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What does Medicare Supplement Plan L Cover and Who Should Buy It?
Easy Article Navigation
- What are the Benefits of the Out-Of-Pocket Limit?
- What Does Plan L Cover?
- What is Medigap?
- Medicare Supplements vs Medicare Advantage
- Cost of Plan L Compared to Other Popular Plans
- Plan L Coverage Compared to Other Popular Plans
- Who is Plan L Best Suited For?
Medicare Plan L is one of two Medigap plans that feature a yearly out-of-pocket limit. The other plan with the out-of-pocket limit is Plan K.
After you fulfill your yearly Part B deductible and meet any cost-sharing obligations, Plan K then pays for 100 percent of covered services for the rest of the year.
Out-of-pocket limits for each plan:
- Plan L: $3,110 for 2021
- Plan K: $6,220 for 2021
What are the Benefits of an Annual Out-Of-Pocket Limit?
With original Medicare Part A and Part B, you are not limited in how much of your healthcare expenses you must pay each year. One of the reasons many individuals purchase a Medicare supplement plan (Medigap) is to limit spending on healthcare.
Since Medicare Supplement Plan L has an annual out-of-pocket limit, you can better plan for your medical expenses. That’s because you’ll know the most you may have to spend on covered medical treatments in any given year.
The out-of-pocket limit will be considerably helpful for applicants who:
- have high ongoing medical costs due to a chronic health condition
- prefer to be prepared if faced with unexpected healthcare costs due to an expensive and unexpected medical situation
What Does Medicare Supplement Plan L Cover?
Medicare Supplement plans cover coinsurance after the deductible has been met, and some offer to pay the deductible as well. Coverage with Medicare Supplement Plan L includes:
|Original Medicare||Plan L|
|Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used||100%|
|Part B Coinsurance or Copayments||75%|
|Blood - First 3 Pints||75%|
|Part A Hospice Coinsurance or Copayment||75%|
|Skilled Nursing Facility Coinsurance||75%|
|Part A Deductible||75%|
|Part B Deductible||X|
|Part B Excess Charges||X|
|Foreign Travel Emergency||X|
|Maximum Annual Out-Of-Pocket||$3,110|
What is Medigap?
Medigap (Medicare Supplement) insurance can be especially useful for individuals enrolled in Medicare since it covers many costs that are not covered by Original Medicare Part A and B.
These standardized supplement plans are regulated under federal and state laws, but in Massachusetts, Minnesota, and Wisconsin, the standardization is different In most states, Medicare supplement plans are identified by the same letter, which means Medicare Supplement Plan L will be the same in every state that has it available.
The eligibility requirements for Medigap insurance include:
- applicants must be enrolled in original Medicare parts A and B
- only one person can be listed on the policy
- policyholders must continue to pay the Medicare Part B premium
You cannot have both a Medicare Supplemental Insurance (Medigap) and a Medicare Advantage Plan.
Medicare Supplement Plans vs. Medicare Advantage
Medicare Supplement plans work along with Original Medicare Part A and Part B, and fill the gaps resulting from certain costs that Original Medicare will not cover.
In contrast, Medicare Advantage plans (Medicare Part C) are an alternative to Original Medicare. When enrolled in a Medicare Advantage plan, the policyholder is still in the Medicare program.
Additionally, most Medicare Advantage plans include additional coverages like prescription drug and dental coverage that Medicare Supplement plans do not offer.
How Does the Cost of Medicare Supplement Plan L Compare with Other Plans?
Now that Medicare Supplements cannot cover the annual deductible in Medicare Part B, Medicare Supplement plans C and F cannot be purchased if the applicant became eligible for Original Medicare on January 1, 2020, or later.
With Plan L, the policyholder will have a trade-off of coverage for a lower premium, but for many the lower premium and limit on out-of-pocket expenses is worth the coverage trade-off.
Here’s how Plan L premiums compare with other very popular plans:
|Medicare Supplement Plan||Monthly Premium|
|Plan K||$62 – $135|
|Plan L||$119 – $301|
|Plan M||$201 – $430|
|Plan N||$146 – $289|
How Does Plan L Compare with Plans K, M, and N?
Since Medicare Supplement L is very popular because of its annual limit on out-of-pocket expenses and savings on monthly premium, here is the coverage difference between plans M and N which are also very popular because of coverages provided:
|Part A Coinsurance||100%||100%||100%||100%|
|Part B Coinsurance||50%||75%||100%||100%|
|Blood - First 3 Pints||50%||75%||100%||100%|
|Part A Hospice Coinsurance||50%||75%||100%||100%|
|Skilled Nursing Facility Coinsurance||50%||75%||100%||100%|
|Part A Deductible||50%||75%||50%||100%|
|Part B Deductible||X||X||X||X|
|Part B Excess Charges||X||X||X||X|
|Foreign Travel Emergency||X||X||80%||80%|
|Max Out-Of-Pocket||$6,220||$3,110||No Limit||No Limit|
Note: The out-of-pocket expense limit for Plan L is half that of Plan K.
Who is the Medicare Supplement Plan L Best Suited For?
When it comes to shopping for Medicare Supplement Plans (Medigap), we find that there are generally two kinds of shoppers:
- those who are dealing with health issues and are seeing one or more physicians several times each year. Generally, these individuals prefer a plan that covers all of the gaps found in Original Medicare Part A and Part B. and coverage is a priority over premium.
- those who are in good health and rarely see a physician except for an annual checkup and are more concerned about the monthly premium for coverage. Generally, these individuals are looking to limit their out-of-pocket expenses if a costly unexpected medical condition arises.
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