Medigap Plan L – Reduced Premium / Cost Sharing

Medigap Plan L is a less popular Medicare Supplement Plan due to the reduced coverage and minimal cost savings as compared with many other Medicare Supplement Plans. Medigap Plan L has a cost-sharing component that makes it initially attractive to some folks, however by the time the cost/benefit ratio is factored in, the Plan L becomes less favorable.

 

Medigap Plan L includes somewhat less coverage of Original Medicare costs than most supplement plans, but it does have a cap on your out-of-pocket spending, which most supplement policies don’t have.

Because of the higher degree of cost-sharing, Supplement Plan L policies sometimes have lower premiums than more comprehensive Medicare Supplement insurance plans, such as Plan G. Supplement Plan L covers the basic benefits that all Medicare Supplement insurance plans are required to offer, but covers some costs partially instead of fully. if you enroll in a Supplement Plan L, the insurance carrier will pay 75% of your covered medical expenses on most items, and you will pay the other 25%. You also agree to pay the Medicare Part B deductible and any excess charges on your own.

Supplement Plan L – Out of Pocket Safety Net

A Plan L Medigap policy also includes a maximum cap on your expenses. This is referred to as your out-of-pocket limit or maximum. Medicare sets this limit annually, and in 2020, the limit for Plan L is $2,940. This means that if in any one calendar year your spending reaches $2,940 in Medicare-approved covered expenses, then the supplement insurance carrier pays the rest. The cap makes it much easier to agree to share in 25% of the costs on the items listed because you know that even if a year of bad health occurs, you won’t spend more than $2,940 for that year.

What Does Medigap Plan L Cover?

Medigap Plan L completely covers Medicare Part A coinsurance and coverage for hospital stays up to 365 days after standard Medicare benefits are used up.

Medigap Plan L also covers 75% of the following services:

  • Coinsurance and co-payments not covered by Medicare Part B
  • Blood deductible (the cost of the first three pints of blood)
  • Coinsurance or co-payments for hospice care not covered by Medicare Part A
  • Coinsurance for time spent in a skilled nursing care facility
  • Deductibles not covered by Medicare Part A 

Medigap Plan L Does NOT Cover 

  • Part B Deductible & Co-pays
  • Part B Excess Charges
  • Coinsurance for Skilled Nursing
  • At Home Recovery
  • Preventative Care
  • Vision Care
  • Dental Care
  • Foreign Travel Emergency Care

 

At Nevada Medicare we can help you sort through the different plans, confusion and understand your options. Let us do all the work for you Contact US today.