Medigap Plan K and Plan L trade a lower monthly premium for something the popular letters don't have: an annual out-of-pocket cap of $8,000 for Plan K and $4,000 for Plan L in 2026. For 2027, the caps rise to $8,360 and $4,180. You share your Medicare costs during the year until you reach that limit and have paid the Part B deductible, and then the plan pays 100% of covered services for the rest of the year.

In This Guide

What Plan K and Plan L Actually Are

Most Medigap plans work by covering the gaps that Original Medicare leaves behind, and they cover a lot of them right away. With Medicare Part A and Part B alone, you're on the hook for the Part B deductible ($283 in 2026) and then 20% of the approved amount for most outpatient care, with no ceiling on how high that 20% can climb. A plan like Plan G steps in and covers almost all of that from the first dollar, which is why its premium runs higher.

Plan K and Plan L take a different shape. Instead of covering nearly everything up front, they pay a set share of your Medicare cost-sharing and leave the rest to you, up to a yearly limit. That share is what separates the two letters: Plan K pays 50% and Plan L pays 75% of the benefits they split, which are the Part B coinsurance, the first three pints of blood, the Part A deductible, the skilled nursing facility coinsurance, and the Part A hospice coinsurance. You pay the remainder until you hit the cap. Neither letter covers the Part B deductible, so the order matters: you pay the Part B deductible ($283 in 2026) yourself first, and only after that does the plan start paying its 50% or 75% share of the Part B coinsurance.

One part is not split, and it is the part that protects you in the worst case: both plans still cover the Part A coinsurance and hospital costs for up to an additional 365 days at 100%. So Plan K is not "half a Medigap plan." It covers the long-hospital-stay benefit in full and asks you to share the rest. Think of it less as a plan that erases your bills and more as one that puts a firm ceiling on your worst year.

That ceiling is the whole point. Both plans are built around an annual out-of-pocket maximum, so no matter how sick you get or how many services you use, your share of covered costs stops at a known number.

Medigap Plan K and Plan L Out-of-Pocket Limits in 2026

Here's the figure that matters most. In 2026, the annual out-of-pocket limit is $8,000 for Plan K and $4,000 for Plan L. That's the maximum you would pay toward covered Medicare cost-sharing in a single calendar year under each plan.

For 2027, CMS has set the limits at $8,360 for Plan K and $4,180 for Plan L. If you're choosing a plan now for next year, use those figures.

Once you reach your plan's limit and you've paid the annual Part B deductible ($283 in 2026), your Medigap plan pays 100% of covered services for the rest of the calendar year., After that point, your covered costs for the year are done.

A couple of things are worth being clear about. The limit resets every January 1, so a heavy year doesn't carry protection into the next one. And the cap applies to your share of Medicare-covered costs, not to things Medicare doesn't cover in the first place, like most dental, vision, or long-term care. Those stay outside the count.

The dollar amounts also aren't frozen. The $8,000 and $4,000 figures are the limits set for 2026. By law the limits started at $4,000 for Plan K and $2,000 for Plan L in 2006 and rise each year by an inflation adjustment; for 2027 CMS based that adjustment on projected growth in Medicare Part A and Part B costs per person, which is how the caps reached $8,360 and $4,180. If you're reading this after 2027, check the current numbers before you rely on them.

Plan K vs. Plan L: Comparing Two Medigap Out-of-Pocket Limit Plans

The plans share the same basic design, so the difference between them comes down to that cap.

Plan L sets a lower ceiling, $4,000 in 2026, which means it protects you sooner. You reach the point where the plan covers everything after less spending out of your own pocket. Plan K sets a higher ceiling, $8,000 in 2026, so more cost can fall on you before the plan takes over completely.

That difference tends to show up in the premium. Because Plan L covers a larger share of your costs along the way and caps your spending sooner, it typically costs more per month than Plan K, which asks you to shoulder more before the cap kicks in. Medicare doesn't publish one price for either letter: a Medigap premium varies based on which policy you buy, where you live, and other factors, and the amount can change each year. So the exact gap depends on the quotes in front of you, but the general pattern follows the coverage.

