By: Eligibility Team

Plan L is a type of Medicare Supplement (also known as Medigap) plan.

Why might you want one of these plans? Many people are surprised to learn that Medicare does not cover all health care expenses. Medicare Supplement plans help fill in the gaps, paying for expenses that Medicare doesn’t cover. In 2019, there are 10 Medicare Supplement plans available to new enrollees, named by letters. For a refresher on Medicare Supplement plans overall, check out our Medicare Supplement Plans Guide.

Plan L is one of the Medicare Supplement plans with the lowest monthly premiums. However, lower monthly premiums mean less coverage. You’ll need to pay more when you get medical care, so it’s best to stay as healthy as you can.

Plan L is different from most other Medigap plans because it has an annual out-of-pocket limit. It’s one of only two plans that have this feature (plan K is the other). Read on to learn specifically about Plan L.

Plan L: Who is it for?

  • People who don’t typically need much medical care: While Plan L has low monthly premiums, those who use their insurance frequently may find it to be more expensive.
  • People who don’t mind researching providers: Plan L does not cover Medicare Part B excess charges. That means people on Plan L need to choose their providers carefully, confirming that each one accepts Medicare assignment before they receive services.
  • Primarily domestic travelers (or homebodies): Plan L does not cover emergency medical costs in other countries, so this plan works best for people who don’t travel or who only travel within the US.

Example: Tom is 65, retired, and applying for Medicare Part A and Part B. Tom is relatively healthy and loves to hike. He and his wife plan to downsize their home and tour the US in an RV, visiting many national parks and other sights. Tom wants to set aside as much money as possible for their adventures and pay for care only as he needs it. After doing some research, Tom decided to purchase Medigap Plan L, as it will cover the better part of his medical expenses in exchange for a low monthly premium.

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What Plan L covers

ServiceIs it covered?
Part A coinsurance past 365 days100%
Part B coinsurance or copayment75%
Blood (first 3 pints)75%
Part A hospice coinsurance or copayment75%
Skilled nursing facility coinsurance75%
Part A deductible75%
Part B deductibleNot covered
Part B excess chargeNot covered
Foreign travel exchangeNot covered
Out-of-pocket limit$2,780

Table created using information available at Medicare.gov as of 8/2/19.

What Medigap Plan L covers at 100%

There are limits to how long Medicare Part A will cover a hospital stay. Plan L (as well as every other Medicare Supplement plan) extends this coverage for a full year (365 days) after your Medicare benefits are exhausted.

Find out the details of what Part A covers.

What Medigap Plan L covers at 75%

Where other Medicare Supplement plans cover 100% of some services, Plan L tends to cover just 75%. You pay the difference until you reach your out-of-pocket limit ($2,780 in 2019), and then Plan L pays the rest.

Plan L covers 75% of your coinsurance and copayments for hospice care under Part A and doctor visits under Part B. Also covered at 75% are the first three pints of blood used for a medical procedure and your coinsurance for being treated at a skilled nursing facility.

Plan L also pays for 75% of your Part A deductible, which is the amount you have to pay before Medicare starts covering your hospital costs. The Part A deductible is $1,364 in 2019, leaving you responsible for $341 after Plan L’s coverage.

What Medigap Plan L does not cover

Plan L provides no coverage for your Part B deductible ($185 in 2019). However, starting in January 2020, no Medicare Supplement plans offered to new enrollees will cover the Part B deductible.

Plan L also doesn’t cover any Part B excess charges. These charges (15% above standard Medicare rates) are what physicians are allowed to bill you if they aren’t contracted with Medicare. Some Medicare Supplement plans (such as Plan F and Plan G) cover excess charges, but Plan L does not.

Find out the details of what Part B covers..

Medical emergencies that happen while you are traveling abroad are not covered in any way by Plan L. If you require medical care while in another country, you must pay the entire cost.

Out-of-pocket limit

Plan L has an annual out-of-pocket limit of $2,780 in 2019. That can offer you some peace of mind because you’ll know how much money (in addition to premiums) you may need to pay in a given year.

Medicare Supplement Plan L: What you need to know before enrolling

Before enrolling in a supplement plan such as Plan L, you are required to first sign up for Original Medicare Part A and Part B. Once you do, a supplement plan can be a helpful addition to cover what Medicare doesn’t.

It’s best to enroll in Plan L during your Medigap open enrollment period when you can buy any Medigap policy sold in your state. After that period, you can apply for Medigap coverage (or switch your coverage), but you can be denied or charged more based on your health.

The Medigap open enrollment period lasts six months, and it starts the first month you’re at least 65 and enrolled in Medicare Part B. Whether you’re in the open enrollment period right now or not, our Suggest a Plan tool can help. It gives you a recommendation for a plan that could match your needs.

One important note: Three states have separate rules for Medicare supplement plans, and even different names for their plans. If you are a resident of Massachusetts, Minnesota, or Wisconsin, check with your local state insurance department to understand your options.

Get Medigap Plan L

Pros

  • Low premiums
  • Yearly out-of-pocket limits

Cons

  • Only 75% coverage
  • No coverage for Part B excess charges or foreign travel emergencies

Medicare Supplement Plan L offers low premiums with an annual out-of-pocket limit for peace of mind. Ready to start an application or get answers to questions about your particular situation? Speak to a knowledgeable, licensed agent, and get a quote.

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OR

Call to speak with a Licensed Agent

855-802-1206

Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively “Medicare System Providers”). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.