Medigap Plan K — Medicare Supplement Coverage With an Out-of-Pocket Limit
If you are looking for a Medicare Supplement plan with a lower monthly premium and an annual out-of-pocket spending cap, Medigap Plan K is worth considering. Plan K is one of only two Medigap plans with a built-in out-of-pocket limit providing catastrophic protection while keeping premiums low. As an independent Medicare insurance broker serving New York, New Jersey, and nationwide, here is what you need to know.
What Does Medigap Plan K Cover?
Medigap Plan K provides partial coverage for several Medicare cost-sharing requirements:
- ✅ Part A hospital coinsurance — fully covered up to 365 days after Original Medicare benefits are exhausted
- ✅ Part A deductible — covers 50% of the $1,736 Part A deductible in 2026
- ✅ Part A hospice care coinsurance or copayment — 50% covered
- ✅ Part B coinsurance or copayment — 50% covered
- ✅ Part B preventive care coinsurance — fully covered
- ✅ Skilled nursing facility coinsurance — 50% covered¹
- ✅ First three pints of blood — 50% covered
- ✅ Annual out-of-pocket limit — $7,220 in 2026. After you reach this limit, Plan K pays 100% of covered Medicare costs for the rest of the year
- ❌ Part B deductible — not covered
- ❌ Part B excess charges — not covered
- ❌ Foreign travel emergency coverage — not covered
¹ Skilled Nursing Facility coverage requires you to meet Medicare’s requirements — including a prior hospital stay of at least 3 days and admission to a Medicare-approved facility within 30 days of leaving the hospital. A benefit period begins on the first day you receive inpatient hospital services and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 consecutive days.
Is Medigap Plan K Right for You?
Plan K is a cost-sharing plan — meaning you pay a percentage of costs rather than having them fully covered. The trade-off is a significantly lower monthly premium and the protection of an annual out-of-pocket spending cap of $7,220 in 2026.
Plan K may be a good fit if you are generally healthy, want the lowest possible monthly premium, and value the protection of knowing your annual out-of-pocket costs are capped. However, for most seniors, the more comprehensive coverage of Plan G or Plan N offers better overall value and more predictable costs.
Get a Free Medicare Supplement Consultation
Want to see how Plan K compares to all your other Medicare Supplement options? I can help, completely free of charge.
📞 Contact Craig Smith Insurance Group today at (917) 740-1895 for your free Medigap Plan K consultation. Serving New York, New Jersey, and nationwide.