So the choice between them is really a question about which risk you'd rather carry: a higher monthly bill with a lower worst-case year (Plan L), or a lower monthly bill with a higher worst-case year (Plan K). Neither is objectively better. It depends on your budget and how much unexpected cost you can absorb.

Feature Plan K Plan L
Annual out-of-pocket limit (2026) $8,000 $4,000
Annual out-of-pocket limit (2027) $8,360 $4,180
After you hit the limit and pay the Part B deductible Plan pays 100% of covered services Plan pays 100% of covered services
Cost-sharing you carry before the cap More Less
Monthly premium, generally Lower Higher

Who Plan K and Plan L Suit

These plans aren't the right fit for everyone, and that's by design. If you want the peace of mind of near-zero bills at the doctor and you're comfortable paying more each month for it, a first-dollar plan like Plan G is probably a closer match than Plan K or Plan L.

Plan K and Plan L tend to suit people who are relatively healthy, who don't expect heavy medical use in a typical year, and who would rather keep their monthly premium down while still holding a hard ceiling on a bad year. You take on more of the small, routine costs in exchange for a smaller monthly bill and real protection if something serious happens.

They can also make sense if the first-dollar plans feel out of reach on price. A capped plan still gives you a guaranteed worst-case number, $8,000 for Plan K or $4,000 for Plan L in 2026, which is the protection Original Medicare alone doesn't offer.

One more thing to weigh: in most states these are standardized Medigap plans, so the benefits of Plan K are identical from one insurance company to the next, and the same is true for Plan L. What changes between companies is the premium. Massachusetts, Minnesota, and Wisconsin standardize Medigap differently, so if you live in one of those three states you won't find a Plan K or Plan L as described here; check your own state's plan set instead. If you've decided on a letter, the smart move is to compare prices across carriers for that exact plan, because you're buying the same coverage either way. Medigap is also separate from Medicare Advantage, which bundles coverage differently, so you'd hold one or the other, not both.

Frequently Asked Questions

What are the Plan K and Plan L out-of-pocket limits for 2026 and 2027?

For 2026, the limit is $8,000 for Plan K and $4,000 for Plan L. Two details are easy to miss: the figure counts only your share of Medicare-covered cost-sharing (not premiums or services Medicare doesn't cover), and it's the 2026 limit. For 2027, the limits are $8,360 for Plan K and $4,180 for Plan L.

What happens after I hit my plan's cap?

Once you've also paid the annual Part B deductible ($283 in 2026), your Medigap plan pays 100% of covered services for the remainder of the calendar year., The cap resets each January 1, so the protection applies to that one year and starts over the next.

Is Plan L better than Plan K?

Neither is better in the abstract. Plan L has a lower cap ($4,000 in 2026) and generally a higher monthly premium, so it protects you sooner but costs more each month. Plan K has a higher cap ($8,000 in 2026) and generally a lower premium. The right one depends on your budget and how much unexpected cost you can absorb.

Does the out-of-pocket limit include things Medicare doesn't cover?

No. The cap applies to your share of Medicare-covered cost-sharing. Costs for services Medicare doesn't cover at all, like most dental, vision, and long-term care, don't count toward the limit.

Are Plan K premiums the same at every insurance company?

The benefits are, in most states. Medigap plans are standardized, so Plan K's coverage is identical from one carrier to another, and the same goes for Plan L. The premium is what varies, so it pays to compare prices across companies for the exact plan letter you want. The exception is Massachusetts, Minnesota, and Wisconsin, which standardize Medigap their own way, so a resident there won't find a Plan K or Plan L as described here.

Learn More

MedicareMedigap (Medicare Supplement): How the Lettered Plans WorkMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedigap Plan G vs Plan N: Which Should You Pick?Medigap Plan G vs Plan N comes down to two things: Plan N's office and ER copays and its excess-charge gap, traded for a lower premium. Here's how to choose. MedicareHow Medigap Premiums Are PricedTwo people can pay very different premiums for the same Medigap plan. Here's how community-rated, issue-age, and attained-age pricing methods differ. MedicareHow Much Does Medicare Cost in 2026?How much does Medicare cost in 2026? Part A, B, C, and D premiums, deductibles, and coinsurance, plus IRMAA and ways to lower your Medicare costs.

Find personalized help comparing Medigap plans at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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