Understanding Medicare Supplement Plan L Coverage and Costs
Medicare Supplement (also called Medigap) plans help pay for out-of-pocket charges that Original Medicare doesn’t cover. Medicare Supplement Plan L is one of ten options for a Supplement plan. Both Plan L and Plan K are different from other Medicare Supplement plans in a couple of ways. These plans usually have lower premiums, but only pay for a percentage of certain out-of-pocket costs, rather than the entire amount. To make sure enrollees don’t experience catastrophic costs, these plans also have maximum out-of-pocket costs.
Compared to Plan K, Plan L covers a higher percentage of your expenses and includes a lower yearly out-of-pocket maximum. Because of these increased benefits, Plan L will generally have a slightly higher monthly premium than Medigap Plan K.
Key takeaways:
Medicare Supplement Plan L is one of ten Medicare Supplement plans available to Medicare recipients.
Plan L tends to come with lower premiums, but higher out-of-pocket costs compared to more comprehensive Medicare Supplement plans, like Plan G and Plan N.
Medicare Supplement Plan L has an annual out-of-pocket maximum of $3,530 (in 2024).
Medicare is not one-size-fits-all. If you have questions about what plan is right for your needs, we suggest talking to one of our licensed Medicare Supplement Advisors for a free consultation.
What are Medicare Supplement plans?
Designed to help fill in the “gaps” or out-of-pocket charges that Original Medicare doesn’t cover, Medicare Supplement (also called Medigap) plans are insurance policies that help pay for the remaining costs of Original medicare. These include copayments, coinsurance, and deductibles.
Important note: Massachusetts, Minnesota, and Wisconsin offer a different set of standardized Medicare Supplement plans. These states do not offer a Medigap Plan L.
Benefits of Medicare Supplement plans
Original Medicare has 20% coinsurance, which means you’re responsible for 20% of the costs for covered services once you’ve met your deductible. Medicare Supplement plans help cover some of the costs that are left over by Original Medicare, which makes each visit to the doctor less expensive.
Standardization
Each Medicare Supplement plan of the same type provides the same coverage, even if the pricing varies. For instance, all Plan Ls give you identical benefits regardless of the premium amounts or the insurance carrier providing the plan.
No restrictive provider networks
Both Original Medicare and Medicare Supplement plans don't limit you to specific networks of doctors. This means you can visit any doctor across the country who accepts Medicare, which is 90% of all providers in the US. This is great for those who travel a lot domestically and may need to seek care outside of their home state.
No need for prior authorization
Unlike with most Medicare Advantage plans, you won’t need prior authorization for covered services if you have Original Medicare and Medicare Supplement. This makes it easier to get the care you need quickly because you don’t have to wait for authorization before receiving treatment.
Eligibility for Medicare Supplement plans
You are eligible for a Medicare Supplement plan if you’re enrolled in Original Medicare (Part A and Part B) and not enrolled in Medicare Advantage. The best time to submit your application is during your Medigap Open Enrollment, which is a 6-month window after your Part B begins. During this time, you are guaranteed acceptance into any Medigap plan, regardless of your age and health status. We explain more about how enrollment works below.
Comparing Medicare Supplement plans
Medicare provides ten different types of Medigap plans, each covering a different level of out-of-pocket costs. Take a look at this chart to learn what each plan covers.
Understanding the different parts and plans of Medicare can feel complicated. If you need help comparing different plans and choosing the right one for you, our licensed Medicare Advisors are here to help! Give us a call at (855)-900-2427 for free advice based on your unique health and financial circumstances.
Medicare Supplement Plan L costs and coverage
Not many people who are eligible for Medicare sign up for Plan L. In fact, only 0.2% of beneficiaries are enrolled in Plan L. Even though Plan L has lower premiums than other Medigap plans, your costs may be higher. This is because it doesn’t cover the same level of out-of-pocket costs as some of the more comprehensive Medigap plans
We recommend taking a look at Plan G or Plan N for a more comprehensive option. These are two of the most popular Medigap plans among Medicare beneficiaries because they provide the most coverage at the best value.
What’s covered under Medigap Plan L?
Medigap Plan L covers 100% of the costs of:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
Medigap Plan L covers 75% of the costs of:
Part B coinsurance or copayments
Blood transfusion (up to 3 pints)
Part A hospice care coinsurance or copayments
Skilled nursing facility care coinsurance
Part A deductible
What’s not covered?
Medigap Plan L does not cover the following costs at all:
Part B deductible
Travel-abroad emergency medical care
Generally, Medigap only provides coverage for out-of-pocket costs leftover by Original Medicare. It will not cover additional healthcare needs like:
Long-term care and private nurses
Prescription drugs
Medicare Supplement Plan L out-of-pocket costs and maximums
Plan L covers 75% of many out-of-pocket costs, but it doesn't pay for certain expenses that some other Medicare Supplement plans do. However, it does have an out-of-pocket maximum that limits the amount you'd need to pay each year. In 2024, this limit is $3,530. Once you reach this number, Medigap will cover 100% of the cost for covered services for the rest of the year.
Medicare Supplement Plan L premiums
How much you pay for your specific Medigap Plan L will depend on factors, like:
Where you live
Your smoking status
Your age
Your gender
The insurance carrier
Household discounts (offered by some Medigap plans)
Will my Medicare Supplement premium change over time?
Your premium can change over time based on your plan’s pricing structure. There are three standard types of pricing or “rating” structures that determine how your Medicare Supplement premium changes over time. Your plan’s price may also change due to inflation and other economic factors.
Community-rated (aka no-age-rated): The premium you pay is the same as everyone else with the same policy, regardless of age. This means your premium will not increase as you age.
Issue-age-rated (aka entry age-rated): The premium you pay is based on the age you were when you first enrolled in your Medigap plan. This means your premium will not go up as you age.
Attained-age-rated: How much you pay is based on the age you currently are (the age you’ve “attained”). Your premium is generally lower at first and can increase as you get older.
How to enroll in a Medicare Supplement Plan L
Your Medigap Open Enrollment period is the best time to enroll in a Medicare Supplement plan. This is a 6-month window right after your Medicare Part B coverage begins. If you apply outside of this window or other guaranteed issue periods, you may need to go through Medigap underwriting (answering questions about your health history) to apply—and your application could be denied. Learn more about how Medigap enrollment here.
How to choose the right Medicare Supplement Plan
If you have questions about Plan L or your other Medicare options, our licensed Medicare Advisors are ready to help! We provide free, unbiased advice to help you make the best decision about your health insurance.
Schedule a free consultation or call us at (855) 900-2427.