Juniper Tree Investments, Financial Planning, Health, Retirement
 
 

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A Quick Look at the
Basic Benefits for Medigap Plans K and L
Basic Benefit

What Medigap Plans K and L pay in 2005
(These amounts can change each year.)

Medicare Part A
coinsurance and
hospital benefits

Plan K and Plan L pay
• $228 per day for days 61 - 90 of a hospital stay
• $456 per day for days 91 - 150 of a hospital stay
• Up to 365 more days of a hospital stay during your lifetime
after you use all Medicare hospital benefits.

Medicare Part B
coinsurance or
copayment
  • Plan K pays 50% Part B coinsurance after you meet the
    Part B $110 yearly deductible. It pays 100% coinsurance for Part B preventive services.
  • Plan L pays 75% Part B coinsurance after you meet the Part B $100 yearly deductible. It pays 100% coinsurance for Part B preventive services.


Blood

  • Plan K pays 50% of the first three pints of blood or equal amounts of packed red blood cells per calendar year, unless your or someone else donates blood to replace what you use.
  • Plan L pays 75% of the first three pints of blood or equal amounts of packed red blood cells per calendar year, unless you or someone else donates blood to replace what you use.


Hospice Care

  • Plan K pays 50% hospice cost-sharing for all Part A Medicare covered expenses and respite care.
  • Plan L pays 75% hospice cost-sharing for all Part A Medicare covered expenses and respite care.


Note:
Plan K has a $40,000 out-of-pocket annual limit. Plan L has a $2,000 out-of-pocket annual limit. Once you meet the annual limit, the plan pays 100% of the Medicare Part A and Part B copayments and coinsurance for the rest of the calendar year. Charges fro your doctor that exceed Medicare-approved amounts, called "excess charges" aren't covered and don't count toward the out-of-pocket limit. You will have to pay these excess charges. The out-of-pocket annual limit can increase each year because of inflation.

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