by Russell Noga | Updated August 17th, 2023
Medicare Parts A & B are available to seniors after turning 65. These federally-funded insurance policies cover 80% of the costs associated with medical and hospital care.
The beneficiary is responsible for paying the remaining fees out-of-pocket. That’s an issue for many seniors and can ruin their financial planning for their retirement.
Despite Original Medicare Parts A & B providing financial relief for healthcare expenses, you could still end up with a huge bill after an extended stay in the hospital.
Medicare Part A & B beneficiaries can enroll in a Medicare supplement plan known as “Medigap” to mitigate unexpected healthcare costs.
Medigap policies fully or partially cover the remaining out-of-pocket expenses left unpaid by Parts A & B.
Depending on your plan, you could end up with nothing to pay for your annual healthcare costs.
What Is Medicare Supplement Plan L?
Medicare supplement Plan L is one of two products in the Medigap range using a cost-sharing model. The other is Plan K.
Plan L has the higher cost-sharing benefit, covering up to 75% of most Part A & B expenses. It also comes with an annual out-of-pocket limit of $3,470.
Plan L uses a model where after meeting the Part B deductible and the out-of-pocket limit, the plan covers 100% of services for the rest of the calendar year.
With Plan L, you’ll know the maximum amount you’ll spend on covered medical services for the year, bringing better predictability to your financial planning.
An out-of-pocket limit is good for Medicare beneficiaries with chronic conditions who want coverage for expensive and unexpected medical events.
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What Does Medicare Supplement Plan L Cover?
The CMS, a federal agency, governs the Medigap industry. It ensures all providers offering Medicare supplement Plan L provide the same benefits to beneficiaries.
So, you can expect to receive the same coverage regardless of which provider you use for your plan.
The benefits of Plan L include the following.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- 75% of Part A hospice care coinsurance or copayment.
- 75% of Part B coinsurance or copayment.
- 75% of Blood transfusion costs for the first three pints of blood. 95% after the first 3 pints and paying the Part B deductible.
- 75% of Part A deductible.
- 75% of Skilled nursing facility care coinsurance.
- Out-of-pocket limit: $3,470.
- 100% of covered services for the year after meeting the annual Part B deductible and reaching the yearly out-of-pocket limit.
What Isn’t Covered by Medicare Supplement Plan L?
Medicare supplement Plan L doesn’t cover the following Part B expenses.
- Part B deductible.
- Part B excess charges.
- Foreign travel medical coverage.
Like other Medigap plans, Plan L doesn’t include coverage for healthcare expenses unrelated to Original Medicare Parts A & B.
That means you don’t have coverage for preventative care services involving visits to the chiropractor, physiotherapist, acupuncturist, and podiatrist.
There’s no coverage for prescriptions or hearing, vision, and dental services.
Medigap plans in 2024 don’t cover the costs of private-duty nursing, stays at unskilled nursing homes, or cosmetic treatments.
What are the Average Monthly Premiums for Medicare Supplement Plan L?
According to our research, the average cost of Medigap Plan L ranges between $172 – $279 across all states and all providers. Some providers may charge more than others for Plan L.
There’s no regulation by the CMS on what healthcare insurers can charge beneficiaries for these plans.
So, you might find UnitedHealthcare offers the most affordable Plan L in one state, and Aetna has the best deal on premiums in another state.
The insurer also uses your age, gender, and smoking status when assessing you for your monthly premiums. Men usually pay more than women, and smokers pay more than nonsmokers.
Is Medicare Supplement Plan L Available in Massachusetts, Minnesota, or Wisconsin?
Minnesota, Massachusetts, and Wisconsin have federal waivers to set their rules for Medigap plans. As a result, they don’t follow the traditional route of offering Medigap plans specified by letters.
You have Basic, Basic with Riders, Extended Basic, and Medigap plans F, K, L, M, and N as your plan options in these states.
So, you can get Medigap plan L from select insurers in that state.
How Do You Enroll in Medicare Supplement Plan L?
You can enroll in Medigap Plan L during the six months after your 65th birthday, known as the “Open Enrollment” period.
