Cost-sharing is the way you contribute to your health insurance plan. This includes copayments, coinsurance, premiums, and deductibles. Premiums are a set monthly rate that you must pay consistently in order to remain active on your plan. A deductible is an annual fee you pay before you receive your first benefit of that year. Medigap Plans K and L are great lower-cost Medigap options that are considered cost-sharing plans.
About Copays
Copayments and coinsurance fees are your contribution towards the total cost of the service. Say, for example, you receive a service that costs $2,000. A coinsurance fee would be a flat amount you must cover—say, for instance, $300. Copayments (which are the way you will be making most of your cost-sharing payments for K and L) are a percentage contribution. Say your copayment rate is 20%—for a $2,000 benefit, you’ll pay $400 out-of-pocket.
This is the primary focus when it comes to cost-sharing, especially for Plans K and L.
Benefits of Plans K and L
Every supplement plan has its own list of covered benefits. Plans K and L, however, are some of the only ones that offer them at a lower coverage rate, i.e., they only cover a certain percentage of the benefit, while the rest comes out-of-pocket.
Plan K covers:
- 100% of Part A Coinsurance and Hospital Costs
- 50% of Part B Coinsurance/Copayment
- 50% of the First 3 Pints of Blood for Transfusions
- 50% of Part A Hospice Care Coinsurance or Copayment
- 50% of Skilled Nursing Care Facility Coinsurance
- 50% of the Part A Deductible
Plan L covers:
- 100% of Part A Coinsurance and Hospital Costs
- 75% of Part B Coinsurance/Copayment
- 75% of the First 3 Pints of Blood for Transfusions
- 75% of Part A Hospice Care Coinsurance or Copayment
- 75% of Skilled Nursing Care Facility Coinsurance
- 75% of the Part A Deductible
Plans K and L Comparison
Almost all of your benefits under either K or L are a percentage of the entire cost—the rest comes out-of-pocket, plus your premiums and deductibles. But what are the benefits of such an arrangement?
A lot of Medicare beneficiaries skip over plans like K and L in favor of the higher coverage. The difference? K and L have significantly cheaper premiums and deductibles than the other options.
While you pay more when you use a benefit, you do not pay nearly as much on a regular basis. Plans K and L are incredibly useful, especially for individuals who use benefits a little less often so that you can save money on your premiums and deductibles instead.
Compare Medigap Plans with iHealthBrokers—Call Today
When deciding on a supplement plan, you need advice from agents who know what you want and how to get it. iHealthBrokers will make sure you get the coverage you need. Call us at (888) 918-0518.
Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.
