Medicare Supplement Plan L is a Medigap plan that has a lower premium due to cost-sharing. In exchange for this lower premium, you agree to pay a 25% coinsurance for services received.

Medicare Supplement Plan L

The golden rule of insurance is that the more coverage you purchase, the more you will have to pay for it. It’s a pretty self-explanatory rule. The benefits offered by Medicare Supplement Plan L are a way of finding a middle ground. Those benefits include:

  • 100% of your Medicare Part A coinsurance costs for up to 365 days after Medicare benefits run out (for inpatient hospital treatment only)
  • 75% of your Part B copay and/or co-insurance costs
  • 75% of the cost of your first 3 pints of blood should you require a blood transfusion while receiving inpatient hospital treatment
  • 75% of your Part A hospice care co-payments and/or co-insurance
  • 75% of your coinsurance costs for care in a skilled nursing facility
  • 75% of your Medicare Part A deductible

Even though Medicare Supplement Plan L is still fairly comprehensive despite your 25% cost share responsibility, this plan will not cover:

  • Your Medicare Part B deductible
  • Your Medicare Part B excess charges
  • Emergency foreign travel assistance

How Much Does Medigap Plan L Cost?

As far as monthly premiums go, the average cost for a Medigap Plan L is between $100 to $130 per month, depending on where you live and how much healthcare costs in your area. In addition to that, you should budget for the following:

Your Medicare Part A deductible with Plan L

You’ll be responsible for 25% of your Medicare Part A deductible which, starting in 2022, will cost you $389 per benefit period if you are admitted for inpatient hospital treatment.

Keep in mind that annual deductibles and benefit period deductibles are two different payments; it is possible to end up going through more than one benefit period in the same year under certain circumstances.

Your Medicare Part B deductible with Plan L

The Medicare Part B deductible will cost more going forward. This annual deductible will now start costing beneficiaries $170.10 per year for their outpatient and doctor visits (and all other care that falls under Medicare Part B).

Medicare Part B excess charges

Medicare Part B out-of-pocket charges happen when a doctor or facility doesn’t want to pay the Medicare assignment price and tacks on an additional 15% to the Medicare assignment cost.

Because of this, Medicare will start by paying the Medicare assignment price, and those charges will be your responsibility. Call ahead when and where you can to make sure the care you are getting is not subject to Part B excess charges, and try your best to budget for those costs in an emergency situation.

Foreign travel emergency assistance

Medigap Plan L does not provide benefits for beneficiaries who get sick while traveling abroad. So if you plan on globetrotting during your golden years, make sure to either budget for this or stick to countries that have relatively low out-of-pocket medical costs for foreigners.

Out-of-pocket costs

The maximum out-of-pocket cost for Medigap Plan L will be $3,310. That means if you spend more than that on your healthcare in a calendar year, your Medigap plan will pay 100% of your medical costs after you meet this deductible.

Cost-share plans like Medigap Plan L can be financially beneficial for beneficiaries with a decent medical care budget but not many medical care needs.

This plan still covers 75% of the Medicare gaps which you may fall into if you aren’t careful. And the low $3,310 out-of-pocket maximum provides good financial protection for beneficiaries who are less flexible in a medical emergency.

Overall, it provides a good balance between beneficiaries who need more comprehensive coverage but don’t exactly have the funds for a “Cadillac plan”.

FAQs

Even if you dedicate yourself to learning everything you need to know about Medicare, you’re still more likely than not to have questions. Well, we’ve got answers.

These are the most frequent questions we received from beneficiaries who need our help. And we hope these answers can help you, too.

Is Medigap Plan L Available in My State?

If you live in Minnesota, Wisconsin, or Massachusetts, the answer to that question is no. The reason why is because each state is allowed to pass its own unique insurance laws. These states offer their own Medigap plans instead of the 10 standardized plans available in the other 47 states. For more information on which one of these states’ plans will best meet your needs, contact your insurance agent or your local CMS Office.

Which Beneficiaries Benefit the Most from Medigap Plan L?

The questionnaire below can help you figure out whether or not Medigap Plan L is right for you:

  • Has your state passed laws to make excess charges for Medicare Part B illegal?
  • Do you think you’ll be using more of your Medicare Part B benefits than your Medicare Part A benefits?
  • Are you still relatively young and in excellent health?
  • Do you have a modest healthcare budget, but aren’t in the market for a fancy Cadillac plan?
  • Are you planning on only traveling domestically, or not at all?

Medigap Plan L will do a good job of letting you get comprehensive coverage and paying a discounted premium.

How to Enroll in Medicare Supplement Plan L

That’s not as surprising as you may think. Our Medicare experts know how difficult it can be to get a great plan at a great price. But the good news is that you’re not alone. Give us a call, or complete our online rate form to get started now.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.