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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.

Learn more about Medigap Plan L, including its 2019 out-of-pocket spending limit and the benefits it offers. Find out if Plan L may be right for your needs.

 

Find Medigap Plan L in your area.

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What Is Medigap Plan L?

When you use your Original Medicare coverage (Medicare Part A and Part B), you are required to pay for a number of out-of-pocket costs like deductibles, coinsurance and copayments.

Medigap Plan L helps pay for some of these out-of-pocket costs.

Each Medigap plan offers its own combination of a pre-determined set of benefits, and the coverage for each type of plan is standardized.

This means that Plan L will offer the exact same set of benefits to beneficiaries in one state as Plan L in another state, no matter where it is sold or by whom.

Medigap Pan L is accepted by any provider who accepts Medicare. 

Medigap Plan L Has an Out-of-Pocket Spending Limit

Plan L doesn’t offer full coverage for some of the benefits it pays for.

For example, instead of covering the entire Medicare Part A deductible, Plan L only pays 75% of it. You would have to pay the remaining 25%.

However, Plan L does include an annual out-of-pocket spending limit. Once you hit that limit, Plan L starts paying for 100% of your covered benefits for the rest of the year, and you don’t have to pay any additional costs.

The out-of-pocket limit for Plan L is $2,780 in 2019.

What Does Medicare Supplement Plan L Cover?

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 coinsurance and hospital costs

Medicare Part B coinsurance or copayment

75%

First 3 pints of blood

75%

Part A hospice care coinsurance or copayment

75%

Coinsurance 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 Coinsurance

Medicare Part A is known as hospital insurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if you stay in the hospital for longer than 60 days.

Plan L fully covers your Medicare Part A coinsurance.

Medicare Part B Coinsurance and Copayment

Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care.

Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving you to pay a 20% coinsurance after you meet your Part B deductible for the year.

Plan L pays for 75% of your Part B coinsurance or copayment costs.

First 3 Pints of Blood

If you need a blood transfusion during a medical procedure, Original Medicare only covers the cost of 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 Coinsurance or Copayment

Medicare Part A covers some hospice care services, but it requires copayments.

These copays include a $5 charge for certain prescription drugs and 5% of the Medicare-approved amount for inpatient respite care.

Plan L covers 75% of your Part A hospice care coinsurance and copays.

Coinsurance for Skilled Nursing Facility Care

If you receive care as an inpatient at a skilled nursing facility, Medicare Part A requires you to pay coinsurance costs after the 20th day of your stay. In 2019, the Part A coinsurance for skilled nursing facility care is $170.50 per day.

Plan L covers 75% of the coinsurance for medical care provided at skilled nursing care facilities.

Medicare Part A Deductible

Before your Part A coverage kicks in, you must meet a deductible.

The Medicare Part A deductible is $1,364 per benefit period in 2019. Because this deductible isn’t based on an annual basis, you could potentially have to pay this deductible more than once in a single year.

Medigap 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  per year in 2019.

Plan L vs. Plan K and Other Medigap Plans

Plan L is most similar to Plan K out of all the other types of Medigap plans, but it provides more financial coverage than Plan K.

Plan K only covers 50% of the costs that Plan L covers at 75%. Plan K also has an out-of-pocket spending limit, which is higher than Plan L’s at $5,560 for the year in 2019.

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

2019 Medigap plans comparison chart

Why Choose Plan L?

Why might a beneficiary choose Plan L over other available plans?

One aspect that some Medigap beneficiaries may appreciate about Plan L is the out-of-pocket limit.

A serious illness or injury that leads to an extended inpatient hospital stay can result in out-of-pocket costs that add up quickly. Plan L can help protect you from Medicare costs that accumulate over the course of a year.

Here are some other aspects of Plan L to consider:

  • Medicare Part B deductible
    The Medicare Part B deductible is $185 per year in 2019, which is a relatively small expense compared to certain other out-of-pocket Medicare costs. Depending on your situation, you may not feel that it’s necessary to have full coverage for the Part B deductible.

  • Part B excess charges
    Certain health care providers do not accept the Medicare-approved amount as full payment for their service or items. These providers do not accept Medicare assignment and are classified as “non-participating.”

    Providers who don’t accept Medicare assignment reserve the right to charge up to 15 percent more than the Medicare-approved amount. This is called a Medicare Part B “excess charge.”

    You can avoid facing Medicare excess charges by only visiting health care providers who accept Medicare assignment. Most providers accept Medicare assignment.

  • Foreign emergency care.
    Some Medigap plans help cover up to 80 percent of the costs for emergency care you receive while outside the U.S., which Original Medicare typically doesn’t cover at all.

    If you do not plan to travel outside of the U.S., you likely don’t need this added coverage and may benefit from enrolling in a Medigap plan that doesn’t include foreign travel emergency care. 

Plan L Enrollment

Plan L is not as widely distributed as other Medigap plans. In 2017, just 15 percent of all insurance companies that sold Medigap policies offered Plan L.1 

Plan L also has a low enrollment rate. In 2017, fewer than one percent of all Medigap beneficiaries were enrolled in Plan L. However, Plan L saw a 3% increase in enrollment from 2016 to 2017, making it the fifth-fastest growing plan during that time period.

Find Medigap Plan L Where You Live

Plan L options may be available where you live.

Call today to speak with a licensed insurance agent who can help you compare the Medigap plans in your area so that you can find a plan that fits your needs.

 

Find Medigap Plan L in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.


1 AHIP. The State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.

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