Medigap Plan L

Plan L is a cost-sharing supplement that pays 75% of covered costs on most items while you cover 25%, plus the Part B deductible, with an annual spending cap.

Plan L is another cost-sharing supplement. Enroll in a Plan L policy and the insurer pays 75% of your covered medical costs on most items, leaving the remaining 25% to you. You also agree to handle the Medicare Part B deductible ($203 in 2021) along with any excess charges. Quottes breaks down the details of Plan L so you can decide whether it suits you.

What Plan L Covers

  • Medicare Part A coinsurance and hospital costs
  • 75% of the Part B copayment
  • 75% of blood
  • 75% of the Part A hospice care copayment
  • 75% of the Part A deductible
  • 75% of skilled nursing facility coinsurance

As with Medigap Plan K, Plan L provides no coverage for foreign travel emergency care.

Who Qualifies and When to Sign Up

A few eligibility requirements apply when purchasing any Medigap plan:

  • You need Original Medicare Parts A and B, and you cannot hold both Medigap and Medicare Advantage at once.
  • A Medigap policy covers only one person. Your spouse would need to buy their own separate plan.
  • Insurers are not legally required to sell Medigap coverage to people under 65. If you're under 65 with Original Medicare, the plan you want may not be available to you.

If Plan L interests you, your first opportunity to enroll is during Medigap Initial Enrollment β€” a six-month window that begins when you turn 65 and sign up for Medicare Part B. Miss it and you might be unable to get your preferred plan, or it may cost more.

How Insurers Set Your Rate

Every Medigap policy carries a monthly premium, and the exact amount can vary by location, gender, and tobacco use. Insurers use three approaches to price their premiums:

  • Community rated β€” Every purchaser of the plan pays an identical monthly amount regardless of age.
  • Issue-age rated β€” Your premium depends on your age when you first bought the plan. Buying younger means a lower premium, and it won't rise just because you age.
  • Attained-age rated β€” Your premium reflects your CURRENT age, so it climbs as you grow older.

Is Plan L a Smart Choice?

This Medigap plan rewards you with lower premiums in exchange for sharing the costs. It also caps your spending at $3,110 in 2021. So if in any calendar year your out-of-pocket spending reaches $3,110 in covered, Medicare-approved costs, the insurer pays whatever remains.

This maximum out-of-pocket limit makes agreeing to cover 25% of the costs on the listed items far easier to accept. Even during a year of poor health, you can count on the protection of the cap.

Need Help? We're Here!

Quottes is an independent agency delivering excellent service, unbiased guidance, and timely resources to support your Medicare coverage. Making well-informed decisions matters so you end up with the right plan for your needs and budget.

Our team continues to work with top-rated insurance carriers. That means we can lay out several options for you and then offer recommendations tailored to your situation. Wherever you stand in your Medicare journey, don't hesitate to reach us at 941-894-6460!

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