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2022 Medicare Supplement Plan K Review (+ Cheat Sheet!)

Medicare Supplement Plan K

Medicare Supplement Plan K is one of the most popular medical supplement insurance plans.  Given that it limits your annual out-of-pocket costs, it is particularly attractive to those with chronic conditions.

If you are eligible for the Federal Medicare Program (Parts A & B, also referred to as Original Medicare), you can purchase a Medicare supplement insurance plan. With many plans to choose from (ten different plans, as of 2021), it can be challenging to know which plan to select and which private insurance company to buy from.

In this article, we will discuss what Medicare Supplement Insurance is at a general level, followed by a detailed review of the benefits of Medigap Plan K.

What Are Medicare Supplement Insurance Plans?

Because they help fill gaps in coverage left by Original Medicare, these supplemental plans are often called “Medigap” plans.

Medicare Supplement Insurance helps pay for our Original Medicare deductibles and coinsurance.  It does NOT provide additional benefits.

There are ten different Medigap Plan types (A, B, C, D, F, G, J, K, L, M, and N).  Plans F and G also have a high-deductible option in some states, which combines health insurance coverage with a savings component through an HSA (health savings account).

Table Comparing The Benefits Of All 10 Medicare Supplement Insurance Plans

Medicare Supplement Insurance Plan K​

Medicare Supplement Plan K covers services similar to other Medicare Supplement insurance policies, but instead of paying all your costs, the plan pays a percentage.

If you have a serious illness or injury, you have the protection of an annual out-of-pocket limit.  Once you reach this “cap” on your out-of-pocket costs, the plan pays 100% of Medicare-approved costs for the rest of the year.

This plan is a good option if you prefer a lower premium but still want a fair amount of coverage for a wide variety of services.

Medicare Plan K Benefits

We will dive into these benefits at a deeper level in the tables below, but at a high level, Medicare Supplement Plan K coverage provides:

  • 100% coverage for Part A hospitalization coinsurance plus coverage for 365 days after Medicare benefits end
  • 50% hospice coverage for Part A coinsurance
  • 50% of Medicare-eligible expenses for the first 3 pints of blood
  • 50% Part B coinsurance, except for preventive care services, which are covered 100%

In addition to these basic benefits, Plan K also provides:

  • 50% coverage for Skilled Nursing Facility coinsurance
  • 50% coverage for your Medicare Part A deductibles
  • $6,220 out-of-pocket annual limit for 2021 (this limit adjusts each year for inflation)

Medigap Plan K Benefits Cheat Sheet (Printable PDF)

If you’re like me and understand things better on paper, we’ve put together a printable, one-page cheat sheet to help you get your head around Plan K.

Medicare Supplement Plan K Benefits Cheat Sheet

In the sections below, we’ll go through each of these benefits in more detail.

Covered Services and
What You Owe

Basic Costs

ServiceYou Pay
Part A Inpatient Hospital Deductible50% ($742)
Annual Part B Deductible100% ($203)
Out of Pocket Maximum$6,220
Part B Excess ChargesNot Covered

If you have Plan K, you will be responsible for 50% of your $1,484 Part A deductible (or $742).

Like all Medicare Supplement plans available to new Medicare enrollees, Plan K does not cover your Part B deductible ($203).

While Part B excess charges are not covered, this should not influence your decision. Part B excess charges are rare (and illegal in 8 states: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, Vermont).

Doctor Visits

ServiceYou Pay
Primary Care Visits10% Coinsurance
Specialist Visits10% Coinsurance
Referral To Specialist Required?No
Provider Network Required?No
Preventive ServicesAll costs above Medicare-approved amounts

For doctor visits, you are well-covered with Plan K.  For both primary care and specialist visits, you will pay only 10% coinsurance.

Unlike Medicare Advantage plans, with Medigap plans (like Plan K), you are not limited to a provider network, and you do not need a referral to see a specialist.

Emergency Care

ServiceYou Pay
Urgent Care10% Coinsurance
Emergency Care10% Coinsurance
Ground Ambulance Services10% Coinsurance
Air Ambulance Services10% Coinsurance
Foreign Travel EmergencyNot Covered

Coverage for urgent and emergency care is similar to that for doctor visits.

For urgent or emergency care as well as ground or air ambulance services, you will pay only 10% coinsurance.

Note that Plan K does not cover foreign travel emergency care, so if you are planning significant international travel, you may want to consider plans that provide this coverage (e.g., Plan G).

Inpatient Care

ServiceYou Pay
Inpatient Hospital CareFor Days 1-60: $742 per day;
For Days 61-90: $0;
For Days 91-425: $0;
Then: All costs
Skilled Nursing FacilityFor Days 1-20: $0;
For Days 21-100: $92.75 per day;
For Days 101+: All costs

Here’s what happens with your inpatient hospital or skilled nursing facility benefits:

  1. Your Medicare Part A hospital benefits are used
  2. When these are exhausted, your Medigap insurer pays for an additional 365 days

During this time, the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

A benefit period begins when you are admitted to a hospital as an inpatient and ends when you have been out of the hospital for 60 days in a row, having received no skilled care in any other facility.

Outpatient Care

ServiceYou Pay
Ambulatory Surgical Center10% Coinsurance
Outpatient Hospital Services10% Coinsurance
Mental Health - Outpatient10% Coinsurance

Outpatient care is covered similarly to doctor visits and urgent/emergency care: you pay 10% coinsurance, and your medicare supplemental insurance covers the rest.

Lab & X-Ray

ServiceYou Pay
Lab Services$0
Diagnostic Radiology Services10% Coinsurance
Outpatient X-Rays10% Coinsurance
Durable Medical Equipment10% Coinsurance

Lab services are not subject to the Part B deductible and are paid at 100% by Medicare.

Medicare Supplement Plan K covers services similar to other Medigap plans, but instead of paying all your costs, the plan pays a percentage. The key benefit of Plan K is that there is an annual limit on your out-of-pocket costs, which can be a lifesaver if you have a serious illness or injury.

Generally, Plan K insurance has lower monthly premiums, but involves higher coinsurance amounts and a higher annual out-of-pocket limit than Plan L.

The AARP-UnitedHealthCare Medicare Supplement Insurance Plan K covers 100% of your Medicare Part A deductible ($1,484). However, it does not cover your $203 Medicare Part B deductible.

We hope you found this overview helpful!  If you have a question we did not cover, however, don’t hesitate to leave a comment or send us an email at hello@getsure.org.  We’ll be sure to get back to you within 24 hours.

Warm Regards,
The GetSure Team

  1. Medicare.gov. 

    (n.d.). 

    Medicare & You 2022 Handbook. 

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