Medicare Supplement Plan K — Complete 2026 Guide
Plan K is a cost-sharing plan that covers 50% of several Medicare cost-sharing items rather than 100%. It covers Part A coinsurance and hospital costs in full, and covers 50% of the Part A deductible, skilled nursing facility coinsurance, and Part A hospice copayments. It does not cover Part B excess charges or foreign travel. However, Plan K has a $7,220 out-of-pocket maximum in 2026 — once you reach that limit, the plan pays 100%.
What Plan K Covers
Below is the complete coverage table for Plan K. This is the federally standardized benefit chart — every insurer selling Plan K must provide these exact benefits.
| Medicare Cost | Plan K Covers? | Notes |
|---|---|---|
| Part A coinsurance & hospital costs (up to 365 days after Medicare) | Covered | — |
| Part A deductible ($1,676 in 2026) | 50% Covered | — |
| Part A hospice care coinsurance or copayment | 50% Covered | — |
| Part B coinsurance or copayment (20% of outpatient costs) | 50% Covered | — |
| Part B deductible ($257 in 2026) | Not Covered | — |
| Part B excess charges (above Medicare-approved amount) | Not Covered | — |
| Skilled nursing facility care coinsurance | 50% Covered | — |
| Foreign travel emergency coverage (up to plan limits) | Not Covered | — |
| Out-of-pocket limit (then plan pays 100%) | Covered | $7,220 in 2026; then 100% covered |
Source: CMS standardized Medigap benefit chart. CMS Publication 02110.
Who Should Choose Plan K?
Budget-conscious beneficiaries who want a meaningful cap on annual healthcare costs while keeping monthly premiums low.
Average Plan K Premiums by State (2026)
Premiums for Plan K vary significantly by state due to differences in rating laws, local healthcare costs, and insurer competition. The table below shows estimates for a 65-year-old non-smoking female. Your actual premium will depend on your age, gender, tobacco use, and the specific insurer you choose.
Always get multiple quotes before choosing an insurer. Use the official Medicare Plan Finder or a licensed broker who represents multiple companies.
| State | Est. Monthly Premium (Age 65) | Rating Method | Special Protections |
|---|---|---|---|
| California | ~$165/mo | community | ✓ Birthday Rule ✓ Community Rated |
| Florida | ~$175/mo | attained age | Federal standard |
| Texas | ~$138/mo | attained age | Federal standard |
| New York | ~$260/mo | community | ✓ Community Rated |
| Pennsylvania | ~$152/mo | attained age | Federal standard |
| Ohio | ~$124/mo | attained age | Federal standard |
| Illinois | ~$140/mo | attained age | Federal standard |
| North Carolina | ~$132/mo | attained age | Federal standard |
| Michigan | ~$132/mo | attained age | Federal standard |
| Georgia | ~$125/mo | attained age | Federal standard |
* Estimates based on Medicare.gov plan finder data sampling, April 2026. Premiums vary by insurer, age, gender, and tobacco use. Verify current rates at Medicare.gov.
How Plan K Compares to Other Plans
The right Medigap plan depends on your health, how often you use medical services, and how much premium you're comfortable paying. Here are the key comparisons for Plan K:
Compare all Medicare Supplement plans side by side to understand how Plan K fits within the full range of options.
How to Enroll in Plan K
You can enroll in a Medicare Supplement plan through any private insurance company that sells Medigap plans in your state. Here's the process:
- Confirm eligibility: You must be enrolled in Medicare Parts A and B. Most people are first eligible at age 65.
- Enroll during your Open Enrollment Period: Your 6-month OEP begins when you're both 65 and enrolled in Part B. During this window, you have guaranteed issue rights — insurers cannot deny you coverage or charge more based on your health.
- Get quotes from multiple insurers: Because benefits are standardized, the only variable is the premium. Use Medicare.gov or a licensed broker.
- Complete the application: Outside your OEP, insurers can require medical underwriting in most states (exceptions: CA, NY, NJ, OR, FL birthday rules; MA, WI, MN unique rules).
- Pair with a Part D plan: Medigap does not cover prescription drugs. You'll need a separate Part D plan for drug coverage.
Frequently Asked Questions
What is the out-of-pocket limit for Plan K in 2026?
The out-of-pocket limit for Plan K is $7,220 in 2026. Once you have paid this amount in cost-sharing, Plan K covers 100% of Medicare-approved costs for the rest of the year.
Does Plan K cover prescription drugs?
No. Like all Medigap plans, Plan K does not cover prescription drugs. You need a separate Medicare Part D plan for drug coverage.
This site provides general information about Medicare Supplement insurance and medical alert devices. It is not affiliated with or endorsed by the Centers for Medicare & Medicaid Services (CMS) or any government agency. This is not medical or insurance advice. Always consult a licensed insurance professional for personalized guidance.
Medicare rules, premiums, and plan availability change annually. Always verify current information with Medicare.gov, your State Insurance Department, or a licensed insurance advisor. For free, unbiased help, contact your State Health Insurance Assistance Program (SHIP) at shiphelp.org.
Sources
- Centers for Medicare & Medicaid Services. Medicare Supplement Insurance (Medigap). medicare.gov. Retrieved June 2026.
- CMS. Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Publication 02110. cms.gov. Retrieved June 2026.
- CMS. 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved June 2026.