Medigap Plan L is a Medicare supplement insurance plan that provides coverage for certain medical expenses not covered by Original Medicare. It offers a slightly different level of coverage compared to other Medigap plans, with the goal of reducing your out-of-pocket costs.
With Medigap Plan L, you will be responsible for paying a portion of your healthcare expenses, including Medicare Part A coinsurance and hospital costs, Medicare Part B coinsurance or copayment, and blood expenses. The plan covers 75% of your Part A hospice care coinsurance or copayment, as well as 75% of skilled nursing facility care coinsurance.
Similar to other Medigap plans, Medigap Plan L also has an out-of-pocket limit ($3.530 for 2024). Once you reach this limit in annual out-of-pocket expenses, the plan will cover 100% of your covered services for the rest of the year. This feature provides some financial protection and helps you manage your healthcare costs.
Medigap Plan L may be a suitable option if you are looking for a lower-cost plan and are willing to share a larger portion of your medical expenses. However, it's important to carefully consider your healthcare needs and budget to determine if this plan meets your coverage preferences. Remember to review the specific benefits of Medigap Plan L and compare them with your individual healthcare requirements before making a decision.
Below is a comprehensive list of the covered services provided by Medicare Supplement Plan L, which include benefits under Medicare Part A, Medicare Part B, and other areas:
Service | Who pays what? |
---|---|
First 60 days | Medicare pays: All cost but $1,632 Plan pays: 75% of Part A Deductible ($1,224) Member pays[*]: 25% of Part A Deductible ($408) |
61st thru 90th day | Medicare pays: All cost but $408/day Plan pays: 75% of cost ($306/day) Member pays[*]: 25% of cost ($102/day) |
91st day and after (While using 60 lifetime reserve days) | Medicare pays: All cost but $816/day
Plan pays: 75% of cost ($612/day) Member pays[*]: 25% of cost ($204/day) |
Once lifetime reserve days are used; additional 365 days | Medicare pays: Nothing Plan pays: 75% of Medicare-eligible expenses Member pays[*]: 25% of Medicare-eligible expenses |
Beyond the additional 365 days | Medicare pays: Nothing
Plan pays: Nothing Member pays[*]: All cost |
Service | Who pays what? |
---|---|
First 20 days | Medicare pays: All cost Plan pays: Nothing Member pays[*]: Nothing |
21st thru 100th day | Medicare pays: All but $204/day Plan pays: Up to 75% (Up to $153/day) Member pays[*]: Up to 25% (Up to $51/day) |
101st day and after | Medicare pays: Nothing Plan pays: Nothing Member pays[*]: All cost |
Service | Who pays what? |
---|---|
Hospice Care | Medicare pays: All but very limited
copayment/ coinsurance for outpatient drugs and inpatient respite care Plan pays: 75% of Medicare copayment and coinsurance Member pays[*]: 25% of Medicare copayment and coinsurance |
Service | Who pays what? |
---|---|
Part B Deductible | Medicare pays: Nothing Plan pays: Nothing Member pays[*]: $240 (Part B Deductible) |
Part B Coinsurance | Medicare pays: 80% Plan pays: %15 of all cost Member pays[*]: 5% of all cost |
Part B Excess Charges
(above Medicare approved amounts) | Medicare pays: Plan pays: Nothing Member pays[*]: All cost |
Service | Who pays what? |
---|---|
Test for diagnostic lab services | Medicare pays: All cost Plan pays: Nothing Member pays[*]: Nothing |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: All cost Plan pays: Nothing Member pays[*]: Nothing |
Additional amount (First $226 of
Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays[*]: $240 (Part B deductible) |
Remainder of Medicare approved amounts | Medicare pays: 80% Plan pays: 15% of all cost Member pays[*]: 5% of all cost |
Service | Who pays what? |
---|---|
Medically necessary skilled care
services and medical supplies/ Durable medical equipment (First $226 of Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays[*]: $240 (Part B deductible) |
61st thru 90th day | Medicare pays: 80% Plan pays: 15% of all cost Member pays[*]: 5% of all cost |
Service | Who pays what? |
---|---|
First $250 each calendar
year/Remainder of charges | Medicare pays: Nothing Plan pays: Nothing Member pays[*]: All cost |
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