Medigap Plan L Supplement Insurance

Medigap Plan L is a Medicare Supplement plan. Unlike most Medigap plans that cover 100 percent of covered out-of-pocket costs, Medigap Plan L pays 75 percent of most costs until you hit the out-of-pocket limit for the plan. Once you’ve reached the limit, Plan L pays 100 percent for the rest of the year.

What Is Medigap Plan L and What Does It Cover?

Medigap Plan L is one of eight Medicare Supplement insurance plans available for newly eligible Medicare enrollees. It helps cover your out-of-pocket costs with Original Medicare – both Medicare Part A and Part B.

Most Medigap plans pay 100 percent of the costs they cover. But Medigap Plan L will pay 75 percent of covered costs once you meet your Part B deductible – $203 for 2021.

What Medigap Plan L Covers
  • 100 percent of your Medicare Part A coinsurance and hospital costs up to an extra 365 days after you have exhausted your Medicare benefits
  • 75 percent of the following Medicare costs until you hit your annual out-of-pocket limit:
    • Medicare Part A deductible
    • Medicare Part A hospice care coinsurance or copayment
    • Medicare Part B coinsurance or copayment
    • First three pints of blood for medical procedures each year
    • Skilled nursing facility care coinsurance
  • 100 percent of the above-listed costs once you meet your Part B deductible and your annual out-of-pocket limit ($3,100 for 2021)
Source: U.S. Centers for Medicare & Medicaid Services

Because Medigap Plan L provides less coverage, it can cost less. It would be best to compare Medigap plans to see which is best for your health and financial situation.

Free Medicare Help
Connect with a Medicare expert to find the health care plan that works best for your situation and budget.

Medigap Plan L doesn’t cover all out-of-pocket costs related to Original Medicare. There are some expenses you’ll still be responsible for even if you reach your limit.

What Medigap Plan L Does Not Cover
  • Medicare Part B medical insurance deductible
  • Medicare Part B excess charges – the amount over the Medicare-approved cost that doctors or other health care providers can charge you
  • Costs for emergency medical services you receive while traveling in a foreign country
  • Prescription drugs you take at home
  • Dental care
  • Vision care
  • Hearing aids or hearing care services
Source: U.S. Centers for Medicare & Medicaid Services

If you want prescription drug coverage, you can add a Medicare Part D prescription drug plan to Original Medicare.

Most Medicare Advantage plans also include a Medicare Part D plan. Medicare Advantage plans may also cover dental, hearing and vision care. You cannot have both a Medicare Advantage plan and a Medigap plan at the same time.

Both Medicare Part D plans and Medicare Advantage plans are sold through private insurers.

How Much Does Medigap Plan L Cost?

Medigap Plan L, like all other Medigap plans, is also sold through private insurers.

You will pay a monthly premium for Medigap Plan L in addition to the premiums you pay for Original Medicare and any Medicare Part D plan you may have. These monthly premium costs do not apply toward your yearly out-of-pocket limit for Plan L.

Rates and plan availability may vary depending on the insurance company selling Medigap policies and where you live.

Medigap Plan L Costs
  • Your annual out-of-pocket limit – $3,110 in 2021
  • Monthly Plan L premium (does not apply toward your annual out-of-pocket limit)
  • Medicare Part B deductible – $203 in 2021 (does not apply toward your annual out-of-pocket limit)
  • Medicare Part B excess charges you may have to pay
  • 100 percent of emergency medical services you need while traveling outside the United States
Source: U.S. Centers for Medicare & Medicaid Services

What Is the Biggest Difference Between Medicare Plan L and Plan K?

The biggest difference between Medigap Plan K and Plan L is that Plan L pays a higher percentage of covered costs and has a lower out-of-pocket limit than Plan K. Both plans are similar in that they are the only two Medigap plans that do not pay 100 percent of covered out-of-pocket expenses.

Medigap Plan K vs. Plan L
ITEMMEDIGAP PLAN K AMOUNTMEDIGAP PLAN L AMOUNT
Medicare Part A deductible50%75%
Medicare Part A coinsurance and hospital costs up to 365 days after Medicare benefits are used up100%100%
Medicare Part B coinsurance or copayment50%75%
First three pints of blood per calendar year50%75%
Medicare Part A hospice coinsurance or copayment50%75%
Skilled nursing facility care coinsurance50%75%
Out-of-pocket limit for 2021$6,220$3,110
Source: U.S. Centers for Medicare & Medicaid Services

Medigap Plan L offers a little more protection and typically has a higher monthly premium than Medigap Plan K. It is probably best suited for someone who only has minor health problems and lives in a state that doesn’t allow excess charges.

Last Modified: July 13, 2021

6 Cited Research Articles

  1. U.S. Centers for Medicare & Medicare Services. (2020, November). Getting Started With Medicare. Download. Retrieved from https://cmsnationaltrainingprogram.cms.gov/system/files_force/2020_Medigap_508_FINAL.pptx?download=1
  2. U.S. Centers for Medicare & Medicare Services. (2020, October 6). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/Medicare/Health-Plans/Medigap/KandL
  3. Bunis, D. (2020, July 6). Medigap Plans Help Bridge Gap of Original Medicare Costs. Retrieved from https://www.aarp.org/health/medicare-insurance/info-2017/choosing-right-medigap-plan.html
  4. U.S. Centers for Medicare & Medicare Services. (2020, February). Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf
  5. U.S. Centers for Medicare & Medicare Services. (n.d.). How to Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
  6. U.S. Centers for Medicare & Medicare Services. (n.d.). What’s Medicare Supplement Insurance (Medigap)? Retrieved from https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap