Medigap Plan L Benefits
- Medicare Part A coinsurance and hospital costs
- 75% of Part B copayment
- 75% of blood
- 75% of Part A hospice care copayment
- 75% of Part A deductible
- 75% of skilled nursing facility coinsurance
Like Medigap Plan K, Plan L does not cover foreign travel emergency care.
Plan L Eligibility and Enrollment
There are certain eligibility rules you should know when buying any Medigap plan:
- You must have Original Medicare A and B, and you can’t have Medigap and Medicare Advantage.
- A Medigap policy just covers one person. Your spouse will need to buy a separate policy.
- Insurers aren’t legally required to sell Medigap plans to those under 65. If you’re under 65 and on Original Medicare, you may not be able to buy the plan you want.
If you’re interested in Plan L, you can first enroll during Medigap Initial Enrollment — a six-month period that begins when you turn 65 and enroll in Medicare Part B. If you don’t sign up during this time, you may not be able to get the plan you want or it might cost more.
How the Companies Charge You
Every Medigap policy has a monthly premium. The exact amount may vary by area, gender, and tobacco status. Insurers can set monthly premiums for their policies in three ways:
- Community rated — Everybody who buys the plan pays the same monthly amount no matter their age.
- Issue-age rated — Monthly premiums are based on the age when you first buy a plan. Younger buyers will have lower premiums, and the premiums don’t go up as you get older.
- Attained-age rated — Monthly premiums are based on your CURRENT age. So, your premium will increase as you get older.
Is Plan L a Good Option?
This Medigap plan offers lower premiums if you share the costs. It also has a cap on your expenses — $3,110 in 2021. So if any calendar year your spending hits $3,110 in covered, Medicare-approved costs, the insurance company pays the remainder.
This maximum out-of-pocket limit makes it easier to agree to share in 25% of the expenses on the listed items. Even if you have a year of poor health, you know you’ll have cap protection.