Medicare Supplement Plan L vs Plan K: Cost and Coverage Comparison 2026
Medicare Supplement Plan L vs Plan K: Cost and Coverage Comparison 2026
TL;DR Quick Answer
Plan L covers 75% of your cost-sharing and has a lower out-of-pocket cap ($3,470 in 2026), making it the better choice for most seniors who want predictable expenses with moderate premiums.
Plan K covers 50% of your cost-sharing and has a higher out-of-pocket cap ($6,940 in 2026), but offers the lowest monthly premiums among all Medigap plans that include an annual spending limit.
Both Plan K and Plan L are “cost-sharing” Medigap plans, meaning they pay a fixed percentage (50% or 75%) of certain Medicare costs rather than 100%. In return, you get significantly lower monthly premiums compared to comprehensive plans like Plan G or Plan N. The key difference is how much risk you keep versus how much premium you save.
Key Takeaways
- Plan L pays 75% of covered cost-sharing; Plan K pays 50% — Plan L provides substantially more financial protection for a moderately higher premium
- Plan L’s out-of-pocket maximum is half of Plan K’s — $3,470 vs $6,940 in 2026, meaning Plan L caps your worst-case annual spending at roughly half the level
- Both plans include an annual out-of-pocket limit — Unlike most Medigap plans, Plans K and L cap your total spending, which protects you from catastrophic costs
- Monthly premium savings are significant — Plan K premiums are typically 40-55% lower than Plan G; Plan L premiums are 25-40% lower than Plan G
- Neither plan covers the Part B deductible — You pay the full $257 Part B deductible yourself under both plans
- Best for budget-conscious seniors — If you’re healthy and want catastrophic protection without high premiums, Plan K or Plan L may be your smartest option
What Are Medicare Supplement Plans K and L?
Plans K and L are two of the ten standardized Medigap plans available in most states. They are classified as partial-coverage or cost-sharing plans because they cover a specific percentage of your Medicare out-of-pocket costs rather than 100%.
How Cost-Sharing Works
With a traditional Medigap plan (like Plan G), the insurance company pays 100% of covered expenses after you meet any applicable deductible. With Plan K or Plan L, the insurance company pays a percentage:
- Plan K: Insurance pays 50% of covered cost-sharing
- Plan L: Insurance pays 75% of covered cost-sharing
You pay the remaining percentage until you hit the plan’s annual out-of-pocket limit. Once you reach that cap, the plan pays 100% of covered services for the rest of the calendar year.
Which Benefits Do Plans K and L Partially Cover?
Both plans cover the following benefits at their respective percentage rates:
| Benefit | Plan K Covers | Plan L Covers | You Pay (Plan K) | You Pay (Plan L) |
|---|---|---|---|---|
| Part B coinsurance/copayment | 50% | 75% | 50% | 25% |
| Part A deductible | 50% | 75% | 50% | 25% |
| Skilled nursing facility coinsurance | 50% | 75% | 50% | 25% |
| Part A hospice coinsurance/copayment | 50% | 75% | 50% | 25% |
| First 3 pints of blood | 50% | 75% | 50% | 25% |
Benefits Covered at 100%
Both plans cover certain benefits in full, regardless of their cost-sharing percentage:
| Benefit | Plan K | Plan L |
|---|---|---|
| Part A coinsurance (hospital stays) | 100% | 100% |
| Part A hospital costs (365 additional days) | 100% | 100% |
Benefits NOT Covered
Neither Plan K nor Plan L covers the following:
| Benefit | Plan K | Plan L |
|---|---|---|
| Part B deductible ($257 in 2026) | Not covered | Not covered |
| Part B excess charges | Not covered | Not covered |
| Foreign travel emergency | Not covered | Not covered |
| At-home recovery | Not covered | Not covered |
2026 Out-of-Pocket Maximum Comparison
The most important feature that sets Plans K and L apart from other Medigap plans is the annual out-of-pocket limit. CMS updates these limits each year.
2026 Out-of-Pocket Limits
| Plan | 2026 Annual Out-of-Pocket Limit |
|---|---|
| Plan K | $6,940 |
| Plan L | $3,470 |
What Counts Toward the Out-of-Pocket Limit
Your cost-sharing amounts for the following services count toward the annual cap:
- Your share of Part B coinsurance (50% or 25% depending on plan)
- Your share of the Part A deductible ($830 per benefit period in 2026)
- Your share of skilled nursing facility coinsurance
- Your share of hospice coinsurance/copayments
- Your share of the first 3 pints of blood
What Does NOT Count Toward the Limit
- Monthly plan premiums
- The Part B deductible ($257 in 2026)
- Part B excess charges (not covered by either plan)
- Costs for services Medicare doesn’t cover (dental, vision, hearing)
- Prescription drug costs (covered under Part D separately)
How the Out-of-Pocket Cap Works in Practice
Example with Plan K:
You have multiple hospitalizations and outpatient procedures in 2026. Your cost-sharing adds up throughout the year:
| Service | Total Cost | Your 50% Share |
|---|---|---|
| Part A deductible (2 benefit periods) | $1,660 | $830 |
| Part B coinsurance (various visits) | $6,000 | $3,000 |
| Skilled nursing (20 days) | $2,220 | $1,110 |
| Total cost-sharing | $9,880 | $4,940 |
Since $4,940 is less than the $6,940 cap, you continue paying 50% for the rest of the year. But if your share reaches $6,940, Plan K starts paying 100% of covered services for the remainder of the calendar year.
