If you are a beneficiary of Medicare, your Part A and Part B benefits cover hospitalization and some outpatient medical services. However, there are still out-of-pocket costs that you will incur such as deductibles, copayments, and coinsurance.

Medicare supplement plans help to cover these out-of-pocket costs. There are ten standardized Medicare supplement plans available to choose from including Plans A, B, C, D, F, G, K, L, M, and N.

If you are looking for a cost-sharing supplement plan with low out-of-pocket maximums, Plan L is a good option.

What is Medicare Supplement Plan L?

Medicare Supplement Plan L is a cost-sharing plan where a percentage of your out-of-pocket costs are covered by the plan and you pay the rest. Like other Medigap plans, Plan L does not include additional coverage like vision, dental, or prescription drugs. Rather it helps to cover the gaps in the benefits you already have from Original Medicare.

Anyone enrolled in Original Medicare can enroll in Medigap Plan L. Keep in mind that this plan is offered by private insurers so you need to find a Medigap Plan L that is available in your area and enroll. 

Note that Medigap plans are not available to senior Americans enrolled in Medicare Advantage.

What does Medicare Supplement Plan L cover?

Medicare Supplement Plan L covers a specified percentage of out-of-pocket costs that you incur under Original Medicare.

Coverages included in Medigap Plan L are:

·        100% Part A coinsurance and hospital costs (coverage lasts up to 365 days after Medicare benefits are used up);

·        75% Part A deductible;

·        75% Part A hospice care coinsurance or copayment;

·        75% Part B coinsurance or copayment;

·        75% skilled nursing facility care coinsurance;

·        75% blood transfusion costs (first three pints).

Your Medicare Supplement Plan L has a maximum out-of-pocket limit (MOOP) ($3,530 in 2024). The MOOP limit can change from year to year. Once you reach the MOOP limit, your plan will cover all costs for covered services for the remainder of the benefit year.

What Medigap Plan L doesn’t cover:

·        Part B deductible;

·        Part B excess charges;

·        Emergency care during foreign travel;

·        Prescription drugs;

·        Non-skilled long-term care;

·        Dental or vision care.

Enrolling in Medicare Supplement Plan L

You can enroll for Medigap Plan L during the Medigap Open Enrollment Period. This period only happens once in a lifetime and it is important to not confuse with Medicare Annual Open Enrollment Period. It is the six months period that starts when you turn 65 and enroll in Part B.

If you enroll for Plan L during the open enrollment period, you will have guaranteed issue rights. These rights give you protections to ensure that:

·        The insurer cannot deny you coverage based on your medical history, age, or any other underwriting factors.

·        The insurer will not charge you higher rates than normal based on your health or any other underwriting factors.

·        You will not be subject to a waiting period if you have a pre-existing condition.

In case you miss the Medigap Open Enrollment Period you can still enroll for Plan L anytime during the year but you may be denied coverage or forced to pay higher rates based on your medical history.

Once you enroll in Medicare Supplement Plan L, you have a 30-day free look period. During this time you can choose to either keep your coverage or switch to a different plan.

Medigap Plan L costs

Medigap plans are sold by private insurers, so costs can vary depending on the provider, your location, and other individual factors. However, on average, Medigap Plan L premiums range between $80-$180 per month.

Note that besides your monthly premium, you will need to cover up to $3,530 in 2024 in out-of-pocket costs before your plan can pay for covered services in full.

Is Medigap Plan L right for you?

The best Medicare Supplement plan will mostly depend on your budget and needs. Plan L is a good option for those who are on a budget and want a cost-sharing plan that helps to cover their out-of-pocket costs under Original Medicare.

Plan L may also be a better option compared to Plan K since it covers a higher percentage of costs (75%) and has a lower out-of-pocket maximum. However, both Plans K and L offer limited coverage benefits.

For Medicare beneficiaries looking for Medigap plans with more comprehensive coverage, it may be worth considering Supplement Plans like Medigap Plan F or Plan G.

Article updated on December 13, 2023.