Plan K
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Plan K covers:
- Fifty percent of your Part A deductible and coinsurance
- The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
- Preventive benefits for Medicare-covered services usually leave you with 25% to pay — plan K pays that 25%
- Ten percent of your 20% Part B coinsurance and the 50% of the cost of the first three pints of blood
- Fifty percent of the skilled nursing facility copayment
- Once you’ve reached your $6,620 annual out-of-pocket limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year.
There is also a BCBSIL Medicare-Select Plan K that offers the same benefits as Standard Plan K but provides costs savings by agreeing to use a Medicare Select participating hospital for non-emergencies. You may still see any doctor you choose with Medicare-Select plans. If your hospital is part of the Medicare Select network, the Med-Select plan is a good option to consider.
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Plan K Benefits
| Benefit | What Plan K Covers |
|---|---|
| Part A Deductible You may need this benefit if you have to stay in the hospital. The Part A deductible is $1,632. This amount can change every year. You have to pay this deductible for each benefit period. | Plan K covers 100% of the $1,632 deductible |
| Part B Deductible You may want to consider this benefit if you have Medicare Part B. Each year you must pay the Part B deductible (which is $240) before Medicare starts to pay its share. If you have this benefit, the Medigap plan would pay this amount each year. | Plan K does not cover the Medicare Part B $240 deductible |
| Part B Coinsurance Without this benefit, you generally pay 20% of the Medicare-approved amount for Medicare Part B covered services and supplies (like doctor services and outpatient hospital care). This benefit will help you to reduce your out of pocket after Part B deductible. | Plan K covers 10% of the remaining costs after you pay the $240 Part B deductible |
| 365 Extra Days of Hospital Stay After you use all Medicare hospital benefits, you can receive up to 365 more days for hospital stays during your lifetime. | Plan K covers all of the costs for an additional 365 additional hospital days |
| 3 Pints of Blood The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced. | Plan K covers 50% of the costs of 3 pints of blood per calendar year |
| Part B Excess Charges Under federal law, doctors who don’t accept “assignment” (take Medicare’s approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to think about this benefit if your doctors don’t accept assignment. You may also want this benefit if you have to stay in the hospital and can’t control whether the doctors you see accept assignment. | Plan K does not covers Part B Excess Charges |
| Hospice Care Hospice is a special way of caring for people who are terminally ill and for their families. This care includes physical care and counseling. The goal of hospice is to care for you and your family, not to cure your illness. | Plan K covers 50% of your copay |
| Foreign Travel Emergency If you travel outside the United States, this benefit could save you money for emergency care. | Plan K does not cover foreign travel emergencies |
| Skilled Nursing Coinsurance Medicare pays for the first 20 days of a skilled nursing facility. If you need to go to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days, this benefit begins. | Plan K covers up to 50% of $148 per day for days 21-100. |
| Home Health Care Home Health Care is skilled nursing care and certain other health care services you get in your home for the treatment of an illness or injury. | Plan K covers 10% of the remainder after the $147 Medicare Part B deductible. |
| Out of Pocket Limit The maximum costs you are responsible for in a calendar year. | Plan K will cover 100% of all costs if you reach the $4,640 out of pocket limit |
Plan K Rates
The following rates are for Illinois residents living in the following Counties:
- Cook
- DuPage
- Kane
- Lake
- McHenry
- Will
| Plan | Age | Standard | Med-Select |
|---|---|---|---|
| K | 65 | $79.00 | $74.00 |
| 66 | $83.00 | $80.00 | |
| 67 | $90.00 | $89.00 | |
| 68 | $95.00 | $96.00 | |
| 69 | $100.00 | $100.00 | |
| 70 | $107.00 | $104.00 | |
| 71 | $112.00 | $108.00 | |
| 72 | $118.00 | $112.00 | |
| 73 | $124.00 | $116.00 | |
| 74 | $130.00 | $120.00 | |
| 75 | $134.00 | $123.00 | |
| 76 | $137.00 | $124.00 | |
| 77 | $141.00 | $126.00 | |
| 78 | $145.00 | $128.00 | |
| 79 | $147.00 | $129.00 | |
| 80 | $149.00 | $130.00 | |
| 99+ | $176.00 | $155.00 |
The following rates are for Illinois residents living OUTSIDE the following Counties:
- Cook
- DuPage
- Kane
- Lake
- McHenry
- Will
| Plan | Age | Standard | Med-Select |
|---|---|---|---|
| K | 65 | $85.00 | $84.00 |
| 66 | $88.00 | $87.00 | |
| 67 | $95.00 | $92.00 | |
| 68 | $100.00 | $98.00 | |
| 69 | $107.00 | $101.00 | |
| 70 | $111.00 | $107.00 | |
| 71 | $118.00 | $110.00 | |
| 72 | $123.00 | $114.00 | |
| 73 | $129.00 | $119.00 | |
| 74 | $135.00 | $123.00 | |
| 75 | $139.00 | $125.00 | |
| 76 | $142.00 | $126.00 | |
| 77 | $145.00 | $130.00 | |
| 78 | $149.00 | $131.00 | |
| 79 | $152.00 | $131.00 | |
| 80 | $154.00 | $133.00 | |
| 99+ | $185.00 | $156.00 |
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