Medigap Plan L

Plan L is another cost-sharing supplement. If you enroll in a Plan L policy, the insurance company will pay 75% of your covered medical costs on most items, and you’ll handle the other 25%. You also agree to take care of the Medicare Part B deductible ($203 in 2021) and any excess charges. Carolina Senior Benefits explains more about Plan L so you can decide if it makes sense for you.

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.

We’re Here When You Need Us.

Need Help? We’re Here!

Carolina Senior Benefits is an independent agency that provides excellent service, unbiased advice, and timely resources to help you with your Medicare coverage. It’s important to make educated decisions so you can get the right plan for your needs and budget.

Located just north of Charlotte, we continue to work with the top-rated insurance companies. This means we can present you with multiple options and then make suggestions based on your situation. Wherever you are in your Medicare journey, please don’t hesitate to contact us at (704) 765-4689!