Key takeaways
- Medicare Plan K is a Medigap policy that helps cover costs associated with Original Medicare (parts A and B), such as coinsurance, copayments, and hospital costs. However, unlike most other Medigap plans, it only covers 50% of these costs.
- Plan K has an out-of-pocket limit that is subject to annual change, after which the plan pays 100% of covered services for the remainder of the year. However, it doesn’t cover the Medicare Part B deductible or excess charges.
- Plan K is available in most states for those eligible for Medicare, but premiums vary based on factors such as location, age, and tobacco use. Therefore, it’s important to compare costs and availability in your specific area.
Medicare supplemental insurance (Medigap) helps cover certain costs associated with Original Medicare (parts A and B).
Medigap policies are sold by Medicare-approved private insurance companies. These policies are standardized and follow federal and state laws.
In most states, Medigap policies are identified by the same letter, so Plan K coverage is the same across the country.
Plan K covers 100% of Part A coinsurance and hospital costs up to an additional 365 days after Original Medicare (parts A and B) benefits are depleted.
It also covers 50% of the cost of:
- Part A deductible
- Part A hospice coinsurance or copayments
- Part B coinsurance or copayments
- skilled nursing facility coinsurance
- first three pints of blood
Plan K is one of only two Medigap plans with an annual out-of-pocket limit, which is subject to annual change.
After you pay your Part B deductible and reach your out-of-pocket limit for Plan K, Medigap covers 100% of the cost for approved services.
What isn’t covered by Plan K?
Like most Medigap plans, Plan K does not cover the Part B deductible or Plan B excess charges. It also does not cover emergency medical care during international travel.
It’s also important to note that no Medigap plan sold after 2005 includes prescription drug (Part D) coverage.
All Medigap plans have premiums, and premiums typically increase each year. Although a plan’s coverage is the same everywhere it’s offered, its premium depends on a wide range of factors.
Insurance companies may take the following into consideration:
- location
- sex
- gender
- age
- marital status
- medical history
- tobacco use
Here are examples of what you may expect to pay for Plan K in 2025. The states were selected based on Medigap enrollment data reported by the nonprofit KFF, and the cities were chosen based on the most populated zip code.
| Location | Plan K Monthly Premium |
|---|---|
| West Covina, California | $78 to $397 |
| El Paso, Texas | $63 to $233 |
| Delray Beach, Florida | $96 to $704 |
| Chicago, Illinois | $76 to $252 |
| Philadelphia, Pennsylvania | $72 to $235 |
| Hamilton, Ohio | $61 to $213 |
| Lakewood, New Jersey | $58 to $405 |
| Ridgewood, New York | $88 to $153 |
| Charlotte, North Carolina | $56 to $215 |
| Woodbridge, Virginia | $61 to $205 |
If you’re eligible for Medicare, you’re likely eligible for Medigap. The Medigap Open Enrollment Period (OEP) starts the first month you’re enrolled in Part B and are 65 or older.
You might be able to buy Medigap early if you have Medicare because of a chronic condition or disability, but this varies by state.
Plan K is available in all states except Massachusetts, Minnesota, and Wisconsin. However, it may not be available in every city or county. Use the Medicare search tool to find out which plans are available in your location.
Once you’ve settled on Plan K or another Medigap policy, contact the insurance company to apply. Your policy will automatically renew every year as long as you pay your Medigap and Part B premiums.
Keep in mind that you can only purchase a Medigap plan if you have Original Medicare (parts A and B). You cannot have both Medicare Advantage (Part C) and Medigap.
Medigap helps cover certain out-of-pocket costs associated with Original Medicare. Although Plan K pays a lower percentage for covered services than other options, it’s one of the only plans with an out-of-pocket maximum.
If you have questions about your eligibility, you can call Medicare at 1-800-633-4227 (TTY: 1-877-486-2048).
You can also contact your local State Health Insurance Assistance Program (SHIP) for free health insurance counseling. To find a program near you, call the SHIP National Technical Assistance Center at 1-877-839-2675.