Example with Plan L (same scenario):
| Service | Total Cost | Your 25% Share |
|---|---|---|
| Part A deductible (2 benefit periods) | $1,660 | $415 |
| Part B coinsurance (various visits) | $6,000 | $1,500 |
| Skilled nursing (20 days) | $2,220 | $555 |
| Total cost-sharing | $9,880 | $2,470 |
Your share is $2,470, well under the $3,470 cap. Plan L would have to accumulate significantly more cost-sharing before the cap kicks in.
Monthly Premium Comparison: Plan K vs Plan L vs Plan G
The primary reason seniors choose Plan K or Plan L is lower monthly premiums. Here’s how typical premiums compare across these plans for a 65-year-old non-tobacco female:
| Plan | Monthly Premium Range | Annual Premium |
|---|---|---|
| Plan K | $45 – $95 | $540 – $1,140 |
| Plan L | $70 – $140 | $840 – $1,680 |
| Plan G | $120 – $210 | $1,440 – $2,520 |
| Plan N | $95 – $175 | $1,140 – $2,100 |
Premium ranges vary significantly by state, age, gender, tobacco status, and insurance company. Use our Medicare Supplement Plan Cost Estimator for personalized estimates.
Annual Savings vs Plan G
| Comparison | Monthly Savings | Annual Savings |
|---|---|---|
| Plan K vs Plan G | $50 – $120 | $600 – $1,440 |
| Plan L vs Plan G | $25 – $80 | $300 – $960 |
| Plan K vs Plan L | $20 – $50 | $240 – $600 |
Real-World Cost Scenario: Plan K vs Plan L
Let’s compare total annual costs (premiums + out-of-pocket) for a 67-year-old with moderate healthcare usage:
Scenario: 4 doctor visits, 1 outpatient procedure ($3,000), no hospitalization
| Cost Component | Plan K | Plan L |
|---|---|---|
| Annual premium | $720 ($60/mo) | $1,020 ($85/mo) |
| Part B deductible (you pay full) | $257 | $257 |
| Part B coinsurance (your share) | $300 (50% of $600) | $150 (25% of $600) |
| Part A deductible (none) | $0 | $0 |
| Total annual cost | $1,277 | $1,427 |
In this moderate-use scenario, Plan K saves $150/year because the lower premium outweighs the higher cost-sharing.
Scenario: 1 hospitalization + 20 days skilled nursing + 6 doctor visits
| Cost Component | Plan K | Plan L |
|---|---|---|
| Annual premium | $720 ($60/mo) | $1,020 ($85/mo) |
| Part B deductible | $257 | $257 |
| Part A deductible (your share) | $415 (50% of $830) | $208 (25% of $830) |
| Part B coinsurance (your share) | $500 (50% of $1,000) | $250 (25% of $1,000) |
| SNF coinsurance (your share) | $1,110 (50% of $2,220) | $555 (25% of $2,220) |
| Total annual cost | $3,002 | $2,290 |
In this higher-use scenario, Plan L saves $712/year because the 75% cost-sharing dramatically reduces out-of-pocket expenses.
Who Should Choose Plan L?
Plan L is the better choice if you:
1. Want Lower Out-of-Pocket Risk
With a $3,470 annual cap (roughly half of Plan K’s $6,940), Plan L provides significantly better worst-case protection. If you have any health concerns, the extra $25-$50/month in premiums buys substantial peace of mind.
2. Expect Moderate Healthcare Usage
If you see a doctor 3-6 times per year or anticipate a possible hospitalization, Plan L’s 75% cost-sharing meaningfully reduces your bills. The break-even point between Plan K and Plan L is typically around $3,000-$4,000 in total Medicare-approved charges per year.
3. Prefer Predictable Costs
Plan L’s higher coverage percentage means smaller bills per visit, making it easier to budget for healthcare expenses throughout the year.
4. Are Choosing Between Plan L and Plan G
If you’ve been considering Medigap Plan G vs Plan N but find both too expensive, Plan L offers a middle ground — more coverage than Plan K or Plan N, with lower premiums than Plan G and a guaranteed out-of-pocket cap.
