Medicare Supplement Plan K, explained.
Plan K works differently from most Medigap plans: it splits many costs with you (paying 50%), which keeps premiums low — but it protects you with a yearly out-of-pocket maximum of $8,000 in 2026, after which it pays 100%. May River Medicare compares every plan against your budget, at no cost.
A cost-sharing plan with a built-in safety net. Open to new enrollees. All figures reflect 2026 amounts.
Plan K is a cost-sharing plan. Instead of paying most costs at 100% like Plan G, Plan K pays 50% of many benefits and you pay the other half — which is why the premium is lower. The trade-off protection: once your out-of-pocket spending hits $8,000 in 2026, Plan K pays 100% of covered services for the rest of the year.
Three things to know about Plan K
50% cost-sharing
Plan K pays half of most benefits — the Part A deductible, Part B coinsurance, blood, hospice, and skilled nursing — and you pay the other half.
A real out-of-pocket cap
Only Plans K and L have a yearly maximum. Once you hit $8,000 in 2026, Plan K covers everything at 100% for the rest of the year.
Some benefits at 100%
Plan K still pays 100% of Part A hospital coinsurance (plus 365 extra days) and 100% of preventive-care coinsurance.
Exactly what Plan A does and doesn’t cover
What Plan K covers
- 100% of Part A hospital coinsurance — plus 365 extra days after Medicare benefits end
- 100% of Part B preventive-care coinsurance
- 50% of the Part A hospital deductible ($868 of the $1,736 in 2026)
- 50% of Part B coinsurance or copayments
- 50% of skilled nursing facility coinsurance
- 50% of the first 3 pints of blood + Part A hospice coinsurance
- $8,000 yearly out-of-pocket max (2026), then 100% coverage
What Plan K does not cover
- Part B deductible ($283 in 2026) — you pay this yourself
- Part B excess charges
- Foreign travel emergency care
- Prescription drugs, dental, vision, hearing (pair with Part D separately)
One important detail: the $283 Part B deductible does not count toward the $8,000 cap — you pay that separately before Plan K’s cost-sharing begins. Plan K rewards healthy people who rarely need major care: the low premium saves money in good years, and the $8,000 cap protects you in a bad one. We’ll compare it against Plan L (which pays 75% with a $4,000 cap) and Plan N so you see the full trade-off.
Who Plan K tends to fit
Healthy savers who want a safety net
If you rarely need major care but still want protection against a catastrophic year, Plan K’s low premium plus $8,000 cap can be a smart balance.
Comfortable with cost-sharing
Plan K fits people who don’t mind paying half of routine costs in exchange for a lower monthly premium. We’ll run the numbers with you.
No Medigap plan includes prescription coverage — you’ll pair Plan A with a separate Part D plan. And your best enrollment window is the 6-month Medigap Open Enrollment Period (starting when you’re 65 and on Part B), when carriers can’t deny you or charge more for health conditions.
Is Plan K’s trade-off right for you? Let’s compare.
We’ll put Plan K side by side with Plan L, Plan N, and Plan G using real rates from 30+ A-rated carriers, so you can weigh the lower premium against the 50% cost-sharing and $8,000 cap. Free, no pressure, no carrier bias.
May River Medicare Insurance is an independent agency and is not affiliated with or endorsed by the U.S. government, the federal Medicare program, or CMS. Medigap benefits are federally standardized; premiums vary by carrier, age, location, and tobacco use. Figures reflect 2026 amounts published by CMS and independent sources. For a complete list of your options, contact Medicare.gov or 1-800-MEDICARE.