Medigap Plan K is a standardized Medicare Supplement plan that uses cost-sharing to help reduce premiums while still providing meaningful protection from Original Medicare expenses. It pays 50% of several Medicare cost-sharing benefits, covers Part A hospital coinsurance at 100%, and includes a $8,000 annual out-of-pocket limit in 2026.
Medigap Plan K covers 100% of Medicare Part A coinsurance and hospital costs for up to an additional 365 days after Medicare benefits are used. It covers 50% of the Part B coinsurance or copayment, the first three pints of blood, Part A hospice cost-sharing, skilled nursing facility coinsurance, and the Part A deductible. It does not cover the Part B deductible, Part B excess charges, or foreign travel emergency care.
Plan K is unusual because it has an annual out-of-pocket limit. In 2026, that limit is $8,000. After you meet that limit and the yearly Medicare Part B deductible of $283, Plan K pays 100% of covered services for the remainder of the calendar year.
Medigap benefits are standardized in most states. The table below shows the benefits Medicare assigns to Plan K in 2026.
| Medigap Benefit | Plan K | What You Should Know |
|---|---|---|
| Part A coinsurance and hospital costs, up to 365 additional days after Medicare benefits are used | ✓ 100% | This is the one major standardized Plan K benefit paid at 100% from the start. |
| Part B coinsurance or copayment | 50% | You are generally responsible for the remaining 50% of this Medigap benefit until the Plan K limit rules are satisfied. |
| Blood benefit, first 3 pints | 50% | Plan K pays half of this standardized benefit. |
| Part A hospice care coinsurance or copayment | 50% | Plan K pays half of the applicable standardized hospice cost-sharing benefit. |
| Skilled nursing facility care coinsurance | 50% | Plan K pays 50% of the Medigap SNF coinsurance benefit. |
| Part A deductible | 50% | The Medicare Part A deductible is $1,736 per benefit period in 2026, so Plan K pays half of the standardized deductible benefit. |
| Part B deductible | ✕ Not covered | You are responsible for the $283 annual Part B deductible in 2026. |
| Part B excess charges | ✕ Not covered | Plan K does not pay permitted Part B excess charges from providers who do not accept Medicare assignment. |
| Foreign travel emergency, up to plan limits | ✕ Not covered | Plan K does not include the standardized foreign travel emergency benefit. |
| 2026 out-of-pocket limit | $8,000 | After the annual limit and Part B deductible are met, Plan K pays 100% of covered services for the rest of the calendar year. |
Plan K is designed differently from more comprehensive Medigap plans such as Plan G. Rather than paying 100% of most standardized Medicare cost-sharing, Plan K shares several of those expenses with you.
After the Part B deductible, Original Medicare generally pays its share of approved Part B services. Plan K then pays 50% of the standardized Part B coinsurance or copayment benefit, leaving you responsible for the other portion until the plan's annual limit rules apply.
Plan K pays 50% of the Medicare Part A deductible. In 2026, the full Part A deductible is $1,736 per benefit period, so Plan K does not eliminate the entire deductible exposure.
Plan K pays 50% of the standardized skilled nursing facility coinsurance benefit. This can be meaningful when a qualifying skilled nursing stay extends beyond the period Medicare covers in full.
Plan K is one of only two standardized Medigap plans with an annual out-of-pocket limit. Plan L has a separate, lower limit and a different cost-sharing percentage.
Medicare states that after you meet Plan K's yearly out-of-pocket limit and your yearly Medicare Part B deductible, the Medigap policy pays 100% of covered services for the rest of that calendar year. The Part B deductible is $283 in 2026.
That makes Plan K structurally different from most other standardized Medigap plans. It can appeal to someone willing to pay a larger share of routine Medicare cost-sharing in exchange for a policy design that includes an annual limit.
Plan K helps with Original Medicare cost-sharing, but it does not eliminate every Medicare expense and does not add broad non-Medicare benefits.
You pay the annual Medicare Part B deductible, which is $283 in 2026.
Plan K does not cover permitted excess charges from non-participating providers who do not accept Medicare assignment.
