What Is Medigap Plan L? What You Need to Know
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Medigap Plan L is a Medicare Supplement Insurance plan that helps pay for certain out-of-pocket expenses associated with Medicare Part A and Part B coverage. Plan L may offer lower premiums because unlike other plans, it pays for 75% rather than 100% of most benefits.
How it works
After Medicare pays for its portion of covered services, Medigap plans help pay for the out-of-pocket costs that are left over. Medigap plans only work for beneficiaries with Original Medicare — Medicare Advantage members can’t buy a Medigap plan.
There are 10 standardized Medigap plans available in most states (except Massachusetts, Minnesota and Wisconsin, which use different standards). The plans differ in terms of coverage for services, out-of-pocket limits and premium costs.
Medigap Plan L pays for 75% of most of its covered services. (It’s similar to Plan K, which pays 50%.) So if you were billed for a $100 Part B coinsurance, Plan L would cover $75, and you’d owe the other $25 out of pocket.
Medigap Plan L also has an out-of-pocket limit — another feature it shares only with Plan K. When you reach Plan L’s limit of $3,530 for 2024, the plan pays for 100% of its covered services until the end of the calendar year.
Medicare will have big changes in 2025. Compare Medigap plans
What Medigap Plan L covers
Medigap Plan L covers the following, according to Medicare.gov:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
Part A deductible (75%).
Part A hospice care coinsurance or copayment (75%).
Part B coinsurance or copayment (75%).
Skilled nursing facility care coinsurance (75%).
Blood transfusion, first three pints (75%).
Annual out-of-pocket limit of $3,530 in 2024.
What Medigap Plan L doesn’t cover
Here are the benefits Medigap Plan L doesn’t cover that are included in some other plans:
Medicare Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).
Emergency care during travel outside the U.S.
Additionally, all Medigap plans — including Plan L — sold to new Medicare members don’t cover the following:
Part B deductible (since 2020, new Medicare members can’t buy any plan that covers the Part B deductible, although existing members may own older plans that do).
Prescription drugs (that's Medicare Part D).
Long-term care (like non-skilled care you get in a nursing home).
Private-duty nursing.
Shopping for Medigap plans? We have you covered.
MEDICARE SUPPLEMENT, or Medigap, is private health insurance that covers “gaps” in traditional Medicare coverage. Compare options from our Medigap roundup. | |
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How much does Medigap Plan L cost?
Plan L has lower premiums than most other Medigap options as a result of its reduced coverage. While the plan is regulated by the government, the private companies that sell policies set the prices. Premiums vary according to factors including age, location and tobacco use.
In Atlanta, a metro area with average costs for Medicare Supplement Insurance, monthly Medigap Plan L premiums for a 65-year-old female nonsmoker range from $127 to $208.
A $127 Medigap Plan L policy has the same standardized Medicare coverage as one that costs $208. Companies may add on extra perks like discounted gym memberships, but the core Medicare benefits are the same, so go ahead and compare based on price.
You can get the best price and have the easiest time enrolling in a Medigap plan during your Medigap open enrollment period.
This period happens only once. It starts once you’re 65 and enrolled in Medicare Part B, and lasts for six months. (If you're still working after 65 and covered by a group employer plan that is deemed creditable coverage, your six-month period starts after you’ve ended active employment or no longer have that insurance.)
Medigap policies are cheapest and easiest to get during this open enrollment period because insurance companies aren’t allowed to factor your health or medical history into your price. After the period ends, the prices may go up or you may be denied coverage due to your health status or medical history.
In some states, insurance companies sell Medigap plans to those under 65 who are living with a disability and are eligible for Medicare. You can find more information through your State Health Insurance Assistance Program, or SHIP.
Compare alternative plans
Get details on Medicare Supplement plan options | |
Coverage | Medigap Plan |
Basic benefits | |
Basics plus some extras | |
Highest coverage | |
Lower premiums, but higher copays | |
Lowest premiums — partial coverage | |
No longer for sale to new Medicare members | |
Medicare will have big changes in 2025. Compare Medigap plans
