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Medicare Cost-Sharing Plans

A Medicare Supplement cost-sharing plan can be an excellent alternative for those looking to avoid higher premiums. Also known as Medigap plans, there are 12 different lettered options, but when it comes to Medicare cost-sharing plans, you’ll typically enjoy a much lower premium. Medicare Supplement cost-sharing plans include Plan L, Plan K, and Plan M. Learn more about each option, if you can benefit from them, and how to sign up.

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What is a Medicare Cost Sharing Plan?

A Medicare cost-sharing plan is a type of Medicare Supplement coverage that can help beneficiaries enjoy generous benefits while cutting their monthly premium. Medigap cost-sharing plans can be great options for those who do not often require healthcare services. While the premiums are lower, it’s important to note that these coverage options require beneficiaries to cover costs associated with their healthcare, including:

  • Deductibles
  • Coinsurance
  • Copayments
  • Other healthcare-related expenses

Original Medicare (Medicare Part A and Part B) provides plenty of benefits. However, there are still leftover costs, which is why supplemental coverage can help beneficiaries cover plenty of healthcare-related expenses. But to do so means paying a monthly premium, and if you don’t often receive healthcare, it may feel as if the costs outweigh the benefits. Medicare cost-sharing plans are great options to help you save on premiums and still retain helpful benefits when you visit your healthcare provider.

What Are the Top Medicare Cost-Sharing Plans for 2024?

The two most popular Medicare cost-sharing plans are Medicare Supplement Plan L and Plan K. Both have identical benefits but different cost-sharing levels. Each also has an annual out-of-pocket maximum, which protects you from outrageous medical bills by covering 100% of your healthcare costs once the maximum is met.

Everyone’s healthcare and budget needs will differ, and one of the great things about Medigap plans is that there are varying levels of benefits to help you find benefits that match your individual needs.

While Medicare cost-sharing plans aren’t included in the best Medicare Supplement plans, they still offer value. Not all carriers offer every plan option, but if you’re looking for a Medigap Plan K or Plan L, speak to a licensed insurance agent that represents the top-rated insurance companies in your area.

Plan L Cost-Sharing

While Plan L will cover 75% of the cost of covered medical expenses for most services, you’ll be responsible for the other 25%. For example, if 20% not covered by Original Medicare is $100, you’ll only pay $25, and your Medicare Supplement Plan L benefits will cover the other $75.

Additionally, you must cover the Part B deductible and any Part B excess charges that apply. While some may worry this will lead to being nickel and dimed to death on copayments, safeguards are in place. When you enroll in Medigap Plan L benefits, there is also an out-of-pocket maximum that applies.

This annual limit is unique to Plan L and a feature not available on Medigap Plan N. Medicare Supplement Plan L is one of the top Medicare cost-sharing plans because it covers Part A coinsurance at 100% and includes the following benefits at 75% coverage:

  • First 3 pints of blood
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance
  • Part A Hospice coinsurance

Although this plan provides plenty of useful benefits, it’s important to understand that Medigap Plan L won’t cover everything. For example, Plan L won’t cover your Part B deductible, Part B excess charges, or foreign travel emergency care.

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Overall, if your health is great, and you aren’t traveling outside of the United States, Medicare Supplement Plan L could be ideal for you by covering some of the healthcare costs you may face and helping you enjoy a lower monthly premium.

Enrolling in Plan L

To enroll in Medicare Supplement Plan L, you’ll need to contact a licensed Medicare insurance agent. Here at MedicareFAQ, our agents are experts and ready to help you find the coverage you need.

There are many different Medigap companies on the market, but not all companies offer Medigap Plan L. If you work with one of our licensed insurance experts, you can minimize the effort and time put into finding the ideal company and price.

Our agents specialize in Medicare, their advice doesn’t cost anything, and they even walk you through the enrollment process. Furthermore, rather than trying to sell you a policy, our team is here to help match you with the best benefits that match your specific needs for your healthcare and your budget.

Plan K Cost-Sharing

Medicare Supplement Plan K is very similar to Plan L, but instead of 75% coverage, you’ll get 50%. While this means you’ll be responsible for more out-of-pocket costs when receiving healthcare services, you’ll also enjoy a lower premium as a result.

Medigap Plan K is a top Medicare cost-sharing plan, and just like Plan L, Medicare Supplement Plan K includes a maximum out-of-pocket, limiting the amount you’ll have to pay annually. Your benefits cover you 100% on Medicare-approved healthcare services when you reach your maximum out-of-pocket.

Medigap Plan K will cover 100% of your Part A coinsurance, just like Plan L, and also includes the following benefits at 50% coverage:

  • First 3 pints of blood
  • Part A deductible
  • Skilled nursing facility coinsurance
  • Part B coinsurance
  • Part A Hospice coinsurance

Medigap Plan K remains a great option for beneficiaries but doesn’t cover all benefits. For example, Medicare Supplement Plan K won’t cover your Part B deductible, Part B excess charges, or foreign travel emergency care.

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It’s a great option for anyone looking into Medicare cost-sharing plans, but you’ll want to take all of these factors into consideration. Beneficiaries that receive less healthcare and don’t travel outside of the United States can often find value in these benefits while saving on premiums.

