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Medigap Plan L

While many Medigap plans either pay or don’t pay for an out-of-pocket expense, Plan L often pays 75% of an expense. The table below illustrates this benefit tendency within Plan L (for example, see “Medicare Part A Deductible” and “Copayment or Co-Insurance Fee for Medicare Part A Hospice Care”).

Plan L Coverage
Medicare Part A Deductible75% coverage
Medicare Part B DeductibleNo coverage
Medicare Part B “Excess Charges”*No coverage
Copayment or Co-Insurance Fee for Medicare Part B services75% coverage
Part A Co-Insurance Fees & Hospital Costs for up to 365 days after Original Medicare Benefits are Exhausted100% coverage
Cost of first 3 Pints of Blood75% coverage
Copayment or Co-Insurance Fee for Medicare Part A Hospice Care75% coverage
Co-Insurance Fees for Skilled Nursing Facility Care75% coverage
Foreign Travel Medical Emergency Coverage (up to plan limits)No Coverage
Annual Limit on Enrollee Out-of-Pocket Expenses?$2,470

Plan L has an annual out-of-pocket limit of $2,470. Once an enrollee’s out-of-pocket costs reach this amount, Plan L fully pays for all remaining out-of-pocket costs for covered services until the beginning of a new calendar year. Plan L is one of only two Medigap Plans that have an annual limit on Medicare out-of-pocket costs. Plan K is the other Medicare Supplement insurance plan with an annual out-of-pocket limit.

Plan L may be attractive to Medicare beneficiaries who want to protect themselves from catastrophic out-of-pocket costs but don’t mind the prospect of paying $2,470 in a year if they have heavy healthcare use.

If you desire coverage for all of the out-of-pocket costs listed in the above table, you may want to investigate Plan F.

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