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 – $233 for 2022.
- 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
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.
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.
- 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
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.
- Your annual out-of-pocket limit – $3,310 in 2022
- Monthly Plan L premium (does not apply toward your annual out-of-pocket limit)
- Medicare Part B deductible – $233 in 2022 (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
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.
|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 2022||$6,620||$3,310|
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.
6 Cited Research Articles
- 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
- 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
- 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
- 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
- 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