Medicare Supplement (Medigap) Plan L: Costs & Coverage
Key Takeaways
- Medicare Plan L is a Medicare Supplement (Medigap)Medicare Supplement Insurance (Medigap) is designed to provide coverage that Original Medicare (Parts A and B) does not. Medigap policies are purchased in addition to Original Medicare and have their own monthly premiums you’ll need to pay. plan.
- Plans like Plan L are private insurance products that can be used as supplemental insurance with Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). .
- Medigap Plan L can help offset certain medical expenses you might have after Medicare covers its share.
- You cannot purchase Plan L or other Medigap plans if you have a Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plan.
What Is Medicare Supplement Plan L?
Medicare Plan L is one of the 10 Medicare supplemental insurance plans approved by Medicare to help you pay for your medical costs after Medicare pays its share. You can only buy these plans to supplement Original Medicare costs. Medicare Advantage plans have a different set of cost controls.
Each Medigap plan has to follow rules set by Medicare, as well as state-specific standards. Private insurance companies offer these plans, but each has to offer the same basic services, and every insurance company doesn’t have to offer every type of supplemental plan.
Medicare Supplement Plan L Costs
The monthly premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. for Medigap plans varies from one insurance company to the next. Medicare offers an online tool to help you compare what is offered and for what price in your area.
You can receive discounts on your Medigap Plan L premium based on your gender, military background, smoking status and other health or lifestyle factors.[i]
Medigap plans are categorized or “rated” three different ways, based on whether you want to pay more upfront or later:
- Community-rated or “no age-rated” plans charge the same price to everyone regardless of age. Prices can rise, but only due to market conditions (not your age).
- Issue age-related or “entry age-rated plans are priced based on the age you are when you first purchase your Medigap plan. These plans are more affordable when you purchase them when you are younger. Premiums won’t increase as you age but may rise with inflation or other market conditions.
- Attained age-rated plans are based on your current age. This means that your premium may be lower when you are younger, but the price can rise over time as you age.
What Medigap Plan L Covers
Medigap Plan L plans can cover a portion of various healthcare costs that you would normally have to pay on your own after Medicare pays its share. This includes Part A deductibles and coinsurance and copayments from a hospital or skilled nursing facility.
No Medigap plans, including Plan L, are allowed to be used for Part B deductibles or other specific expenses.
How Does Plan L Compare to Plan K?
Medicare Plan K and L are very similar. They offer similar coverage, but the limits on how much can be paid for each type of expense are different.
Plan costs can vary by insurance company, but overall, Plan L has higher coverage amounts and a lower out-of-pocket limit compared to Plan K.
While Plan K will pay 50% of a service — like Part A deductibles and Part B coinsurance — Plan L will cover 75% of these costs. Otherwise, these plans do and don’t cover the same types of services. For 2024, Plan L has a lower annual out-of-pocket limit of $3,530 compared to a $7,060 limit with Plan K.
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Medicare Plan L Benefits
After Medicare pays its share of your Part A and Part B expenses, you still have some costs left to cover on your own. That is where Medigap plans like Plan L come in.
There are 10 different Medigap plans, and each offers slightly different coverage. Plans L and K are the only two plans that limit your annual out-of-pocket costs.
While Medicare Plan L coverage may vary slightly by insurance company, coverage must include the following:
- 100% coverage of Part A coinsurance and hospital costs for up to 365 days after Medicare benefits are exhausted.
- 75% coverage of your Part A deductible.
- 75% coverage of your Part A hospice care coinsurance and copayment.
- 75% coverage of the first three pints of blood you may need.
- 75% coverage of the coinsurance charges for a skilled nursing facility.
- 75% coverage of your Part B coinsurance or copayments.
What’s Not Covered by Plan L?
There are certain costs that the Centers for Medicare & Medicaid Services dictate insurance companies must pay with each Medigap plan — and there are some costs that these plans can’t cover.
Medicare will not allow Medigap Plan L to cover:
- Part B deductible fees
- Excess charges under Medicare Part B
- Foreign travel exchange fees
Plan L vs. Medicare Advantage
Plan L is a supplemental insurance plan you can purchase to cover your share of your medical costs under Original Medicare. Medicare Advantage is also a private insurance product, but it replaces Original Medicare.
Medicare Advantage plans offer all the same services as Original Medicare plus extras depending on what you are willing to pay. There are a variety of Medicare Advantage plans based on your needs and budget, and you can pay higher premiums up front to avoid paying more in out-of-pocket costs after services are provided. Some Medicare Advantage plans cover the same kinds of costs that Medigap plans do, but may go even further by offering coverage for things like fitness classes and hearing aids.
However, you cannot add a Medigap plan to a Medicare Advantage plan.
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FAQs
Can anyone buy Plan L?
Is there a set price for Plan L?
Can I use my Medigap plan for any out-of-pocket medical expenses?
Sources
- Costs of Medigap Policies.. Medicare.gov.
- K & L Out-of-Pocket Limits Announcements.. CMS.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.