Information Provided by a Medicare Supplement Insurance Representative
Medicare with Plan K**
The chart below describes the common Medicare benefits along with gaps left by Medicare for you to pay.
| I. In patient | Gap (you pay) | Plan K** | |
| days 1-60 | deductible* | $1,632.00 | %50 |
| days 61-90 life time reserve | coinsurance | $408.00 | ✔ Paid |
| days 91-150 | coinsurance | $816.00 | ✔ Paid |
| after 150 days Medicare quits paying | next 365 paid in full | ✔ Paid |
| II. Skilled Nursing | Gap (you pay) | Plan K** | |
| Medicare pays 20 days in full | |||
| days 21-100 | $204.00 | %50 |
| Gap (you pay) | Plan K** | |
| Annual Deductible | $240.00 | ✖ Not Paid |
| Medicare Covers 80% | 20% | %50 |
| Part B Excess | 100% | ✖ Not Paid |
| $50,000 emergency medical outside USA $250.00 deductible 80/20 | ✖ Not Paid |
*The hospital benefit period is reset by Medicare 60 days from your previous hospital release date.
**Out of Pocket Limit is $6,220.
Medicare Supplement Plan K offers cost sharing similar to Medicare Supplement Insurance Plan L. This particular plan requires you to pay a percentage of certain covered charges such as: co-payments, coinsurance, or deductibles. Once your out of pocket expenses meet the yearly cap the Medicare Supplement Plan K would then pay 100 percent of your Medicare covered services for you. You will have to pay some out-of-pocket costs for some covered services, also known as a deductible, until you meet the yearly cap for out of pocket spending. Medicare Supplement Plan K offers a fair amount of coverage for a wide variety of services if you prefer a lower premium, have low medical expenses, and are willing to share in the cost throughout the year.
Medicare Supplement Plan K includes basic benefits which include:
- Hospitalization: Medicare Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses: Medicare Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insured to pay a portion of Part B coinsurance or copayments.
- Blood: First 3 pints of blood each year. Hospice: Part A coinsurance.
Hospice Care will be included in all Medicare Supplement Insurance Plans as of June 2010.
Charges from your doctor that exceed Medicare-approved amounts, called excess charges aren’t covered and don’t count toward the out of pocket limit. You will be responsible for paying these excess charges. The maximum amount that you are responsible for paying yourself can also increase each year due to inflation.
Medicare Supplement Insurance Plan K requires you to pay an out-of-pocket deductible. 100 Percent benefits will begin after the annual out of pocket limit has been reached. Specifically included with Medicare Supplement Plan K benefits, Part A coinsurance and all costs after the hospital benefits are exhausted are covered 100%. The copay or coinsurance for Medicare Part B (Medical) care is covered at 50% for services other than preventative. Also covered at 50% are hospice care, the Medicare Part A deductible, and skilled nursing facility services. Blood coverage is also covered at 50% after the first 3 pints.
There are services and benefits not covered under Medicare Supplement Plan K. The deductible for your Medicare Part B (Medical) coverage is not covered. Any excess charges that Medicare does not subsidize, as explained above, are also your responsibility. Emergency travel abroad coverage is not included with this plan, so be aware of this when traveling. Benefits for home health care recovery are also not included in Medicare Supplement Plan K.
All plans were standardized by the federal government in 1992 for your protection. This means that you are to go by the letter I.D. of the plan to determine what benefits each plan will cover.
The only 2 things that an insurance company who offers a Medicare Supplement Plan K can have any control of are:
- Underwriting
- Premium price
We have only briefly touched on one Medicare Supplement Insurance Plan, and as you can see it can be very confusing and somewhat overwhelming. We deal with Medicare daily and your Medicare Specialist here at MedicareMall.com can “Take the Mystery Out of Medicare” by walking you through the maze every step of the way. We are committed to you by shopping the best plans from the top companies available. We will do what it takes to make sure you become a very happy, satisfied MedicareMall.com client. To find out more if a Medicare Supplement Plan K is right for you, contact a Medigap Plan Representative now or talk to one of our licensed Medicare Specialists by entering your zip code and clicking the ‘Go’ button.
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