Medicare Supplement Plan L assists with the payment of certain out-of-pocket expenses associated with Medicare Parts A and B. Plan L, unlike most Medicare Supplement Plans, pays only a portion of the cost of covered services. As a result, you’ll still have some out-of-pocket expenses with this plan. However, the premiums for this plan are less expensive than those of most other Medicare Supplement Plans.
It’s important to note that, unlike some other Medicare Supplement Plans, Plan L has copayments. That means, with this plan, you will be responsible for copayments in addition to deductibles. As well as a portion of your Medicare coinsurance, in addition to the monthly premium for your policy.
But also, unlike other Medicare Supplement Plans, Plan L has an out-of-pocket maximum, which Original Medicare doesn’t. That will probably mean that Plan L would be a welcome addition to your healthcare coverage. Since it offers more benefits than Original Medicare (Parts A and B) alone.
What Plan L Covers
Medicare Supplement Plan L covers the majority of the costs associated with Original Medicare, but not all of them. It also has an out-of-pocket maximum. So, once you pay a certain amount in medical expenses for the year, your insurer will pay your bills in full.
Plan L covers all of Medicare Part A coinsurance and hospital costs. It also covers 75% of the following:
- Medicare Part B coinsurance – Medicare Part B typically charges coinsurance for doctor visits and other outpatient care. After you meet your Part B deductible for the year, Medicare Part B typically pays 80% of the Medicare-approved amount for covered services. Leaving you to pay the remaining 20% (your coinsurance). Plan L covers 75% of your Part B coinsurance.
- Blood – If you require a blood transfusion during a medical procedure, Original Medicare will only pay for the fourth pint of blood and beyond. If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Some hospice care services are covered by Medicare Part A, but there are copayments. Copays for certain prescription drugs are $5, and for inpatient respite care the copayment is 5% of the Medicare-approved amount. Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023. Plan L pays 75% of the coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – You must meet a deductible before your Part A coverage begins. In 2023, the Medicare Part A deductible is $1,600 per benefit period. This deductible is not charged on an annual basis. Instead, it’s based on 60-day benefit periods, you may have to pay it more than once in a single year. Each benefit period, Plan L will cover 75% of the deductible cost. You must still meet your Medicare Part B deductible. Which is $226 per year in 2023, if you choose Plan L.
As pointed out above, Plan L has an out-of-pocket maximum. So, while this plan only pays 75% of the above-mentioned out-of-pocket expenses, once you spend $3,310 out-of-pocket in a year, your medical expenses will be completely covered. That might sound like a lot. But remember you will be responsible for all out-of-pocket costs if you do not have a Medicare Supplement Plan. And Original Medicare does not have an out-of-pocket maximum.
Having a Medicare Supplement Plan ensures that you will never have to pay 100% of your Medicare-related costs.
What Isn’t Covered?
Medicare Supplement Plan L does not cover the Part B deductible, which is $226 in 2023. As well as Part B excess charges and foreign travel emergencies. If you never leave the country, not having coverage for emergencies in other countries will not be a problem.
But since Part B excess charges are not covered make sure that none of your healthcare providers charge excess fees. Most providers do not, but if they do, you may have to pay up to 15% more than what Medicare would pay for the service.
Additionally, Medicare Supplement Plans only cover one person. If your spouse needs a policy, you will need to purchase separate policies.
The Cost of Medicare Supplement Plan L
Because of its limited coverage, Plan L has lower premiums than most other Medicare Supplement Plans. Medicare Supplement Plan L typically costs between $100 and $200 per month. But monthly Medicare Supplement Plan premiums are set by the private companies that sell policies, so you could pay more or less. Premiums vary depending on factors such as your age, location, and tobacco use. But your benefits will never change, since the government regulates them.
As pointed out above, Medicare Supplement Plan L pricing varies by insurance company. There are three pricing options for Medicare Supplement Plans: community-rated, issue-age-rated, and attained-age-rated:
- Community-rated – These plan premiums are based on location. With this type of pricing, everyone who has the same Medicare Supplement Plan in the same geographical area pays the same monthly premium, regardless of age. Premiums may rise due to inflation and other factors, but not due to your age.
- Issued-age-rated – In this case, your premium is determined by the age you are when you purchase your Medicare Supplement Plan. Premiums will be lower the younger you are, and will not increase as you get older. Premiums may rise due to inflation and other factors, but not due to your age.
- Attained-age-rated – This means that your premium will be calculated based on your current age, with the premium increasing as you get older. Premiums will be lower when you are younger, but they will continue to rise as you get older. Premiums may rise as a result of inflation or other factors, as well.
Enrolling in Medicare Supplement Plan L
The best time to enroll in a Medicare Supplement Plan is during your Medicare Supplement Open Enrollment Period. This is because doing so will mean you’ll be given guaranteed issue rights. That means you can’t be denied or charged more for a plan because of your health.
This Open Enrollment Period only occurs once, so make sure you take advantage of it. It begins when you are 65 and enrolled in Medicare Part B and lasts for 6 months. If you continue to work after the age of 65 and have a group employer plan your six-month period begins when you stop working or no longer have that insurance.
So, because insurance companies can’t factor your health or medical history into your price, Medicare Supplement Plans are the cheapest and easiest to obtain during this Open Enrollment Period. Prices may rise after this period ends, or you may be denied coverage due to your medical history, since you may have to undergo a medical exam or a review of your medical history (underwriting).
Be aware that all ten standardized Medicare Supplement Plans are not available from every insurance company. So, you might have to look into multiple insurers to find the specific plan you want, at a price that is right for you.
- What is the difference between Plan L and Plan K?
If you’re comparing Medicare Supplement Plans L and K, remember that Plan L provides more benefits and a lower out-of-pocket maximum. Plan K pays 50% of some out-of-pocket expenses. While Medicare Supplement Plan L pays 75% until you reach the out-of-pocket maximum of $3,470 (in 2023).
But either Plan K or Plan L may be a good fit if you prefer coverage similar to your employer’s health insurance plan, and are not concerned about out-of-pocket costs.
- Who can benefit the most from Plan L?
Consider Plan L if you want a lower premium, as well as a lower annual out-of-pocket maximum before the plan pays 100% of your hospital expenses. This can be useful for unexpected medical emergencies. As well as for people who have chronic health conditions that necessitate a lot of ongoing medical care.
- Does Plan L cover pre-existing conditions?
While insurance companies cannot force you to wait for coverage from a Medicare Supplement Plan to begin, they may force you to wait for coverage for a pre-existing condition. Your insurer can deny pre-existing condition coverage if you receive a diagnosis or treatment within 6 months of the start date of the Medicare Supplement Plan.
After the 6-month waiting period, Your Medicare Supplement Plan will cover the condition. But remember, if you purchase a Medicare Supplement Plan during your Medicare Supplement Open Enrollment Period to replace a “creditable coverage” plan, you can avoid or shorten the waiting period for a pre-existing condition.
How EZ Can Help!
If you’re looking for a Medicare Supplement Plan, it is essential that you compare the benefits and costs of each one. That means doing a lot of research, which can take a long time, since you’ll have to call multiple insurance companies to get rate quotes.
But if you work with one of EZ’s agents, you can cut the time it takes to compare prices in half. Working with a licensed agent gives you access to multiple Medicare Supplement Plan carriers and plans in one place.
Your agent can explain the differences between each plan, in addition to offering your price comparisons. Furthermore, your agent can help you weigh out-of-pocket costs versus premium costs to determine which plan will be the most cost-effective for you. To begin comparing Medicare Supplement Plans, call us at 877-670-3602 today or enter your zip code in the bar below to compare plans online.