During this time, the insurer must accept your application, even if you have chronic conditions. They can’t deny your application to join their Medigap scheme.
The insurer can’t charge above-average rates for your premiums if you have pre-existing health conditions.
Delaying your application until after the Open Enrollment period means the provider can subject you to medical underwriting. If you have pre-existing conditions, they might increase your premiums to above-average rates or deny your application.
You may also qualify for “guaranteed issue rights” in some circumstances.
For instance, if you leave your employer’s healthcare plan, move to a state where your Medigap provider doesn’t operate, or if your provider closes or goes bankrupt.
Our agents can help you understand your guaranteed issue rights.
What are the Best Alternatives to Medicare Supplement Plan L?
We recommend Plan N as the best alternative policy for those Medicare beneficiaries considering Plan L. You get full coverage of the Part A & B benefits, where you must pay 25% out-of-pocket with Plan L.
There are no out-of-pocket limits on your benefits. You also get overseas coverage for medical expenses included.
Plan N comes with a $20 copayment when visiting the doctor and a $50 copayment at the emergency room when not admitted to inpatient care.
Like Plan L, it doesn’t cover the Part B deductible or Part B excess charges. However, many providers offer additional perks when you take a plan N policy.
Call Us to Learn More About Medicare Supplement Plan L
For more information on Medicare supplement plan L or Medigap plans, call us at 1-888-891-0229.
We offer free consultations and quotes on any policy.
Our fully licensed agents are here to help you choose the right plan to meet your healthcare requirements.
If you can’t call us right now, leave your contact details on our form. We’ll get a Medigap professional to call you back.
Or you can use the free tool on this site for an automated quote on any Medigap plan, with the best rates from providers in your state.
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Frequently Asked Questions
What is Medicare Supplement Plan L?
Medicare Supplement Plan L is one of the standardized Medigap plans that work alongside Original Medicare to provide additional coverage. It helps pay for certain out-of-pocket expenses that Medicare doesn’t cover.
What does Medicare Supplement Plan L cover?
Plan L covers a percentage of various Medicare Part A and Part B costs. This includes hospitalization, hospice care, and skilled nursing facility care coinsurance or copayments. It also covers 75% of the Medicare Part A deductible.
Does Plan L cover the Medicare Part B deductible?
No, Medicare Supplement Plan L does not cover the Medicare Part B deductible. Beneficiaries are responsible for paying this deductible out of pocket before their coverage begins.
Are there any annual out-of-pocket limits with Plan L?
Yes, Medicare Supplement Plan L has an out-of-pocket limit. Once you reach this limit, the plan pays 100% of covered services for the remainder of the year.
Can I use any healthcare provider with Plan L?
Yes, you can use any healthcare provider that accepts Medicare assignment with Plan L. There are no restrictions or networks, giving you the freedom to choose your preferred doctors and hospitals.
Is Plan L available in all states?
Yes, Medicare Supplement Plan L is available in all states. However, not all insurance companies offer it. The availability of Medigap plans can vary by state and insurance provider.
Can I switch from my current Medigap plan to Plan L?
Yes, you can switch from your current Medigap plan to Medicare Supplement Plan L. However, depending on your state and the insurance company, you may be subject to medical underwriting, which can affect your eligibility and premium rates.
How does the cost-sharing work with Plan L?
With Plan L, you share costs with the insurance company. After you reach the out-of-pocket limit, the plan pays 100% of covered services for the rest of the year. Until then, you pay a percentage of the costs, such as coinsurance or copayments, for covered services.
Does Plan L cover foreign travel emergency care?
Yes, Medicare Supplement Plan L provides coverage for foreign travel emergency care. It covers 80% of the billed charges for medically necessary emergency care received outside the United States, up to plan limits.
Where can I find more information about Medicare Supplement Plan L?
To find more information about Medicare Supplement Plan L, you can visit the official Medicare website (medicare.gov) or consult with a licensed insurance agent who specializes in Medicare. They can provide detailed information, compare different plans, and assist you in making an informed decision.