Plan K does not include the standardized foreign travel emergency benefit found in some other Medigap plans.
Modern Medigap policies do not include outpatient prescription drug coverage. You can enroll in a separate Medicare Part D plan if needed.
Standard Medigap Plan K does not generally cover routine dental care, routine vision care, hearing aids, or eyeglasses.
Medigap does not provide long-term custodial care coverage simply because Original Medicare excludes that service.
Plans K and L are the two standardized Medigap options built around partial cost-sharing and an annual out-of-pocket limit.
The right Medigap plan depends on premium, expected health care use, risk tolerance, provider habits, and the plans actually offered in your area.
Plan K can make sense for someone who understands that the policy pays only part of several standardized benefits before the annual limit rules apply.
The $8,000 Plan K limit provides a defined ceiling for the plan's covered Medigap cost-sharing structure once the Medicare requirements are also met.
A lower premium can be attractive, but the better comparison is total expected annual cost, including premium plus the portion of cost-sharing you may owe.
A Medigap policy does not replace Medicare premiums or pay every health care expense. Your total cost can include several separate items.
You pay the insurance company's monthly premium for the Medigap policy. Premiums vary by company and market.
You continue paying your Medicare Part B premium. The standard Part B premium is $202.90 per month in 2026, with higher amounts for some higher-income beneficiaries.
You pay the $283 annual Part B deductible in 2026 because Plan K does not cover it.
You generally pay the portion of standardized benefits that Plan K does not cover until the annual limit rules are satisfied.
If you enroll in Medicare Part D, the Part D premium and prescription cost-sharing are separate from Medigap Plan K.
Routine dental, vision, hearing aids, long-term custodial care, and other services not covered by Medicare are generally outside standardized Medigap coverage.
Your strongest federal Medigap enrollment protection generally occurs during your one-time Medigap Open Enrollment Period.
It starts the first month you have Medicare Part B and are age 65 or older. During this period, an insurer generally cannot use medical underwriting to deny you a Medigap policy or charge you more because of health problems. Outside this period, federal protections can be more limited, although guaranteed-issue rights and state-specific rules may apply.
No. The standardized Plan K benefit for Medicare Part A coinsurance and hospital costs, including up to 365 additional days after Medicare benefits are used, is covered at 100%. Several other Plan K benefits are covered at 50%.
The standardized Plan K out-of-pocket limit is $8,000 in 2026. Medicare states that after you meet that limit and your annual Part B deductible, Plan K pays 100% of covered services for the rest of the calendar year.
Plan K covers 50% of the standardized Part A deductible benefit. The full Medicare Part A deductible is $1,736 per benefit period in 2026.
No. Plan K does not cover the Medicare Part B deductible. The Part B deductible is $283 in 2026.
No. Plan K does not cover Part B excess charges. Plan F and Plan G are the standardized plans that cover this benefit where excess charges are permitted.
Yes, but only at 50% of the standardized Medigap skilled nursing facility coinsurance benefit.
No. Standardized Plan K does not include the Medigap foreign travel emergency benefit.
No. Medicare does not have a Part K. Plan K is one of the standardized Medicare Supplement insurance plans that works with Original Medicare Parts A and B.
Not necessarily. Insurance companies set Medigap premiums, and pricing varies by company, location, rating method, discounts, and other factors. Compare the actual premiums available to you rather than assuming one plan letter will always cost less.
Medigap rules and Medicare costs can change. The following Medicare resources are the primary references for the standardized benefits and 2026 amounts used on this page.
Compare premiums, standardized benefits, cost-sharing, provider considerations, and your expected health care use before choosing a Medicare Supplement policy.
Request Medicare Supplement InformationSenior Healthcare Planning is an independent insurance agency that provides education, guidance, and enrollment assistance for Medicare-related insurance products, including Medicare Advantage, Medicare Supplement, and Prescription Drug Plans. Senior Healthcare Planning is not connected with or endorsed by the United States government or the federal Medicare program. Medicare Supplement availability and premiums vary by insurance company and location. Massachusetts, Minnesota, and Wisconsin standardize Medigap differently. This page is for educational purposes and is not a guarantee of coverage or benefits.
