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Medigap Plan K

Medigap Plan K offers a unique set of benefits designed to provide coverage for Medicare beneficiaries with specific healthcare needs. While it offers comprehensive coverage for many Medicare expenses, it operates differently from other Medigap plans

Medigap Plan K benefits

  • Coverage for Medicare Part A coinsurance and hospital costs, including an additional 365 days of hospital coverage after Medicare benefits end.
  • Coverage for Medicare Part B coinsurance or copayments.
  • Blood coverage: the first 3 pints of blood each year.
  • Coverage for hospice care coinsurance or copayments.
  • Out-of-pocket maximum: Medigap Plan K includes an annual out-of-pocket limit, which helps limit your healthcare expenses in case of significant medical needs.

What Medigap Plan K Cover?

Medigap Plan K offers coverage for several key Medicare expenses, providing beneficiaries with financial protection against significant healthcare costs. Here’s what Medigap Plan K covers:

  1. Medicare Part A Coinsurance and Hospital Costs: Plan K covers the coinsurance or copayments for Medicare Part A, which includes hospital stays, skilled nursing facility care, hospice care, and some home health services.

  2. Medicare Part B Coinsurance or Copayments: Plan K pays for 50% of the coinsurance or copayments for Medicare Part B services, such as doctor visits, outpatient care, durable medical equipment, and some preventive services.

  3. Blood Coverage: Plan K covers the first three pints of blood each year, ensuring beneficiaries have access to necessary blood transfusions without additional out-of-pocket costs.

  4. Hospice Care Coinsurance or Copayments: Plan K provides coverage for the coinsurance or copayments associated with hospice care, including respite care and prescription drugs for pain relief.

  5. Out-of-Pocket Maximum: One unique feature of Medigap Plan K is its annual out-of-pocket limit, which helps limit beneficiaries’ healthcare expenses. Once this limit is reached, the plan pays 100% of covered services for the remainder of the calendar year.

What Medigap Plan K Does Not Cover

While Medigap Plan K provides robust coverage, it does not cover all Medicare expenses. It does not cover Medicare Part B deductible, excess charges, or preventive care services.

Out-of-Pocket Maximum for Medigap Plan K

One unique feature of Medigap Plan K is its out-of-pocket maximum. This limit caps the amount you have to pay for covered services each year. Once you reach this limit, the plan pays 100% of covered services for the remainder of the calendar year.

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