Enrollment in Plan K has been steadily increasing according to reports from industry watchdog AHIP’s Center for Policy and Research. The reason for the increased popularity is likely because medicare beneficiaries are becoming more interested in plans that have lower monthly premiums if the consumer accepts more of the cost-sharing.
Medigap Plan K works along with Original Medicare and provides you with the same basic benefits as other supplements, but it has lower monthly premiums. For example, the plan will still cover all preventive care services and pay for your stay as an inpatient in the hospital for an entire year. However, Medicare Plan K will have you split the cost-sharing with the insurance carrier on certain items like the Part A deductible. In other words, the plan pays only 50% and you pay the other 50%. When purchasing this plan you also must be aware that you’ll have to pay the Part B deductible and any excess charges.
Medicare Plan K is unique in another way, it includes a cap or ceiling on your share of medical cost spending called an out-of-pocket maximum. For example, let’s say you were in and out of the hospital and had to deal with alot of medical treatments and procedures one particular year. If your out-of-pocket costs, meaning the actual amount that you’ve personally paid in deductibles, copayments, coinsurance reaches the maximum limit at any point during the year, then your Medigap K policy will kick in and you’ll not pay anymore for the rest for that year. That is because you’ve reached the maximum amount you are required to spend and now the Medicare Plan K pays 100% of all your medical costs through the end of the year. On January 1st of the following year the policy resets back to zero and you’ll need to meet your out-of-pocket medical costs for the next year.
Medicare Supplement Plan K’s cap is set by the Centers for Medicare and Medicaid and currently is $5,120, that is the maximum dollar amount you’re required to spend in any calendar year before your plan pays 100% of all medical charges. The cap works a lot like the out-of-pocket maximums that you’ve probably had in the past through an employer group health insurance plan when you were working fulltime. Your insurance company will keep track of exactly how much you’ve spent year to date for the calendar year. Think of it this way, it’s like having a bucket that only holds $5,120, as you go through the year and have received various medical services through Original Medicare you pay deductibles, coinsurance and copayments as your required by your plan. If at any point you any reason you spend up to cap, then the bucket in a sense is full and now the insurance policy must cover 100% of the rest of your expenses from that point through the end of the year.
Finding the right Medicare Supplemental insurance coverage whether a Plan K or a different plan is not always easy for consumers because not all the private insurer’s that offer Medigap insurance offer Plan K. However our agency has knowledge of which carriers are currently offering Medicare Plan K and we can find you the best rates for this coverage based on your exact zip code. We can easily access the current Medicare Plan K rates for you so that you don’t have to go one by one through 30 carriers to find the 2 or 3 that may be offering this particular coverage.
Since there are only a few insurance companies offering Medicare Plan K at this time, we can help you quickly get a quote from the ones that do. Contact our Medicare Coverage Helpline to request a free quote!