Medigap Plan K is one of 10 standardized Medicare Supplement plans available in most states. It stands apart from other Medigap options with a unique cost-sharing structure. Instead of covering 100% of Medicare’s gaps, this plan splits many costs 50/50 with you. However, it includes an annual out-of-pocket limit that caps your total spending.
Once you reach that limit, the plan pays 100% of covered services for the rest of the year. This design makes Medigap Plan K one of the most affordable supplement options in terms of monthly premiums. It appeals to healthier enrollees who want catastrophic protection without paying top dollar each month. Like all standardized Medigap plans, the benefits are identical regardless of which insurance company sells it.
What Does Medigap Plan K Cover?
Medigap Plan K covers the same benefit categories as other Medigap plans. The key difference is the percentage it pays. For most covered services, Plan K picks up 50% of the cost-sharing amount. You pay the remaining 50%. This is different from plans like Plan G, which cover 100% of most gaps.
There is one important exception. Plan K covers Part A coinsurance and hospital costs at 100%. This includes up to 365 additional days of inpatient care after Medicare benefits run out. This full coverage applies to all Medigap plans, including Plan K.
Three benefit areas receive no coverage under this plan. Plan K does not cover the Part B deductible, which is $283 in 2026. It does not cover Part B excess charges from doctors who do not accept Medicare assignment. It also excludes foreign travel emergency care. As a result, enrollees who travel abroad or see non-participating providers should consider other options.
| Coverage Area | What Medigap Plan K Pays |
|---|---|
| Part A coinsurance and hospital costs (365 extra days) | 100% |
| Part A deductible ($1,736 in 2026) | 50% |
| Part B coinsurance or copayment | 50% |
| Blood (first 3 pints) | 50% |
| Part A hospice care coinsurance | 50% |
| Skilled nursing facility coinsurance | 50% |
| Part B deductible ($283 in 2026) | Not covered |
| Part B excess charges | Not covered |
| Foreign travel emergency | Not covered |
| Annual out-of-pocket limit | $8,000 in 2026 |
Medigap Plan K Benefits Table
The following table compares Medigap Plan K side by side with Plan G and Plan N. These are the two most popular Medigap plans sold today. This comparison highlights the trade-offs between lower premiums and higher cost-sharing.
| Coverage Area | Plan K | Plan G | Plan N |
|---|---|---|---|
| Part A coinsurance (365 extra days) | 100% | 100% | 100% |
| Part A deductible ($1,736) | 50% | 100% | 100% |
| Part B coinsurance | 50% | 100% | 100%* |
| Blood (first 3 pints) | 50% | 100% | 100% |
| Hospice coinsurance | 50% | 100% | 100% |
| Skilled nursing facility coinsurance | 50% | 100% | 100% |
| Part B deductible ($283) | Not covered | Not covered | Not covered |
| Part B excess charges | Not covered | 100% | Not covered |
| Foreign travel emergency | Not covered | 80% | 80% |
| Out-of-pocket limit | $8,000 | None needed | None |
*Plan N covers Part B coinsurance at 100%, but charges up to $20 for some office visits. It also charges up to $50 for emergency room visits that do not result in admission.
How Much Does Medigap Plan K Cost?
Medigap Plan K typically has the lowest monthly premium among all lettered Medigap plans. In most cases, it costs significantly less than Plan G per month. It also tends to be less expensive than Plan N. The lower premium reflects the 50% cost-sharing structure built into the plan.
However, the lower premium comes with a trade-off. You could pay up to $8,000 out of pocket in a single year before full coverage begins. For example, a hospital stay could leave you responsible for half of the $1,736 Part A deductible. You would also owe 50% of any Part B coinsurance for doctor visits and outpatient services.
Insurance companies use three pricing methods for Medigap policies. Community-rated plans charge everyone the same premium regardless of age. Issue-age-rated plans base your premium on the age when you first buy the policy. Attained-age-rated plans increase your premium as you get older. Typically, attained-age plans start lower but cost more over time. The pricing method varies by carrier and state.
Who Should Choose Medigap Plan K?
Medigap Plan K works best for Medicare beneficiaries who are generally healthy. If you rarely visit the doctor and want low monthly premiums, this plan deserves consideration. It provides catastrophic protection through the $8,000 annual limit. This means your total medical costs have a ceiling each year.
This plan also suits people on a tight budget. The premium savings compared to Plan G can add up to hundreds of dollars annually. For someone who uses few medical services, those savings may outweigh the risk of higher cost-sharing. In most cases, healthy enrollees will spend far less than the $8,000 cap.
However, Plan K is not ideal for everyone. If you have chronic health conditions or expect frequent medical care, Plan G offers better protection. Plan G covers nearly everything at 100%, leaving you with only the $283 Part B deductible. Similarly, Plan N provides near-complete coverage at a moderate premium. People who want predictable costs and minimal out-of-pocket exposure should typically choose Plan G or Plan N instead.
Medigap Plan K vs Plan G vs Plan N
The biggest difference between these three plans is how they handle cost-sharing. Plan G covers almost everything Medicare does not. Your only annual cost beyond premiums is the $283 Part B deductible. Plan N is similar but adds small copays for certain visits. Medigap Plan K takes a fundamentally different approach by splitting costs 50/50.
Plan G also covers Part B excess charges at 100%. This protects you from higher bills when seeing doctors who do not accept Medicare assignment. Neither Plan K nor Plan N covers these excess charges. For example, if a specialist charges 15% above the Medicare-approved amount, Plan G pays that difference entirely.
The out-of-pocket limit is unique to Plan K and its companion, Plan L. Plan L works similarly but covers most benefits at 75% instead of 50%. As a result, Plan L has a lower annual cap of $4,000. No other Medigap plans include an out-of-pocket maximum because they cover costs at 100%. When comparing total annual costs, the right choice depends on how much medical care you expect to use.
How to Buy Medigap Plan K
The best time to buy Medigap Plan K is during your Medigap Open Enrollment Period. This six-month window starts when you turn 65 and enroll in Medicare Part B. During this period, insurance companies cannot deny you coverage. They also cannot charge higher premiums based on your health history.
Outside of open enrollment, you may face medical underwriting. Insurers can review your health status and decline your application. However, certain situations trigger guaranteed issue rights. For example, losing employer coverage or leaving a Medicare Advantage plan can qualify you. These rights protect your ability to buy a Medigap policy without health screening.
Medigap Plan K is available in 47 states plus Washington, D.C. Massachusetts, Minnesota, and Wisconsin use their own standardized Medigap systems. In those three states, the standard lettered plans are not sold in the same format. Since benefits are federally standardized everywhere else, you should compare premiums from multiple carriers. The coverage is identical, so the only differences are price and customer service.
Frequently Asked Questions About Medigap Plan K
What happens after I reach the $8,000 out-of-pocket limit?
Once you reach $8,000 in out-of-pocket costs for the year, Medigap Plan K pays 100% of all covered services. This full coverage lasts for the remainder of the calendar year. The limit resets every January 1.
Does Medigap Plan K cover prescription drugs?
No. Like all Medigap plans, Plan K does not cover prescription drugs. You need a separate Medicare Part D plan for drug coverage. You can enroll in Part D alongside any Medigap policy.
Can I switch from Plan K to Plan G later?
You can apply to switch plans at any time. However, outside of your initial open enrollment period, insurers may require medical underwriting. If you have developed health conditions, you could be denied or charged a higher premium. Typically, it is easier to start with a more comprehensive plan than to upgrade later.
Is Medigap Plan K the same as Medicare Advantage?
No. Medigap Plan K is a Medicare Supplement policy that works with Original Medicare. Medicare Advantage replaces Original Medicare with a private plan. You cannot have both a Medigap policy and a Medicare Advantage plan at the same time. They are two separate approaches to covering Medicare’s gaps.
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Official Sources & Resources
For verified Medicare information and enrollment help:
- Medicare.gov: medicare.gov
- CMS.gov: cms.gov
- NAIC Medigap Guide: naic.org
- KFF Medicare Research: kff.org/medicare
- Find Your SHIP: medicare.gov/contacts
Content last reviewed April 2026. If you notice any outdated information, please contact us.