How does Medigap Plan K compare to Plan G for someone on a tight budget?
Answered by 25 licensed agents
Medigap Plan K differs from Medigap Plan G in the following ways: Plan K covers only 50% of coinsurance/copayment costs for benefits such as Part B cost share; blood; Part A hospice; skilled nursing; and Part A deductible. Plan K offers no coverage for costs such as Part B deductible; Part B excess charges; and foreign travel emergency. With an out-of-pocket limit of $7220 in 2025, careful consideration should be taken by an individual on a tight budget to ensure that the premium savings is worth the additional financial exposure. A standard High-Deductible plan G or F may be a better alternative. For more information on your specific situation, please call me directly.
Medicare G is the most comprehensive and most expensive. Plan K is less expensive but has a higher max out of pocket. Ideal for someone in good health and able to pay out of pocket.
Since plan G has been the most popular plan for many years and some insurance firms don't even offer Plan K (I have never written up a K application!) I’d suggest that you ought to pay more attention to the health benefits of G, rather than the saving of money. You only have one life to live!
Medigap Plan K offers lower monthly premiums, but the beneficiary has more out-of-pocket spending. It is similar to a Medicare Advantage plan, except that most Medicare Advantage plans don't have a premium. Plan K only covers a percentage of the costs.
Medigap Plan G has higher monthly premiums, but the only out-of-pocket cost a beneficiary is responsible for is the Part B deductible.
To specifically answer this question and maintain compliance with Medicare guidelines, comparing plans should be discussed with a licensed agent with Medicare approved outlines and sales materials. Most people are enrolled in a Plan G or Plan N. Plan K is not offered by some companies. Plans with less market share tend to be higher in premium in comparison to the benefits.
Medigap Plan K may cost half of Plan G but it has a 7K max out of pocket and cover half of what G does. If you’re healthy it’s a calculated risk. If you become not so healthy you may be stuck in a plan that will cost you out of pocket yearly vs having a G plan with about $250 out of pocket yearly.
For someone on a tight budget, Medigap Plan K is generally a better option than Plan G. Plan K offers lower premiums than Plan G, but with the tradeoff of requiring cost-sharing (paying a percentage of covered services). Plan G, while offering more comprehensive coverage, comes with higher premiums.
Plan K is designed to offer a balance between monthly costs and coverage, potentially suiting individuals who want a lower premium and are comfortable with higher cost-sharing during their Medigap open enrollment period, says Medigap Seminars. If you're generally healthy and don't anticipate frequent medical visits, the lower premiums of Plan K might be appealing. However, be prepared for potential higher costs if you experience an illness or injury requiring significant medical attention. In contrast, Plan G provides more extensive coverage and greater peace of mind against potentially higher medical bills, especially after paying the Part B deductible.
I do not offer plan K as the HDG plan is a much better option than K as the max out of pocket on K in a bad heatlh year is double plus the K plan. In addition the K plan premium is much more than the HDG one. Overall the K plan makes no economic sense to me as the HDG gives you moe coverage for lower premiun
Plan G pays 100% of Medicare-allowed charges after you pay your Part B deductible. Plan K is less expensive, but it only covers Part B allowed charges at 50% until you hit the maximum out-of-pocket limit. For 2025 it is $7,060. After that it will pay 100%, just like a Plan G with a few exceptions.
Plan K also does not cover 15% excess charges that may be allowed. And it does not cover foreign travel emergency services. These are things to consider when comparing the two plans.
Coverage: Covers all of Medicare's Part A and Part B coinsurance and copayments, except for the Part B deductible.
Out-of-pocket costs: After you pay the Part B deductible, Plan G will pay for the rest of your Medicare-approved costs.
Premium: Generally has a higher premium than Plan K.
Plan K:
Coverage: Covers 50% of the cost for many of the gaps in Original Medicare coverage, such as Part B coinsurance and copayments.
Out-of-pocket costs: Has a specific out-of-pocket limit ($7,220 in 2025). After you meet this limit and the Part B deductible, Plan K will cover 100% of your Medicare-approved costs for the rest of the year.
