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Is Medigap Plan L the Best Choice for You?

October 5, 2017

If you’re enrolled in Original Medicare, Part A and Part B, you may also want to consider purchasing a Medicare Supplement plan (also known as Medigap). Medigap plans are available through private insurance companies, and they’re designed to help pay for your Original Medicare out-of-pocket costs, like copayments, coinsurance, and deductibles. Medigap Plan L is one such plan, and it could be right for you if you’re seeking a health plan with a lower monthly premium.

Understanding Medigap Plan L

Medicare Supplement plans are standardized in most states, with lettered names to distinguish them. Plans of the same letter name include the same level of coverage of Original Medicare’s out-of-pocket costs, although some plans might include additional innovative benefits.

Medigap Plan L is one of two standardized Medigap plans that have out-of-pocket spending limits. Plan L includes a percentage of the Medicare expenses listed below, instead of covering the entire amount as most other standardized Medigap plans do. Given the higher cost-sharing for beneficiaries enrolled in Medigap Plan L, the plan may come with a lower monthly premium than some of the other Medigap plans. However, the health insurance companies that offer Plan L set their own premiums, so it’s always a good idea to comparison-shop and see exactly which plans are available in your area and at what price.

Medigap Plan L covers 75% of the following expenses:

  • Medicare Part B copayment or coinsurance coverage
  • First three pints of blood for a covered medical procedure
  • Medicare Part A hospice care coinsurance or copayment
  • Skilled nursing facility (SNF) care coinsurance
  • Medicare Part A deductible

Additionally, Medigap Plan L provides full coverage (100%) for Medicare Part A coinsurance and hospital costs for up to an additional 365 days after your Medicare Part A benefits are exhausted. Note that Medigap Plan L does not offer coverage for the Medicare Part B excess charges or deductible, nor for foreign travel.

Medigap Plan L out-of-pocket expense limit

The annual out-of-pocket expense limit is $2,560 in 2017 for Medigap Plan L beneficiaries. These expenses must be for approved Medicare-related services. After a Medigap Plan L beneficiary spends up to this dollar amount in out-of-pocket expenses within a single year, the plan pays 100% of covered services for the rest of the calendar year.

See how the benefits of Medigap Plan L compare to those of other Medigap plans with our Medigap plan benefit comparison.

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