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Medicare Supplement Insurance Plan L

Medicare Supplement Insurance (or Medigap) Plan L is one of 10 standardized Medicare Supplement insurance plan options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options.) Learn how this Medigap insurance plan works compared to other policies.

Medigap Plan L: An Overview

Medigap Plan L is a cost-sharing plan. That means some of the benefits aren’t fully covered. For example, instead of covering the entire Medicare Part A deductible, it only pays 75% of it. You would have to pay the remaining 25%.

However, there is an annual limit on cost-sharing. Once you hit that limit, Plan L starts paying for 100% of covered benefits, and you don’t have to pay additional costs. This is called an out-of-pocket limit. The out-of-pocket limit is $2,780 in 2019.

Plan L may be harder to find. Only 16% of Medigap insurers offered Plan L in 2014.1

Keep reading for details on Plan L’s benefits and enrollment rates, in addition to how the benefits compare to other plan options.

Benefits

Plan L provides full coverage for 1 benefit and 75% coverage for 5 other benefits.

Plan L benefits

Standard Medicare Supplement Insurance benefits

Plan L

Medicare Part A co-insurance and hospital costs

Medicare Part B co-insurance or co-payment

75%

First 3 pints of blood

75%

Part A hospice care co-insurance or co-payment

75%

Co-insurance for skilled nursing facility

75%

Medicare Part A deductible

75%

Medicare Part B deductible

 

Medicare Part B excess charges

 

Foreign travel emergency

 

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days. Plan L covers all of these costs.

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a co-insurance and co-payments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% co-insurance in most cases. Plan L pays for 75% of the remaining 20% co-insurance or co-payment costs.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond. If you need blood while in the hospital, Plan L will cover 75% of the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care. Plan L covers 75% of these costs.

Co-insurance for skilled nursing facility: Plan L covers 75% of the co-insurance for medical care provided at skilled nursing care facilities.

Medicare Part A deductible: Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019. Medigap Plan G will cover your deductible in full for each benefit period you require. Plan L will pay for 75% of the deductible cost for each benefit period.

With Plan L, you still have to pay the Medicare Part B deductible, which is $185 in 2019.

For more detailed information, read our page about Medicare Supplement Insurance benefits.

Plan option comparison

Plan L is similar to Plan K, but it provides more financial coverage. Instead of only covering 50% of the benefits, Plan L provides 75% of the benefits. This plan does have cost-sharing, but the out-of-pocket limit protects you from paying over a certain amount each year.

To see the difference between Plan L and the other standardized Medigap plan options, please review the chart below.

Plan L vs. other Medigap plan options

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility     50% 75%
Medicare Part A deductible   50% 75% 50%
MedicarePart B deductible                
Medicare Part B excess charges                
Foreign travel emergency     80% 80% 80% 80%     80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything. 2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

Plan L Enrollment Statistics

In 2014, Plan L was only offered by 16% of Medigap insurance companies and represented less than a 0.5% share of the market.


1 https://www.ahip.org/wp-content/uploads/2016/04/MedigapEnrollmentReport_Linked.pdf

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