Premium: Generally has a lower premium than Plan G
Coverage: Plan G offers more comprehensive coverage with no out-of-pocket maximum, while Plan K has an out-of-pocket maximum and only covers 50% of certain costs.
Out-of-pocket costs: Plan G has a predictable Part B deductible, while Plan K has a higher out-of-pocket limit.
Premiums: Plan K typically has a lower monthly premium than Plan G.
In essence, Plan G is a good option for those who want more predictable costs and comprehensive coverage, while Plan K is a good option for those who are willing to pay a lower premium and accept a higher potential out-of-pocket cost in exchange for potentially lower overall costs if their healthcare needs are minimal.
Medicare Plan K only pays for 50% of the costs until the out-of-pocket limit has been reached (for 2025 it is $7,220), then Plan K pays 100%. Plan G will pay 100% of the Medicare-covered charges after the yearly Part B deductible has been met.
In my county, a 65-year-old male non-smoker will pay about $94.00 less per month for Plan K than for Plan G, making it substantially cheaper than Plan G for an AARP United Healthcare Insurance Company Plan.
With a Plan G, in addition to the premium, you will have to pay the part B deductible ($257.00 in 2025) and all Part A and Part B approved charges are paud by the policy at 100%. With the Plan K, in addition to the premium, you will pay the Part B deductible and be responsible for 50% of the approved charges for Part B coinsurance, Blood benefit (firts 3 pints) Part A hospice care, Skilled nursing facility coinsurance, and Part A deduclible. In addition, on Plan K you may be charged excess charges.
If you have a tight budget, Medigap Plan K could be a suitable option since it typically charges a lower monthly premium than Plan G, but also has less comprehensive coverage. Plan K only covers about 50% of many key benefits like Part B coinsurance, skilled nursing facility care, and the Part A deductible. Therefore with Plan K, your fixed costs (monthly premium) would be lower when compared to Plan G, and may be a better option for your tight budget as long as you are relatively healthy and don't require frequent medical care.
Plan G covers almost everything except the Part B deductible, so you pay very little out of pocket — but the monthly premium is higher.
Plan K has a much lower monthly premium, but you pay more when you get care — it only covers part of the costs until you reach your yearly limit.
Plan G is better for people who want to avoid surprise bills, while Plan K is more budget-friendly upfront but could cost more later if you need a lot of care. I hope this answers your question!
Medigap Plan K will likely offer lower monthly premiums than Plan G but the cost sharing for services will be higher. Under a plan K, you'll share the costs for certain services, meaning you'll pay a percentage of the bill (coinsurance/copayment) for things like Part B services, blood, Part A hospice, skilled nursing, and the Part A deductible up to an out of pocket limit of $7,220. Once you meet this amount, the plan K will pay 100% of the remaining costs for the year.
Medigap Plan G has higher monthly premiums than Plan K but offers more comprehensive coverage, covering most of the gaps in Original Medicare Part A and B, except for the Part B deductible ($257 in 2025). Once you pay the annual Part B deductible, you'll generally have very few out-of-pocket costs for Medicare-covered services with Plan G.
After careful thought on this question. I would say Plan K May be a good option if you want lower monthly premiums and you don't mind sharing cost until you attain the out of pocket limits. However, Plan G is also good if you don't mind predictable costs and you can afford the higher premium cost to avoid unexpected medical bills.
With Plan K, you'll typically pay a lower monthly premium, which looks good upfront, but you'll be responsible for half of many medical bills until you hit a set yearly out-of-pocket limit. Plan G, on the other hand, comes with a higher monthly premium, but once you cover the small annual Part B deductible, it pretty much takes care of everything else, offering much more predictable costs throughout the year. So, if you're on a tight budget, it really boils down to whether you prefer a lower regular payment with the risk of higher medical bills if you get sick, or a higher regular payment for the peace of mind that most costs are covered after that initial deductible.
