Medicare Supplement Plans - K, L

[Mack]

We have examined Medicare Supplement Plans A, B,C. D, F, and G, let's see what Plans K and L have to offer. This is current for 2011:


Plan K Covers:

Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
50% of Medicare Part B Coinsurance or Copayment
50% of first 3 pints of Blood
50% of Part A Hospice Care Coinsurance or Copayment
50% of Skilled Nursing Facility Care Coinsurance
50% of Medicare Part A Deductible
Plan K has a $4,640 out of pocket limit per year.


Plan L Covers:

Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
75% of Medicare Part B Coinsurance or Copayment
75% of first 3 pints of Blood
75% of Part A Hospice Care Coinsurance or Copayment
75% of Skilled Nursing Facility Care Coinsurance
75% of Medicare Part A Deductible
Plan L has a $2,320 out of pocket limit per year.

 

[weamish]

I don't understand why anyone would purchase plan K or L in preference to the high-deductible version of Plan F, which has lower premiums and lower out-of-pocket exposure. Am I missing something?

 

[MBSC]

I don't understand why anyone would purchase plan K or L in preference to the high-deductible version of Plan F, which has lower premiums and lower out-of-pocket exposure. Am I missing something?

You are not missing anything. Plan F-HD has lower premiums and lower Maximum Out Of Pocket (MOOP).

When Part B pays 80%, only the remaining 20% coinsurance is applied to the Plan F-HD deductible. Some people think they have to pay the $2180 F-HD deductible first before Medicare starts paying anything. That is NOT the case.

 

[rahod1]

I don't understand why anyone would purchase plan K or L in preference to the high-deductible version of Plan F, which has lower premiums and lower out-of-pocket exposure. Am I missing something?

You are not missing anything. Plan F-HD has lower premiums and lower Maximum Out Of Pocket (MOOP).

When Part B pays 80%, only the remaining 20% coinsurance is applied to the Plan F-HD deductible. Some people think they have to pay the $2180 F-HD deductible first before Medicare starts paying anything. That is NOT the case.

Plan F HD doesn't have a *Maximum out of pocket* per se, but does limit your exposure to $2180. Only K and L have this feature. For F-HD, you must meet the 2180 deductible to get the 20% copay on part B . In plans K and L you get either 50% or 75% off the deductible on part A and B copay (not deductible) right off the bat, so you can see savings right away. I took plan K over F HD for the maximum out of pocket and immediate discount (50% in plan K) on part A deducible and B copay. If you're in good health, K L and even F-HD are all good options in my opinion.

 

[MBSC]

Plan F HD doesn't have a *Maximum out of pocket* per se, but does limit your exposure to $2180. Only K and L have this feature. For F-HD, you must meet the 2180 deductible to get the 20% copay on part B .

If your exposure is limited to $2180, then your MOOP is $2180 for covered services. Calling it a deductible is misleading when Original Medicare pays first, usually at 80% for Part B services.

Actually, it is K and L that do not have a true MOOP since they do not pay for Part B Excess Charges and those charges do not count towards their CMS "limit".

Plan G has a MOOP of $166 in 2016. Plan F has a MOOP of $0.

 

[rahod1]

Plan F HD doesn't have a *Maximum out of pocket* per se, but does limit your exposure to $2180. Only K and L have this feature. For F-HD, you must meet the 2180 deductible to get the 20% copay on part B .

If your exposure is limited to $2180, then your MOOP is $2180 for covered services. Calling it a deductible is misleading when Original Medicare pays first, usually at 80% for Part B services.

Actually, it is K and L that do not have a true MOOP since they do not pay for Part B Excess Charges and those charges do not count towards their CMS "limit".

Plan G has a MOOP of $166 in 2016. Plan F has a MOOP of $0.

True. ....BUT

"Part B excess charges only apply to providers who do not accept Medicare assignment. If a provider accepts Medicare assignment, they cannot charge an excess charge. If you are not sure whether a doctor will charge you an additional amount, you can ask if they accept Medicare assignment."