Medicare Supplement Plan L
Medicare Supplement Plan L does offer some attractive benefits. However, the cost-sharing may or may not work for you.
Traditional Medicare will leave you with many out of pocket expenses; this is due to the gaps in coverage. Original Medicare leaves you responsible for your Part A and B deductible in addition to 20% of the bill.
“First-dollar” coverage plans cover all the gaps in Medicare. Cost Share plans will leave some responsibilities to you, like Plan L.
With a cost-share plan, you’re responsible for some of the healthcare cost, but not all. Plan L certainly has more coverage than traditional Medicare.
Medicare Supplement Plan L Cost Sharing Benefits
Medigap Plan L isn’t the most comprehensive coverage; however, it boasts good coverage at a slightly lower premium than a typical Plan F.
Plan L will cover in full:
- Part A coinsurance and hospital costs
- Up to an additional 365 days after Medicare benefits are exhausted
Plan L will cover 75% of:
- Part B Coinsurance
- First 3 Pints of Blood
- Part A deductible
- Part A Hospice Care Coinsurance
- Skilled Nursing Facility Coinsurance
With every Medicare Supplement, you’ll have access to every doctor that accepts Medicare Assignment in the United States. You can even see any specialist you want, without a referral from your primary care doctor.
Additionally, coverage is guaranteed renewable, meaning coverage can’t be canceled over deteriorating health.
As you can tell, Plan L isn’t a bare-bones policy. Coverage exists where coverage is needed.
Although, there are some things not covered by Plan L that are important to note.
Plan L is Ideal for Those Who:
- Want a lower monthly premium
- Don’t travel outside the U.S.
- Are not concerned about excess charges
Maximum Out of Pocket on Plan L
If you’ve been confused by the term “Maximum Out of Pocket” (MOOP), fear no more. The MOOP is a protection or safety net designed with you in mind.
This is the most you can pay in a calendar year on covered services. For Plan L, the MOOP is $2,780 in 2019.
Although this amount could change annually.
For 2019 the most you can spend on your covered healthcare (outside of the premium of course) is $2,780.
This means if you develop a severe illness and find yourself in and out of the hospital, the most you’ll pay outside your premium is $2,780.
So, once you’ve spent that much on healthcare, you can expect 100% coverage from your carrier on any further covered services during the year.
How Plan L Works
Let’s say Andy has Medigap Plan L and he experiences a heart attack in the grocery store. Well, the ambulance ride is the Part B deductible and coinsurance. So, Andy pays the $185 annual Part B deductible if he hasn’t met that yet; then, Andy pays 25% of the remaining Part B coinsurance.
Andy is going to be inpatient at the hospital, which means his plan pays the Part A deductible in full. Then, Andy will pay 25% of the remaining Part A coinsurance balance. If Andy lives in a state that allows excess charges, he could be responsible for those costs.
Since Andy uses his monthly premium savings to add to an exclusive account, he has the funds set aside to cover these cost-sharing amounts. Now, if you think you’re not comfortable with coverage that requires out of pocket spending, the Plan G or Plan F could be a more suitable option.
Medicare Supplement Plan L Won’t Cover This
When you select a cost-share policy, it means you’ll be responsible for some of the costs associated with your healthcare. Many Medigap plans require beneficiaries to cover some out-of-pocket expense.
Plan L requires you to be responsible for the costs of:
- Part B deductible
- Foreign Travel Emergency care
- Medicare Part B excess charge
Out-of-pocket expenses can be found in the form of a deductible, coinsurance, or copayment. First dollar plans that cover these gaps are retiring in 2020.
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 is eliminating first-dollar coverage for new Medicare beneficiaries beginning on January 1, 2020
Does Medigap Plan L Come with Part D Coverage
If you have a Medicare Supplement, you’re covered when the hospital is administering prescriptions. Although, if the prescribing doctor gives instructions for an at-home drug, you’ll want Part D coverage.
Prescription drug coverage is easy to enroll in, and it protects you for the Part D late enrollment penalty.
Plan L Dental, Vision & Hearing benefits
Medicare Supplement Plan L policy doesn’t cover dental, vision, or hearing; there are still stand-alone policies you can enroll in.
These policies make sense because they’re the price is a bargain, and it’s necessary to have comprehensive coverage when you need it most.
Enrolling in Medicare Supplement Plan L
Having a Medigap policy will protect you from 20% of thousands of dollars or more depending on your health that year.
Depending on when you enroll in a Medicare Supplement, you may qualify for Guaranteed Issue. Meaning, there isn’t any medical underwriting.
You qualify for this during the first six months of your Part B effective date. Although you can apply at any time.
Beneficiaries involuntarily losing coverage are eligible for Plan L enrollment.
The application process is simple, and talking to a licensed insurance agent in your state can make it super easy.
I Can’t Afford Plan L, What Now
Plan N has incredible benefits, and many seniors select it as an option. It’s a simplified plan with a few copays and comprehensive coverage.
If you want more coverage than this, Plan G offers more coverage for a slightly higher premium than Plan N.
Talking to a licensed insurance agent will make selecting coverage easy.
Free Medicare Assistance
Our licensed insurance agents offer time to you, absolutely free. Since Medicare continually changes, it’s nice to have a personal agent in your corner.
Our agents can help answer your pre-enrollment questions, learn about eligibility, and apply for coverage.
Once you become a member, our client care team will keep you informed on Medicare changes as well as assist you with claims and appeals.
Having a policy with us means a team of people that care about your coverage just as much as you are available to call anytime.
Get started by giving us a call at the number above. You can also complete our online rate comparison form to see Medicare Supplement Plan L rates side by side from all the top carriers near you.