Medigap Plan L Overview
Medicare Supplement Plan L fills in some of the gaps in coverage that Original Medicare leaves. Plan L offers supplemental coverage that has a lower monthly premium than some other Medigap plans because it has less benefits.
Remember Medigap plans are designed to complement Original Medicare Part A and Part B. Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you enroll in Medigap Plan L.
Medigap Plan L Benefit Details
|Benefits||Original Medicare Alone||Original Medicare With Medigap Plan L|
|Doctor Network||All Doctors that accept Medicare||All Doctors that accept Medicare|
|Part A Hospital Benefit Period Deductible||You pay $1,408*||You pay 25%|
|Hospital days 61-90||You pay $352 per day per day||You pay $0, after Part A deductible|
|Hospital Days 91-150||You pay $704 per day per day (lifetime reserve days)||You pay $0, after Part A deductible|
|Beyond Lifetime Reserve Days||You pay 100%||You pay $0 up to an additional 365 hospitalization days.|
|Skilled Nursing Facility Care Days 1-20||You pay $0 (Part A deductible applies)**||You pay $0, after Part A deductible|
|Skilled Nursing Facility Care Days 21-100||You pay $176 per day||You pay 25%, after Part A deductible|
|Hospice Respite Care||You pay 5%||You pay 1.25%|
|First 3 Pints of Blood||You pay 100%||You pay 25%, after Part B deductible|
|Additional Blood||You pay $0||You pay $0, after Part B deductible|
|Part B Annual Deductible||You pay $198||You pay $198|
|Ambulance||You pay 20% (Part B deductible applies)||You pay 5%, after Part B deductible|
|Doctor’s Office Copays/Coinsurance||You pay 20% (Part B deductible applies)||You pay 5%, after Part B deductible|
|Durable Medical Equipment||You pay 20% (Part B deductible applies)||You pay 5%, after Part B deductible|
|Part B Excess Charges||You pay 100% (Part B deductible applies)||You pay 100% (Part B deductible applies)|
|Foreign Travel Emergency||You pay 100%||You pay 100%|
|Out-Patient Surgery||You pay 20% (Part B deductible applies)||You pay 5%, after Part B deductible|
|Urgent Care||You pay 20% (Part B deductible applies)||You pay 5%, after Part B deductible|
|Max Out of Pocket||No Max||$2470|
Next Steps for Medigap Plan L
The fine print of the Medigap Plan L Chart Above
*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,408).