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Phone Number

(360)787-1000

Location

Vancouver, WA

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Plan L

Medigap Insurance Plan L is available in all federal states and for a cost of a low monthly premium, offers you more benefits than Original Medicare alone. Even though Original Medicare covers most costs, Medicare Supplement Insurance Plan L can help you cover other remaining costs like coinsurance, deductibles, and copayments.

However, you need to be enrolled in Original Medicare if you want to choose any of the Medicare Supplement Plans, including plan L. With this plan, you can visit any doctor and a hospital that accepts Original Medicare and you don’t need a referral to see a specialist.

Coverage Benefits

Medigap Plan L

Medigap Plan L is a cost-sharing plan, provided by private insurance companies, that covers some benefits in full and others at 70%. It covers the Part B coinsurance for preventive services, the foreign travel emergency coverage, and the Part A coinsurance at 100%

Plan L does not cover the Part B deductible or the Part B excess charges. However, Part B excess charges are not common and if you live in a state that does not allow them, this is not an issue.

Medigap Plan L covers:

  • Part A coinsurance and up to an additional 365 days of hospital costs after Medicare benefits are exhausted
  • 75% of the Part B coinsurance/copayment
  • 75% of the first 3 pints of blood
  • 75% of the Part A hospice care coinsurance/copayment
  • 75% of the skilled nursing facility care coinsurance
  • 75% of the Part A deductible
  • $3,470 out-of-pocket expenses limit (in 2023), then Medigap pays 100%

What Medicare Supplement Plan L Doesn't Cover

  • Medicare Part B excess charges
  • Medicare Part B deductible which you must pay before you choose this plan. The amount of the deductible in 2023 is 226$
  • Foreign Travel Emergency
  • Prescription drug coverage
  • Since this plan covers 75% of the Original Medicare costs, you’ll need to pay for 25% of the remaining costs and you will also need to pay in full for certain expenses that are not covered by Medigap plan L.

Medigap Plan L Premiums

Individual premiums will vary based on which state the individual is seeking coverage in, which carrier they’re purchasing from, and also individual factors like gender, age, tobacco use, and a few other details. The average cost for Plan L ranges from $80-$180 each month. In general, Plan L premiums are higher in states who have a higher cost of living.

Plan L Out-of-Pocket Maximum

Plan K is one of two Medigap plans that offer a maximum out-of-pocket costs(MOOP) limit. In 2023, the out-of-pocket limit will be $3,470, but this typically increases each year. After the maximum has been met, Plan K will pay for 100% of covered services for the remainder of the year.

Medigap Plan L Enrollment

As with other supplement plans, the best time to enroll in Plan L is during the Medigap Open Enrollment Period which lasts six months. This enrollment period begins the first month that you are over 65 with the condition of already being enrolled in Medicare Part B.

To be eligible for Medicare Supplement Insurance Plan L you need to be a legal U.S. citizen or permanent resident for a minimum of five consecutive years. Also, you must already be enrolled in Original Medicare Parts A and B. Most states require individuals to be 65 or older, but there are some insurance carriers that offer plans to Medicare beneficiaries who are younger than 65.

How to Compare

Medigap Plan L Rates

There is a lot of information about each plan online, but to get an accurate quote, you’ll need to enlist the help of a licensed Medicare agent. Instead of calling each insurance carrier to get a quote, we can compare premiums across many different carriers, ensuring that you enroll with one that gives you the best rate.

We’ll need to collect some information from you in order to provide quotes since your premium is based on your information and health history, but our services come at no additional cost to you! If you choose to enroll in a Medigap plan through our agency, we also offer unlimited support. If you have problems with your coverage or have questions about how your plan works, we will be here to help.

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Questions to be advised on:

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Individuals can enroll in Plan L as long as they have already enrolled in Original Medicare – Parts A and B. The best time to enroll is during your open enrollment period, which begins on your Part B effective date. Beneficiaries will have six months from that day to enroll in a plan with guaranteed issue rights. After that time frame, enrollment may be declined based on an individual’s health history.
Any coverage that is additional to Original Medicare is great to have. Plan L has a lower premium than some of the other Medicare supplements, so as long as individuals do not mind having to pay some cost-sharing expenses, Plan L is a good choice. This plan also has an annual out-of-pocket limit, which is helpful if you have high medical bills.
No Medigap plan includes prescription drug coverage outside of some that are administered in an inpatient hospital setting. Medicare beneficiaries who are enrolled in Plan L or any other Medicare supplement should also enroll in a Part D plan. Part D plans include prescription drug coverage.
Medigap plans only cover services that are also covered by Original Medicare – Parts A and B. Part B does offer benefits for mental health services, which includes care received from a psychiatrist. So yes, Plan L does offer mental health service coverage.
First, you’ll need to know if you are eligible for both. Medicare beneficiaries who turn 65 after January 1, 2020 will not be eligible for Plan F. Plan L is a good alternative that comes with lower premiums, but there is some cost-sharing required.
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