Medicare Plans by Turning 65 Solutions


Medicare Supplement (Medigap) Plan L

Medigap Plan L covers a portion of your out-of-pocket costs left over from Original Medicare. Just like Plan K and Plan M, it is a cost-sharing supplemental insurance plan. Because of that, it has the maximum out-of-pocket limit beneficiaries can spend before their policy starts to cover all the costs for the rest of the year. The MOOP for this plan is 3470$ in 2023.

However, only two Medicare Supplement Insurance policies feature this out-of-pocket maximum — Plan L and Plan K. Due to this factor and lower premiums, it could be worth the added cost-sharing for Medicare beneficiaries.

Medigap Plan L Coverage

It is one of the 10 standardized supplement plans, which help out cover the costs left by Original Medicare, but also one of 3 types of cost-sharing plans because its benefits don’t include coverage 100% for all services.

In addition to the out-of-pocket limit ($3470$ in 2023), Medicare Supplement Plan L will provide this type of benefits by percentage to its beneficiaries:

  • 100% Medicare Part A hospital costs coinsurance (up to additional 365 days)
  • 100% Medicare Part B preventive care or coinsurance
  • 75% Medicare Part A deductible
  • 75% Skilled nursing facility care coinsurance
  • 75% Medicare Part B copayment
  • 75% Part A hospice care coinsurance or copayment
  • 75% The first three pints of blood used in a medical procedure

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Medicare Supplement Plan L Out-Of-Pocket Expenses

Under Plan L, you will pay some out-of-pocket expenses associated with Medicare. These costs might be:

  • Foreign travel emergency
  • Medicare Part B deductible which is 226$ in 2023
  • Medicare Part B excess charges: which can be billed to you if you seek hospital and medical services where it is not accepted Medicare Assignment. This means that they don’t accept Medicare payment as payment in full, so they can charge you up to 15% higher than the Medicare-approved amount.

You will also pay 25% of your Original Medicare copayment costs, Part A’s deductible, skilled nursing facility coinsurance, and the first three pints of blood for a medical procedure. You will pay lower premiums because of the cost-sharing. The monthly premium for this plan can be from 80$ to 180$ per month.

Medigap Plan L Out-Of-Pocket Maximum Cap Protection

Although you have some out-of-pocket costs with Medicare Supplement Plan L, there is a maximum cutoff point. Medicare sets the limit each year. In 2023, this limit is $3470. Once you spend this amount of money, the plan protects you which means that the provider will cover 100% of expenses that are left for the rest of the calendar year. The only other plan that has maximum cap protection is Plan K, and its limit is 6940$. Plan K’s monthly premium cost, is lower in comparison to plan L so, you might also consider this plan if you are thinking about cost-sharing plan types. However, this plan covers only 50% of services left by Original Medicare. 

If covering a portion of your out-of-pocket Medicare costs while still having a lower premium sounds intriguing to you, let us help. Call Turning 65 Solutions at 830-313-5173.