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Terry Turner has more than 30 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
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As a licensed insurance agent specializing in providing seniors with Medicare-related products, Joe Benish knows how daunting it can be to learn about Medicare and all of the options available. That’s why he spends his time getting to know his clients and helping them select the right plans for them from the more than 15 insurance companies he represents.Read More
- Published: July 9, 2021
- Updated: December 20, 2022
- 4 min read time
- This page features 10 Cited Research Articles
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% of the costs they cover. But Medigap Plan L will pay 75% of covered costs once you meet your Part B deductible — $226 for 2023.What Medigap Plan L Covers
- 100% of your Medicare Part A coinsurance and hospital costs up to an extra 365 days after you have exhausted your Medicare benefits
75% 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
- Once you meet your Part B deductible and your plan’s annual out-of-pocket limit ($3,470 for 2023) Plan L will pay 100% of remaining costs Medicare does not pay on above-listed costs
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.Don't Leave Your Health to ChanceFind a local Medicare plan that fits your needs by connecting with a licensed GoHealth insurance agent.
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 plan’s out-of-pocket 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 (up to 15% in most states)
- 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
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.Advertisement
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 – $3,470 in 2023
- Monthly Plan L premium (does not apply toward your annual out-of-pocket limit)
- Medicare Part B deductible – $226 in 2023 (does not apply toward your annual out-of-pocket limit)
- Medicare Part B excess charges you may have to pay (up to 15% in most states)
- 100% of emergency medical services you need while traveling outside the United States
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% of covered out-of-pocket expenses.Medigap Plan K vs. Plan L
ITEM MEDIGAP PLAN K AMOUNT MEDIGAP PLAN L AMOUNT Medicare Part A deductible 50% 75% Medicare Part A coinsurance and hospital costs up to 365 days after Medicare benefits are used up 100% 100% Medicare Part B coinsurance or copayment 50% 75% First three pints of blood per calendar year 50% 75% Medicare Part A hospice coinsurance or copayment 50% 75% Skilled nursing facility care coinsurance 50% 75% Out-of-pocket limit for 2023 $6,940 $3,470Source: 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: December 20, 2022
10 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2022, September 30). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/medicare/health-plans/medigap/kandl
- U.S. Centers for Medicare & Medicaid Services. (2022, September). National Medicare Handbook. Retrieved from https://www.medicare.gov/publications/10050-Medicare-and-You.pdf
- U.S. Centers for Medicare & Medicaid Services. (2022). Costs. Retrieved from https://www.medicare.gov/basics/costs/medicare-costs
- U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
- Bunis, D. (2022, May 11). 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
- U.S. Centers for Medicare & Medicare Services. (2022, March). Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare. Retrieved from https://www.medicare.gov/sites/default/files/2022-03/02110-medigap-guide-health-insurance.pdf
- U.S. Centers for Medicare & Medicare Services. (2021, December 1). K & L Out-of-Pocket Limits Announcements. Retrieved from https://www.cms.gov/Medicare/Health-Plans/Medigap/KandL
- U.S. Centers for Medicare & Medicare Services. (2021). Getting Started With Medicare. Download. Retrieved from https://cmsnationaltrainingprogram.cms.gov/sites/default/files/shared/2022_2023_Getting%20Started%20With%20Medicare_Temp.pptx
- 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
- 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
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