When researching Medigap policies, you may want more information on Medicare Supplement Plans K & L. These two unique options are less popular than traditional policies like G & N, but they do offer value.
They might be right for some, but not all consumers. It’s important to understand what you can expect from these two cost-sharing plans should you enroll.
You may have more out of pocket, but premiums are less. We’ll compare Plan K & L to traditional Plans like F, G & N.
Supplement Plans K & L: More Cost Sharing
Aside from Plan F, every Medicare supplement sold today has some amount of cost sharing for the insured. This means you will likely have some amount to pay if you go to the doctor or hospital. It can be a copay with Plan N – or a small deductible with Plan G.
Of all the plans sold, Plans K and L have the most cost sharing. This means you are responsible for more of the bill. When you look at the abbreviated Medicare Supplement coverage chart below, you see there are a couple of gaps plans K & L don’t cover – and some only covered at a certain percentage. This leaves an out of pocket maximum for the insured each year.
|Part A Hospital Coinsurance|
|365 Hospital Days|
|Parts A and B Blood||50%||75%|
|Part B Coinsurance||50%||75%|
|Part A Deductible||50%||75%|
|Part B Deductible|
|Part B Excess|
|Foreign Travel Emergency|
|2021 Out of Pocket||$0||$203||$6,220||$3,110||N/A|
Key: The ✔ means the benefit is covered by the supplement. For example, Plans F, G & N cover Foreign Travel Emergency, but Plans K & L do not.
*With Plan N, you have $20 office and $50 ER copays.
Understanding The Medicare Supplement Gaps
Looking at the chart, you see plans K & L do not cover the Part B Deductible or Part B Excess Charges. In this way, they are similar to popular supplemental plans G and N.
Then there are five highlighted gaps that Plan K covers at 50% and Plan L covers at 75% respectively. This is what sets these two Medigap plans apart from the rest. By only covering a percentage of each gap, they leave behind more cost sharing for the insured.
For any given year, there is a maximum out of pocket for each policy. You can see those amounts in the chart above. This is your maximum exposure should you reach it through doctor’s visits and/or hospital expenses. Put another way, this is the amount you would pay after Medicare and your chosen supplement pay their parts.
(It’s difficult to determine the out of pocket maximum for Plan N even though it’s a comprehensive plan. Copays and Excess charges are different for everyone.)
Do Plans K & L Offer Good Value Overall?
When it comes to Medicare Supplement Insurance, you want to balance premiums and benefits. Simply stated, some policies do not provide great value. You might be paying for benefits you won’t use – or paying higher premiums than needed to fill small gaps.
Monthly premiums for supplements differ widely and depend on several factors. But in our experience, premiums for Plans K and L are not extremely compelling based on their out of pocket exposure. One reason is these two plans are not extremely popular. Without competition amongst insurers, rates remain higher.
A fair comparison might be with High Deductible Plan G. This option has roughly $2,400 in out of pocket exposure. But this plan can be found for under $50 a month across the country. Both Plans K and L have more out of pocket and usually come with higher monthly premiums. It should be noted that Plans K and L begin paying before High Deductible plans do, however.
Our advice: Shop wisely and with agent assistance.
Understanding Your Medigap Options
There is a lot of nuance when it comes to Medicare supplements. It’s not a one size fits all proposition. You might be surprised how much there is to know
It’s smart to work with an independent broker. Not only do we provide needed insight, but you don’t pay a penny more for our services. Contact us today to review quotes and strategies.