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Understanding Medigap Plan L

Medicare is a government-run health insurance program that helps seniors and other eligible individuals pay for medical care. However, Medicare doesn’t cover everything. Gaps in coverage can leave beneficiaries responsible…

November 18, 2022

Written by Nikki Grillo

Medicare is a government-run health insurance program that helps seniors and other eligible individuals pay for medical care. However, Medicare doesn’t cover everything. Gaps in coverage can leave beneficiaries responsible for a significant portion of their medical costs.

Luckily, Medigap plans are private health insurance policies that help to cover some gaps in Original Medicare. There are many different Medigap plans available, including Plan L. This blog post will discuss Medigap Plan L, what it covers, and more.

What Is Medigap Plan L, And What Does It Cover?

As we mentioned, Medigap Plan L is a supplemental health insurance policy that helps cover the gaps in Original Medicare coverage. The federal government standardizes all Medigap Plans. Therefore, you know you’re getting the same coverage no matter which company you purchase your policy from.

Plan L covers:

  • 100% of Part A coinsurance and hospital fees for up to an extra 365 days after you’ve used your Medicare benefits.
  • 75% of Part B copayments or coinsurance.
  • 75% of the first three pints of blood you need each year.
  • 75% of Part A hospice care copayments or coinsurance.
  • 75% of skilled nursing facility care coinsurance.
  • 75% of Part A deductible.
  • 100% of covered services after you reach your $3,310 yearly out-of-pocket-limit.

Plan L doesn’t cover:

  • Part B deductible. Your deductible is the amount you must pay each year for Part B-covered services before your Medigap policy begins to pay. In 2022, the Part B deductible is $233.
  • Part B excess charges. When you receive care from a doctor who doesn’t accept Medicare assignments, they can charge you up to 15% more than the Medicare-approved amount for their services. These are called excess charges.
  • Foreign travel emergency care. If you require emergency care outside the U.S., your Plan L policy won’t cover it. You may consider purchasing a supplemental policy covering foreign travel emergencies.

Medigap Plan L Eligibility And Enrollment Periods

You must first be a beneficiary of Original Medicare to be eligible for a Medigap policy. Original Medicare is available to people 65 or older or younger people with disabilities. If you have End-Stage Renal Disease (ESRD), you may also be eligible for Original Medicare regardless of age. There are two times when you can sign up for a Medigap policy:

During Your Open Enrollment Period

You get a six-month window to enroll in a Medigap policy when you first become eligible for Original Medicare. You can sign up for any Medigap plan during the Open Enrollment period. Your insurer can’t refuse to sell you a policy or charge you more because of your health.

Outside Of The Open Enrollment Period

Suppose you don’t enroll during your Open Enrollment Period. In that case, you may still be able to purchase a policy, but you may have to go through medical underwriting. The insurance provider will examine your medical history to determine if they will approve your coverage and at what rate.

How To Enroll In Medigap Plan L

If you’re ready to enroll in Medigap Plan L, the first step is to find insurance companies that sell the plan in your area. Alternatively, you can team up with a Medicare insurance agent to help you find the best policy for your needs. Once you’ve found a few insurers that offer the plan you’re interested in, it’s time to start checking prices.

When comparing plans, look at more than just the monthly premium. You’ll also want to consider factors like:

  • The insurer’s experience.
  • How easy it is to contact customer service.
  • The company’s reputation.

After deciding on an insurer, you can apply for coverage online, over the phone, or through a paper application.

Medigap Plan L Costs

The cost of Medigap Plan L will vary depending on the insurer you choose and where you live. Medigap plans are generally more expensive in states with higher health care costs. You’ll also pay more if you choose a plan with extra coverage.

Remember that you’ll still have to pay your Part B premium, which is $170.10 per month in 2022. That said, there are some ways to save money on your Medigap Plan L premium. For example, if you’re married, you may be able to get a discount on your premium. Some insurers also offer discounts for policyholders who don’t smoke.

Nesso Senior Benefits – We Help You Find The Right Health Insurance Plan

At Nesso Senior Benefits, we understand that choosing the right health insurance plan can be daunting; that’s why we’re here to assist you. We’ll work with you to understand your needs and find the best Medigap policy for you. Our team is honest and transparent, and we’ll always have your best interests at heart. Contact the Nesso Group today, and attain confidence in your life decisions


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