Medicare Supplement Plan L is one of the two Medigap plans with a yearly cap on out-of-pocket spending.
Medigap plans, also called Medicare supplement plans, are offered by private companies to help cover some healthcare costs not paid for by original Medicare.
Read on to learn more about Medicare Plan L coverage and more.
A Medigap Plan L policy helps cover many of the gaps in your original Medicare coverage, such as the Part A deductible.
Below are things that are and aren’t covered:
|Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up||100%|
|Part A deductible||75%|
|Part A hospice care coinsurance or copayment||75%|
|blood (first 3 pints) / (after first 3 pints)||75%/100%|
|skilled nursing facility care coinsurance||75%|
|Part B coinsurance or copayment||75%|
|Part B deductible||not covered|
|Part B excess charge||not covered|
|foreign travel exchange||not covered|
If you purchase a Medigap Plan L policy, it will only cover you. If your spouse is eligible for Medicare and needs Medigap coverage, they’ll need to purchase a separate policy.
Medigap plans, including Plan L, don’t cover outpatient prescriptions. If you want this coverage, you must purchase Medicare Part D.
Keep in mind: You can’t have both a Medigap plan and a Medicare Advantage Plan.
The following services and treatments aren’t covered by Medicare Plan L:
- outpatient retail prescriptions
In 2020, the out-of-pocket limit for Plan L is $3110. Once you meet your yearly Part B deductible ($198 in 2020) and your out-of-pocket yearly limit, Medigap will pay for 100 percent of covered services for the rest of the year.
A popular feature of Medigap Plan L is the yearly cap on out-of-pocket spending. Only 2 of the 10 Medigap plans offer this feature:
- Medicare Supplement Plan L: out-of-pocket limit of $3110 in 2021
- Medicare Supplement Plan K: out-of-pocket limit of $6220 in 2021
With original Medicare and the other 8 Medigap plans (A, B, C, D, F, G, M, N), there’s no cap on your yearly out-of-pocket healthcare costs.
What does a yearly out-of-pocket limit mean?
Once you’ve met your yearly Part B deductible and your out-of-pocket yearly limit, 100 percent of all covered services for the rest of the year are paid for.
Because of the out-of-pocket limit, purchasing Plan L can help you identify your maximum out-of-pocket health expenses for the year. This may be especially useful if you:
- expect high costs for ongoing medical care, such as with an existing chronic health condition
- are worried about a potential financial drain if you should experience an expensive health situation
Medicare Plan L is one of the Medigap offerings to help cover some costs not paid by original Medicare. One popular feature of this plan is capping your annual Medicare-related out-of-pocket costs.
Coverage not included with Medigap Plan L includes vision, hearing, dental, and prescription drugs.
This article was updated on October 30, 2020, to reflect 2021 Medicare information.
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