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. You share your Medicare costs during the year until you reach that limit, 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 cover a portion of your Medicare cost-sharing and leave the rest to you, up to a yearly limit. Think of it less as a plan that erases your bills and more as a plan 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.

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 here are the limits set for 2026; they can change from one year to the next, so if you're reading this in a later year, 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. Premiums are set by each insurance company rather than by Medicare, so the exact gap varies by carrier, 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
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: 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. 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?

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 set by CMS each year, so it can move up or down for 2027. Verify the current number before you rely on it.

What happens after I hit my plan's cap?

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) 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. 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.

Learn More

MedicareMedigap Plans Explained: Plan G vs. Plan NMedigap (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. 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.

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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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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.