Original Medicare offers basic coverage for certain hospital and medical needs, but some individuals find that they need more assistance with their expenses. One of several supplemental plans, Part K might be a good option for you depending on your medical needs. This plan is designed to help reduce the out of pocket expenses after Medicare Parts A and B play their role.
Part K Details
Designed to offer additional coverage to Original Medicare enrollees, Medicare Part K has a very specific set of services that it will help pay toward. To review, Medicare Part A helps with hospital care including facility stays, hospice care, and skilled nursing facility care, while Part B addresses more routine expenses including lab work and some durable medical equipment. In most situations, individuals will be left with out of pocket expenses after their Original Medicare plan makes its payment.
This is where Part K steps in, as it pays roughly 50% of many of the leftover costs. It’s important to keep in mind that this plan does not pay toward Part A or Part B deductibles or Part B excess charges. These expenses are the difference between what your doctor charges and what Medicare pays for a specific billable service. Some Medicare providers may offer discounted rates for specific services, making Part K a smarter option for your unique medical needs.
Another facet of Part K has to do with out of pocket limits, as it is only one of two plans that include a maximum yearly cap. This amount may change each year, but it provides peace of mind for individuals who need extensive medical treatment as this plan will cover all charges after this limit has been met. Original Medicare without any supplemental coverage does not have any limit whatsoever, leaving individuals in a situation where an emergency could cost them far more than they were anticipating.
Things To Consider
When evaluating which Medicare plans you’d like to enroll in, keep in mind that Part K may include higher out of pocket costs than other supplements as it only pays 50% toward many covered services. However, this does mean that monthly premiums may be lower as a result. Depending on how frequently you plan on using your Part K coverage, you may find that this plan meets your needs or it may be too expensive given the frequency of its use.
It’s recommended that you attempt to plan out your annual medical expenses before your enrollment period, as this will inform you as to which supplemental plans will best meet your needs. If you anticipate using your Medicare coverage quite a bit during the coming year, Part K may not be the best option for you, and a more comprehensive option could help to lower your overall expenses even if the monthly premiums are slightly higher.