As Medicare original part A and B don´t cover all costs, private health insurance companies offer supplemental plans, which cover these costs that you would otherwise have to pay out of your own pocket. The premium rates for these plans vary on the type that you choose. Plans who cover more benefits tend to be more expensive and the ones covering less will also cost less. Which of these options is best really depends on the individual and their personal situation. While to some it´s important to have a supplement plan that covers everything, others find this to be necessary and would rather want a different type of security.
There are two available Medicare supplement plans, that have an out-of-pocket limit; plan L and supplement plan K. This means, that your costs for medical care in one year can only reach that firmly set limit. Everything you might require and that might cost above the limit you had already paid for the year, will be covered by these supplement plans. This is a great way of additional insurance for those who don´t really need to have full-coverage, but also want to avoid very high costs, for example in a case of an emergency surgery.
Medicare Supplement Plan K
In 2018, the Medicare supplement plan K limit was at 5,240$. There are benefits that are covered up to 50%, however after reaching this limit and depending on the case, the supplement plan K should cover the expenses to a 100% after having reached the limit. The benefits covered by supplement plan K are:
- Costs for Medicare Part A deductible
- Costs for Part A coinsurance or copayment, due to hospice care
- Costs for skilled nursing facility care coinsurance
- Costs for Medicare Part B copayment or coinsurance
- Costs for first three pints of blood, necessary for a medical procedure (per year)
What Medicare Supplement Plan K doesn´t cover?
Bevor and after reaching the set limit, there are certain expenses that aren´t covered by Medicare supplement plan K at all. This is important to keep in mind, as should you be looking for a plan that covers exactly these expenses, plan K is not be the best option for you to lower your medical care expenses. The plan K doesn´t cover:
- Medicare part B deductible
- Medicare part B copayments
- Prescription medication
- Vision screenings
- Hearing aids
Depending on the health insurance company, the cost for Medicare supplement plan K can vary. While health insurance companies don´t get to individually decide what benefits the plan covers, they are allowed to set their own prices for the plan. This can start at around 500$, with the highest premium for the Medicare supplement plan K laying at around 2000$. Also, prices may and can vary from individual to individual. Another thing to keep in mind is that this standardization is applied in 47 states only. Citizens of Massachusetts, Wisconsin and Minnesota have different standardizations. This Medicare supplement plan is also only available to those who are over the age of 65.