Who Should Choose Plan K?
Plan K is the better choice if you:
1. Are in Excellent Health
If you rarely visit doctors and have no chronic conditions, Plan K’s ultra-low premiums can save you hundreds per year. The 50% cost-sharing only matters when you actually use healthcare services.
2. Want the Lowest Possible Premium
Plan K typically has the lowest or second-lowest premiums among all Medigap plans (similar to Plan A), but unlike Plan A, Plan K includes an annual out-of-pocket cap that protects you from catastrophic costs.
3. Have Supplemental Coverage Elsewhere
If you have VA benefits, employer retiree coverage, or other supplemental insurance that covers some costs, Plan K’s minimal premiums may be sufficient to fill the remaining gaps. Our Medigap for Veterans guide explains how VA benefits coordinate with Medigap.
4. Want Catastrophic Protection on a Budget
Plan K is the cheapest way to get a Medigap plan with an annual out-of-pocket maximum. Even with 50% cost-sharing, your total annual exposure is capped at $6,940 — far less than unlimited 20% coinsurance under original Medicare alone.
Plan K vs Plan L vs Other Popular Medigap Plans
To help you understand where Plans K and L fit in the broader Medigap landscape, here’s how they compare to popular alternatives:
| Feature | Plan K | Plan L | Plan G | Plan N | Plan A |
|---|---|---|---|---|---|
| Part B coinsurance | 50% | 75% | 100% | 100%* | 100% |
| Part A deductible | 50% | 75% | 100% | 100% | 0% |
| Part B deductible | Not covered | Not covered | Not covered | Not covered | Not covered |
| Skilled nursing | 50% | 75% | 100% | 100% | 0% |
| Foreign travel | Not covered | Not covered | 80% | 80% | Not covered |
| Excess charges | Not covered | Not covered | 100% | Not covered | Not covered |
| Out-of-pocket cap | $6,940 | $3,470 | None | None | None |
| Doctor copays | None | None | None | $20/$50 | None |
| Typical premium | $ | $$ | $$$$ | $$$ | $$ |
*Plan N requires $20 doctor copays and $50 ER copays
Where Plans K and L Shine
Plans K and L are the only Medigap plans that offer an annual out-of-pocket maximum. This makes them uniquely valuable for seniors who want:
- Lower premiums than comprehensive plans
- A guaranteed cap on annual spending
- Protection from unlimited 20% coinsurance exposure
For a full comparison across all available plans, visit our Medicare Supplement Plans Comparison by State guide.
How Plan K and Plan L Pricing Methods Affect Your Costs
Like all Medigap plans, Plan K and Plan L premiums can be priced using three different methods. Understanding these methods is critical because they affect how much you’ll pay over time. Our detailed Medigap Issue Age vs Attained Age Pricing Guide covers this in depth.
Community-Rated (No Age Factor)
Premiums are the same regardless of your age. Plan K and Plan L typically start at moderate premiums that don’t increase because of your birthday (though they may increase for inflation).
Issue-Age Rated
Premiums are based on your age when you buy the policy. Buying at 65 locks in a lower base rate than buying at 72. Annual increases are typically smaller and inflation-based only.
Attained-Age Rated
Premiums increase as you get older. A cheap premium at 65 can become expensive by 75. This pricing method is common for Plan K and Plan L because their already-low premiums are attractive entry points.
Which Pricing Method Is Best for Plan K or Plan?
If you plan to keep your policy long-term, community-rated or issue-age rated policies are usually better for Plans K and L because the low premiums won’t escalate with age. Attained-age policies can be tempting at 65 but may become costly in your late 70s and 80s. Check our Medigap Price by Age Chart for age-specific premium estimates.
Enrollment Timing: When to Buy Plan K or Plan L
The best time to enroll in any Medigap plan — including Plans K and L — is during your Medigap Open Enrollment Period (OEP), which starts the month you turn 65 and are enrolled in Medicare Part B. During OEP:
- No medical underwriting required
- No pre-existing condition waiting period
- Guaranteed acceptance at the best available rate
If you miss OEP, you may face medical underwriting and could be denied coverage based on your health history. Our Medicare Supplement Open Enrollment Deadline Checker helps you calculate your exact enrollment window.
Guaranteed Issue Situations
You may have guaranteed issue rights (no underwriting) for Plans K and L in certain situations, such as losing employer coverage or your Medicare Advantage plan leaving your area. Check our Medigap Guaranteed Issue Rights by State guide for your state’s specific rules.
Switching to or from Plan K or Plan L
If you already have a Medigap plan and want to switch to Plan K or Plan L (or vice versa), you generally need to pass medical underwriting unless you have guaranteed issue rights.
