Original Medicare, Part A and Part B do not pay for certain costs. A Medicare Supplement (Medigap) plan will help pay for those certain costs. In most states, there are up to 10 Medigap plans that are obtainable.
Medigap Plan K may be one of those Medigap plans that are obtainable in your state. There are an array of Medicare services and out-of-pocket costs that Plan K can help cover.
Medigap plan K is one of two plan types that has an out-of-pocket annual spending limit. This limit is $5,880 in 2020 for services Medicare covers. Medigap Plan K will cover 100% of covered services for the rest of the calendar year once your out-of-pocket spending has reached its limit.
In Original Medicare, there is no maximum spending limit on your health-care expenses. So, if your medical costs are very high, there will be no limit to how much you will pay. With Medigap Plan K, you will have a limit on out-of-pocket costs, so your annual costs won’t be higher than that limit no matter how high costs may get. Plan K can give you a piece of mind if you have any medical emergencies that can cost you thousands of dollars.
You may have high out-of-pocket costs because you normally need medical services. If this is the case then you may want to check out Plan K if you think your medical costs will be higher than the plan’s annual limit.
What are the Medigap Plan K basic benefits?
Medigap Plan K partially pays for a variety of benefits. For most of the benefit coverage, this plan will pay 50% of the cost. Here are the out-of-pocket expenses it includes:
- Skilled nursing facility (SNF) care coinsurance
- The first 3 pints of blood for medical procedure coverage
- Part A hospice care copayment or coinsurance
- Part B coinsurance or copayment
- Part A deductible
Medigap Plan K does not include the Medicare Part B deductible and Part B excess charges. You must pay these costs in full as Plan K does not cover these costs.
Your doctor may charge you for charges outside of the Medicare-approved charge. For Part B, these are called Medicare Part B excess charges. Doctors may not accept the “fee schedule” of approved amounts by Medicare. They may charge up to 15% above the fee schedule amounts.
For instance, let’s say that the Medicare-approved charge for a doctor appointment is $100. However, the physician rejects that charge and instead bills you an extra 10% for the appointment. This means that Medicare will send the doctor $80 because they are responsible for 80% of the approved charge. And you will handle the left over $20 and also the remaining $10 for the remaining 10% cost. This will make out-of-pocket costs that you owe will total at $30.
If you use up your Medicare Part A coinsurance hospital costs for the year, then Plan K will cover up to an extra 365 days of it. This is the only benefit that Plan K can cover in full.
How to Compare Medigap Plan K with other Medicare Supplement insurance plans
If you don’t feel you will have higher out-of-pocket expenses, then you may not want this plan because there are higher up front costs. So understand what if this plan will fit for you before buying this policy.
You will get the exact same benefits no matter where you live or which insurance company you buy from because Medigap benefits are basically the same across states. The main variant is the premium cost of Medigap plans between states.
Do you want to compare and contrast the benefits of a Medigap Plan K versus other Medicare Supplement insurance plans? Then contact Medicare Insurance Quotes Co to speak with a licensed insurance agent.