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medigap, supplements, k, l

Cost-Sharing: Medigap Plans K and L

Medigap Plans K and L are unique from the rest of Medigap. These cover a broad range of leftover costs, but at a percentage instead of in full. Here, these plans will be analyzed individually and then compared to one another.

Medigap Overview

Also known as the Medicare Supplement Plan, Medigap does exactly what its name suggests – fill in the gaps between what Medicare covers and what the policyholder has to pay out-of-pocket.

Ten different plans exist, all of which have differences in how they handle out-of-pocket costs. The coverage isn’t extended to every type of expense incurred. For example, newcomers will not have the option of a plan offering full coverage for the Medicare Part B deductible.

Acquiring Coverage

Regardless of your chosen plan, your window of opportunity is the same. Your best time to join is within six months of enrolling in Original Medicare (Medicare Part A and Part B together). This begins the first day of the month you turn 65 while also being enrolled in Part B. After this period ends, your chances of getting Medigap coverage are low to the point that you may not be able to get Medigap at all.

Plans K and L

Once you’re eligible, you may be interested in plans that may not cover all remaining costs, but cover a percentage of them. Plans K and L offer coverage for everything except for the Medicare Part B deductible, Part B excess charges, and coverage for medical expenses incurred for medical treatment in a foreign country.

Here are what the plans cover:

  • Medicare Part A costs – hospital coinsurance and other hospital costs, copay or coinsurance for hospice, and skilled nursing facility coinsurance.
  • Medicare Part B costs – copay or coinsurance
  • The first three pints of blood (the Medicare Part responsible for covering this depends on the setting. This is a Part A cost if you’re an inpatient, and Part B if you are an outpatient)

The difference here is that for these covered costs:

  • Plan K covers 50%
  • Plan L covers 75%

 Maximum Out-Of-Pocket

Aside from percentage, these two are unique for their maximum out-of-pocket requirements. That means once the Medicare Part B deductible is met and these expenses are paid, the coverage begins:

  • Plan K’s out-of-pocket limit is $5,880
  • Plan L’s out-of-pocket limit is $2,940

Want To Join?

Cornerstone Senior Advisors allows you to choose between Medigap plans, and we can find the right one for you. We understand Medicare because we understand what it means to provide top-notch customer service. Call us today at 316-260-3331 for a free quote.