Common Switching Scenarios
| From | To | Underwriting Required? |
|---|---|---|
| Plan G → Plan K | Yes, in most states | |
| Plan G → Plan L | Yes, in most states | |
| Plan N → Plan K | Yes, in most states | |
| Plan K → Plan L | Yes, in most states | |
| Plan L → Plan K | Yes, in most states | |
| Medicare Advantage → Plan K/L | Only during trial rights period |
Some states have special rules that make switching easier. Our Medicare Supplement Birthday Rule by State guide covers which states allow annual plan changes without underwriting.
Frequently Asked Questions
Is Plan L better than Plan K?
Plan L provides more coverage (75% vs 50% cost-sharing) and has a lower out-of-pocket cap ($3,470 vs $6,940 in 2026). For most seniors, Plan L is the better value because the modest premium increase ($20-$50/month) buys significantly more financial protection. However, Plan K may be better if you’re very healthy and want the absolute lowest premium.
Do Plans K and L cover prescription drugs?
No. Like all Medigap plans, Plans K and L do not cover prescription drugs. You need a separate Medicare Part D plan for prescription drug coverage. The out-of-pocket limits for Plans K and L only apply to Medicare-covered services, not Part D drug costs.
What happens when I reach the out-of-pocket limit?
Once your cost-sharing reaches the annual out-of-pocket limit ($6,940 for Plan K or $3,470 for Plan L), your Medigap plan pays 100% of covered Medicare services for the rest of the calendar year. You still pay your monthly premium, the Part B deductible, and any costs for services Medicare doesn’t cover.
Can I buy Plan K or Plan L if I’m under 65?
In most states, Medigap plans are only available to people 65 and older enrolled in Medicare Part B. However, some states require insurance companies to offer at least one Medigap plan to Medicare beneficiaries under 65 with disabilities. Check our Medicare Supplement Under 65 Disability Rules guide for your state’s requirements. Plans K and L may or may not be available to under-65 enrollees depending on your state.
How do Plans K and L compare to Medicare Advantage?
Plans K and L offer the freedom of original Medicare (any doctor who accepts Medicare, no network restrictions) with a guaranteed out-of-pocket cap. Medicare Advantage plans also have out-of-pocket limits but restrict you to provider networks and may require prior authorization. Our Medigap vs Medicare Advantage Cost Comparison provides a detailed analysis.
Will Plan K or Plan L premiums increase over time?
Yes. Like all Medigap plans, Plan K and Plan L premiums typically increase over time due to healthcare cost inflation, age (if attained-age rated), and claims experience. However, the rate of increase depends on the pricing method and insurance company. Generally, Plans K and L have lower dollar-amount increases because their base premiums are smaller. Our Medicare Supplement Annual Rate Increase Estimator can help you project future costs.
Do Plan K and Plan L cover the Part B deductible?
No. Neither Plan K nor Plan L covers the Medicare Part B deductible, which is $257 in 2026. You pay this amount yourself before Medicare Part B starts covering its share. Among currently available Medigap plans, only Plan G (for those eligible before 2020) covers the Part B deductible.
Are Plans K and L available in every state?
Plans K and L are available in most states as standardized Medigap plans. However, Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plan structures that differ from the federal standard. In these states, equivalent cost-sharing plans may exist under different names or plan letters.
Bottom Line: Which Plan Should You Choose?
| Your Situation | Recommended Plan |
|---|---|
| Very healthy, want lowest premium | Plan K |
| Moderate health, want balance of cost and coverage | Plan L |
| Frequent doctor visits, chronic conditions | Plan G or Plan N (not K or L) |
| Want catastrophic protection on a tight budget | Plan K |
| Want lower out-of-pocket risk with moderate premium | Plan L |
| Travel internationally | Plan G or Plan N (K and L don’t cover foreign travel) |
Plans K and L are among the most overlooked options in the Medigap marketplace. They offer a unique combination of lower premiums and guaranteed out-of-pocket protection that no other Medigap plans provide. If you’re healthy enough to absorb some cost-sharing but want protection against catastrophic expenses, these plans deserve serious consideration.
Next Steps
- Compare costs for your age and state using our Medicare Supplement Plan Cost Estimator
- Check your enrollment window with our Open Enrollment Deadline Checker
- Understand rate trends with our Medigap Premium Trends 2026-2027 Forecast
- Get quotes from multiple insurers — Plan K and L premiums vary widely by company
Disclaimer: This article is for educational purposes only and is not insurance advice. Medicare Supplement plan availability, premiums, and benefits may vary by state and insurance company. Verify all plan details at Medicare.gov or with a licensed insurance agent. Premium ranges and out-of-pocket limits are based on 2026 CMS data and may change.