Enrolling in Plan K

Finding a quote and enrolling in Medicare Supplement Plan K doesn’t have to be a hassle, but it can be. This is because not all companies offer this policy. Thankfully, we work with several top-rated Medigap providers. This means our clients have access to a wider range of coverage options.

Instead of wasting time and potentially money, our agents are Medicare experts and can easily find the top coverage options for you. Their expertise is free of charge and can help you make an informed decision by answering your questions and comforting your concerns.

The enrollment process is a breeze because our experts will be with you every step of the way and do the heavy lifting for you. Furthermore, because our agents put your needs first, it doesn’t matter which coverage works best. We’re here to provide you with the best solution for your personal needs that help keep you covered and save money.

Deductible Sharing with Plan M

Medicare Supplement Plan M is one of the top Medicare cost-sharing plans. Medigap Plan M only requires you to cost-share on your Part A deductible while covering 50%, and you cover the other half. You’ll also enjoy 100% coverage on the following benefits:

  • Part A Coinsurance & up to an additional 365 lifetime reserve days
  • Part B Coinsurance
  • First 3 Pints of Blood
  • Part A Hospice care
  • Foreign Travel Emergency
  • Skilled Nursing Facility Coinsurance

It’s important to remember that you’re going to have still out-of-pocket costs to cover, including your Medicare Part B deductible or Part B excess charges. For those traveling outside of the U.S., Plan M can be a great option. Of the three Medicare cost-sharing plans listed here, it’s the only plan offering foreign travel emergency benefits.

Deductible Sharing vs. Cost-Sharing

Medicare Supplement Plan M requires you to cover a portion of your Part A deductible. Alternatively, Medigap Plan L and Plan K require you to pay a percentage of certain benefits and your Part A deductible, whereas you are 100% responsible for your Part B deductible.

Therefore, if you’re only paying a percentage of the Part A deductible, then you’re on a deductible-sharing policy. If you pay a portion of the coinsurance and a portion of the deductible, then your policy is a cost-sharing policy.

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If you don’t pay a portion of any of these, you may have first-dollar coverage, but such policies have limitations. Though technically, first-dollar Medicare plans aren’t unavailable, you must have been eligible for Original Medicare before January 1, 2020, in order to enroll in such coverage.

Cost-Sharing Medicare Advantage Plan

Medicare Advantage plans also offer various benefits that can help you cover healthcare expenses and off cost-sharing plans. A recurring theme in the Medicare world is the differing healthcare and budget needs found in individuals, which means that many different plan options are available.

This includes beneficiaries shopping for a Medicare zero-dollar cost-sharing plan. While available, these Medicare Advantage plans can provide cost-effective coverage to those eligible for both Medicare and Medicaid. But it’s important to note that while these cost-sharing plans come with no premium, you may spend more out of pocket than picking a plan offering better benefits at a higher rate.

Just like Medicare Supplement plans, rather than being provided by the federal government, Advantage plans are provided by private carriers. They can help many beneficiaries cut costs, but it depends on various factors that are best reviewed with a licensed Medicare agent.

Furthermore, beneficiaries must choose between the two, meaning they cannot enroll in both a Medicare Supplement and Medicare Advantage plan at the same time. Again, auditing your coverage needs with a licensed agent is the best course of action.

What States Accept Medicare Cost Sharing Plans?

Medicare Supplement plans are available in all 50 states, meaning every state accepts Medicare cost-sharing plans. But beneficiaries need to understand that availability can still depend on location.

This is because private insurance carriers provide these benefits, and some Zip Codes may not have access to the same plans. Therefore, you can find Medicare cost-sharing opportunities in every state, but you will still need to ensure that your desired benefits are available locally.

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How to Choose the Best Medicare Cost-Sharing Plans

Remember, many different plans are available because each individual’s needs can vary. Therefore, the “best” Medicare cost-sharing plan will be relative to your healthcare and budget.

Furthermore, when reviewing your healthcare and budget, it’s essential to consider your current situation and what the future may hold. For example, if you are planning on traveling out of the U.S. in the future, Medigap cost-sharing plans may not be the best option for you.

Researching policies can be intimidating because there are many options, carriers, and factors to consider. By working with one of our Medicare experts, you have the luxury of superior convenience, a wealth of information, and the experience you need to make an informed decision.

Whether you want to choose one of the top Medicare cost-sharing plans or another form of coverage, our agents work with you to find the best plan for your needs. Call us today for free, accurate quotes and enrollment services right over the phone. If you prefer, you can also fill out our online rate comparison form.

Jagger Esch

Jagger Esch

Medicare Educator
Jagger Esch is the Medicare Educator for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.
Ashlee Zareczny

Ashlee Zareczny

Compliance Manager
Ashlee Zareczny is the Compliance Manager for MedicareFAQ. As a licensed Medicare agent in all 50 states, she is dedicated to educating those eligible for Medicare by providing the necessary resources and tools. Additionally, Ashlee trains new and tenured Medicare agents on CMS compliance guidelines. Ashlee is a Medicare expert who specializes in Medicare Supplement, Medicare Advantage, and Medicare Part D education.

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