2026 Medigap Plan K: Covered Services, Exclusions & Pricing

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Understanding Medicare Supplement Plan K

Medicare Supplement Insurance plans, sometimes referred to as Medigap, help cover out-of-pocket costs not covered by Original Medicare (Parts A and B). Medicare Supplement Plan K is one of eight standardized Medicare Supplement Insurance plans available for purchase in most states (Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans).

What does Medicare Supplement Plan K cover?

Medicare Supplement Plan K has similar coverage to other Medicare Supplement insurance plans but offers a coverage percentage instead of paying the full amount of costs. It also offers an out-of-pocket annual limit. Once you reach this limit, your plan will pay 100% of Medicare-approved costs for the rest of the year.

Covered

Hospital Expenses: Pays Part A coinsurance and hospital costs, up to 365 days after Original Medicare benefits are exhausted.

Medical Expenses: Pays 50% Part B coinsurance or copayment, except for preventive care services, which are covered 100%.

Transfusions: Pays 50% of Medicare-eligible expenses for the first three pints of blood.

Hospice Care: Pays 50% of hospice coverage for Part A coinsurance or copayment.

Skilled Nursing: Pays 50% for facility care coinsurance.

Additional Hospitalization Expenses: Pays 50% coverage for your Medicare Part A deductibles.

Not Covered

Part B Deductible: The Medicare Part B deductible for 2025 is $257. After the deductible is met, you pay 20% of the Medicare-approved amount (the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy, and durable medical equipment.¹

Part B Excess Charges: Providers who don’t accept Medicare assignments may charge up to 15% more than what Original Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare-approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.

Foreign Travel Medical Emergencies: In most cases, Original Medicare won’t pay for health care or supplies you get outside of the U.S.

Prescription Drugs: Medicare Supplement Plan K does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.

Who can benefit from this type of supplement plan?

Medicare Supplement Plan K helps cover out-of-pocket costs not covered by Original Medicare. Whether Medicare Supplement Plan K is right for you will depend on your unique circumstances and coverage needs.

Advantages of Medicare Supplement Plan K

Lower premiums
Limits the amount of out-of-pocket expenses you pay each year, which is $7,220 in 2025

Disadvantages of Medicare Supplement Plan K

Covers less of your healthcare expenses like coinsurance and copayments

How much does Medicare Supplement Plan K cost?

[H2] How much does Medicare Supplement Plan K cost?Monthly premiums are set by the private insurance companies that offer Medicare Supplement Insurance plans and are based on factors like location, age, health status, gender, and various other factors. Depending on these factors, insurance companies may charge different premiums for the same Medicare Supplement Plan K.

How Pricing Works For This Plan

Pricing for Medicare Supplement Plan K varies by Medicare insurance carrier. Medigap policies can be priced in three ways: community-rated, issue-age-rated, and attained-age-rated.

Community-Rated: For community-rated priced plans, generally, the same monthly premium is charged to everyone who has the Medigap plan, regardless of age.
Issue-Age-Rated: An issue-age-rated policy premium is based on the age you were when you bought the Medigap plan. Premiums are lowered for people who buy at a younger age and won’t change as you get older. Premiums may go up because of inflation and other factors, but never because of your age.
Attained-Age-Rated: Attained-age-rated policy premiums are based on your current age, increasing your premium as you get older. Premiums are lower when you are younger, but continually increase as you age. Premiums may also increase because of inflation or other factors.²

When to Enroll in Medicare Supplement Plans

When You’re First Eligible: The best time to enroll in a Medicare Supplement plan is when you’re first eligible. You are eligible to purchase a Medicare Supplement policy (Medigap) on the first day of the month in which you turn 65. This marks the beginning of your Medigap Open Enrollment Period, which lasts for six months.

You must already be enrolled in Medicare Part A and Part B. During this period, you can buy any Medigap policy sold in your state, regardless of any health problems.

Outside Open Enrollment: While it’s often better to get coverage when you’re first eligible, you can still apply for Medigap coverage after your Initial Enrollment Period. However, if you apply for coverage after your Initial Enrollment Period, there’s no guarantee that an insurance company will sell you a policy if you don’t meet the medical underwriting requirements.

FAQs About Medicare Supplement Plan K

Below are answers to some frequently asked questions about Medicare Supplement Plan K.

What is the out-of-pocket limit for Medicare Supplement Plan K?

Plan K limits the amount of out-of-pocket expenses you pay each year, which is $7,220 in 2025. This is helpful since Original Medicare does not have an annual out-of-pocket limit, so there’s no maximum cap on healthcare costs for a given year. Once you reach this “cap” on your out-of-pocket expenses, the plan pays 100% of Original Medicare-approved costs for the rest of the year.

How can I lower the costs of my Medigap Plan K?

Since the cost of Medigap plans varies by company, it’s important to shop around. When you work with SelectQuote, our licensed insurance agents can compare all of your Medicare Supplement Insurance plan coverage options to find the right plan at a price that fits your budget.

Do Medigap plans vary by state?

Medigap plans are standardized, meaning they offer the same benefits across most of the states, except for Wisconsin Medicare Supplement Plans, Minnesota Medicare Supplement Plans, and Massachusetts Supplement Plans.

Do Medicare Supplement plans cover pre-existing conditions?

While insurance companies can’t make you wait for your coverage to start, they may make you wait for coverage for a pre-existing condition. Coverage for pre-existing conditions can be excluded if the condition was treated or diagnosed within six months before the coverage starts under the Medicare Supplement plan.

After the six-month period, the Medicare Supplement plan will cover the condition that was previously excluded. However, it is possible to avoid or shorten the waiting period for a pre-existing condition if you buy a Medicare Supplement plan during your Medigap open enrollment period to replace the “creditable coverage” Medigap plan.³

Compare Medicare Supplement Plans

With the number of Medicare Supplement plans available, it’s hard to know which one may be right for your needs. Explore the different Medicare Supplement plans below.

Sources:

¹https://www.medicare.gov/basics/costs/medicare-costs

²https://www.medicare.gov/health-drug-plans/medigap/basics/costs

³https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap

Find the Right Medicare Supplement Plan For You With SelectQuote

At SelectQuote, we’ll take the time to learn about your specific needs to shop and compare Medicare Supplement Insurance plans that may be available in your area. The service is free and there’s no obligation to enroll.