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Medigap Plan L

Medigap Insurance Plan L is a Medicare Supplement Insurance plan that is available in all states and offers additional benefits beyond Original Medicare for a low monthly premium. While Original Medicare covers most costs, Plan L can help you cover remaining costs such as coinsurance, deductibles, and copayments. It’s important to note that you must be enrolled in Original Medicare to choose any Medicare Supplement plan, including Plan L. This plan allows you to visit any doctor or hospital that accepts Original Medicare, and you don’t need a referral to see a specialist.

Medigap Plan L Coverage Benefits

Medigap Plan L is a cost-sharing plan, provided by private insurance companies, that covers some benefits in full and others at 70%. It covers the Part B coinsurance for preventive services, the foreign travel emergency coverage, and the Part A coinsurance at 100%

Plan L does not cover the Part B deductible or the Part B excess charges. However, Part B excess charges are not common and if you live in a state that does not allow them, this is not an issue.

Medigap Plan L Covers:

  • Part A coinsurance and up to an additional 365 days of hospital costs after Medicare benefits are exhausted
  • 75% of the Part B coinsurance/copayment
  • 75% of the first 3 pints of blood
  • 75% of the Part A hospice care coinsurance/copayment
  • 75% of the skilled nursing facility care coinsurance
  • 75% of the Part A deductible
  • $3,470 out-of-pocket expenses limit (in 2023), then Medigap pays 100%

What Medicare Supplement Plan L Doesn't Cover

  • Medicare Part B excess charges
  • Medicare Part B deductible which you must pay before you choose this plan. The amount of the deductible in 2023 is 226$
  • Foreign Travel Emergency
  • Prescription drug coverage
  • Since this plan covers 75% of the Original Medicare costs, you’ll need to pay for 25% of the remaining costs and you will also need to pay in full for certain expenses that are not covered by Medigap plan L.

Medigap Plan L Premiums

The cost of Medigap Plan L for individuals will depend on several factors such as the state where coverage is being sought, the insurance carrier being selected, and personal details like age, gender, and tobacco use. On average, the monthly premium for Plan L is between $80 to $180. States with a higher cost of living tend to have higher premiums for Plan L.

Plan L Out-of-Pocket Maximum

Plan L is one of two Medicare Supplement insurance plans that have a maximum out-of-pocket (MOOP) limit. In 2023, the MOOP limit for Plan L is $3,470, but this amount usually increases every year. Once the maximum out-of-pocket limit is reached, Plan L will cover 100% of the costs of covered services for the rest of the year.

Medigap Plan L Enrollment

To enroll in Medicare Supplement Insurance Plan L, it’s best to do so during the Medigap Open Enrollment Period, which lasts for six months and begins the month you turn 65 and have enrolled in Medicare Part B. In order to be eligible for Plan L, you must be a legal U.S. citizen or permanent resident for at least five consecutive years and already enrolled in Original Medicare Parts A and B. While most states require individuals to be 65 or older, some insurance carriers offer plans to Medicare beneficiaries who are younger than 65.

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