% of your skilled nursing facility care coinsurance  
• 50% on the first three pints of your blood transfusion  
• An annual out-of-pocket limit of $6,620 in 2022

What Plan K doesn’t cover

Plan K doesn’t cover some of the things that are included in some other plans, such as:

• Medicare Part B excess charges  
• Emergency care during travel outside the U.S.  
• Part B deductible (Note: Since 2020, new Medicare members can’t buy any plan that covers the Part B deductible (namely, Plan F), so this may not be an issue for those just enrolling in Medicare for the first time.)

Additionally, there are no Medicare Supplement plans, including Plan K, that cover the following:

• Prescription drugs
• Long-term care, which most receive in a nursing home
• Dental care
• Vision care
• Private-duty nursing
• Some hearing coverage

What does Plan K cost?

Because Plan K covers less than other Medicare Supplement options, it typically has lower premiums. Medicare Supplements are offered by private insurance companies, and plan costs can depend on a variety of factors, such as location, age, and health history.

Plan K caps yearly health care costs. If you’re worried about high or unexpected healthcare costs, this might seem like a positive, but you need to also bear in mind that your costs may be higher up until that point.

In addition to only 50% coverage on most items, Plan K also does not cover Medicare Part B monthly premiums and the Medicare Part B yearly deductible.

A note about yearly out-of-pocket limits

A yearly out-of-pocket spending limit is a feature currently only available on two Medicare Supplements: Plan K and Plan L.

Once you've met your yearly Medicare Part B deductible and your Medicare Supplement out-of-pocket yearly limit, 100% of your Medicare-covered services will be paid by your Medicare Supplement plan for the rest of the year. That means no additional costs once that $6,620 limit is met.

While that might seem nice, it comes at a significant reduction in coverage up until that point. Plan K enrollees may end up paying more for their overall care throughout the year than they would have with a different plan because they do not have enough medical costs to offset any savings that could happen with hitting the out-of-pocket limit.

That’s why we always recommend working with an agent to assess your needs thoroughly before selecting a Medicare Supplement plan.

Plan K availability

Another important factor to note about Plan K is lack of availability.

Most Medicare Supplement companies offer Plans A, F, G, and N, but it's becoming more rare for companies to also offer Plan K.

As an example, in our zip code, there are only 3 companies offering Plan K. However, over 30 companies offer Plan G.

Because there is more competition for a popular plan like Plan G, consumers are able to get a competitive price for better coverage.

Our Plan K recommendations

Here at Senior Allies, we don’t offer Plan K because it’s our opinion that it ends up costing people more money than other Medicare Supplement plan options.

While the max out-of-pocket is appealing, it comes at the cost of lesser coverage until that point. For most situations, it’s not a great fit.

Reach out to talk to one of our licensed insurance agents. We can help you explore your Medicare Supplement options and get you quotes to help you find a plan that is not only is affordable but offers you the coverage you need. We are here to help!