Medicare is a federally funded program that helps elderly and disabled individuals pay for healthcare services. Medicare plan L is one of the most popular types of plan coverage because it’s a stand-alone PPO plan which means there are no deductibles, co-payments, or coinsurance charges. You have access to any doctor or hospital in the country. This Senior Affair article will cover what you need to know about this type of healthcare coverage, including what it covers and whether or not it’s suitable for you.
Table of contents
What is Medicare Plan L?
Plan L is a Medic supplement plan covering Part A and Part B hospitalization benefits. However, this means it covers all the expenses related to your stay in a hospital, including emergency services, inpatient care, surgical care, and inpatient rehabilitation. Medicare plan L is not an insurance plan but a supplement to the original HMO, EPO, or PPO plans. But, on the other hand, you can only purchase it in addition to another Medicare plan.
Plan L is less comprehensive than regular private insurance, as with the other plans. It will not cover emergency transportation, complementary health services, or nursing care expenses. Instead, the client must pay for all these services even if they are plan L-eligible. According to the Medicare website, this plan only covers a hospital portion of benefits and inpatient care.
What Plan L Covers
The Medicare plan L supplement will cover 100% of the costs of covered hospital care if the client stays in a hospital for a period equal to or less than 60 days. If the client remains in a hospital for more than 60 days, Plan L will cover 75% of Part A’s daily coinsurance charge.
Plan L does not cover Part B medical expenses, medications, emergency transportation, or home health care services. Therefore, the client must pay all these expenses out-of-pocket. Plan L covers all insured persons 65 years or older, with Social Security benefits, in the United States and its territories.
What you need to know before enrolling
Plan L requires a monthly premium payment. However, this is the same as for other supplement plans. For example, plan L covers only those continuously insured under the original plans or their EPO, HMO, PPO, or military insurance. Plan L is not an insurance plan but a supplement to the original HMO, EPO, or PPO plans. On the other hand, they can only purchase it in addition to another plan.
What does Medigap Plan L not cover?
Plan L is only offered in addition to the other Medicare plans. However, it does not cover benefits like long-term care, transportation, and skilled nursing care. Therefore, the client must pay for these services out-of-pocket even if Plan L covers them. Although Plan L is a supplement to Medicare, it can only be purchased by individuals who have been continuously insured under the original plans or their equivalents EPO, HMO, PPO, or military insurance.
Plan L does not cover medical emergencies that happen while you are traveling abroad. The Medicare Plan L supplement does not cover any therapies, including those in the facility physician’s office. Instead, it covers only those services related to hospital stays, surgical procedures, and inpatient rehabilitation.
The out-of-pocket limit for Plan L is the same as for all other Medicare supplement plans. It is $1,200 for 12 months. Unlike many other supplement plans, Plan L has no time limit.
How do you purchase Medicare Plan L?
A person can buy this plan in a supplement insurance office or through a Qualified Purchaser QP. The person must already be enrolled in the Original plan. If the person is not yet insured under the original plans, they can enroll in one of these plans and add Plan L to their coverage.
You can also purchase this plan from a private insurance company or enroll directly through the designated plan page. The client must pay the Plan L premium. It is the same as for other supplement plans. If a person is already covered under Original plan L, they need to contact their insurance carrier to add Plan L to their coverage. If they still need a carrier, they must go to an insurance company and add this plan to their coverage.
Is purchasing Medigap Plan L a good idea?
It is good if you are already insured under regular plans and want to add this supplement to your benefits. You will have double protection in case of medical emergencies that require hospitalization. The two plans in place will help cover the expenses related to your stay in the hospital, including any surgeries or rehabilitation treatments.
Plan L will also help pay the costs of the services related to emergency transportation, home health care, and in-home nursing services. If you are already insured under the regular Medicare plans but want to add another supplement, it is not advisable to add Plan L. It does provide benefits that can help reduce your monthly premiums for other plans, and it will cover some of these expenses; however, there are still some services that are not covered by this plan, and you would have to pay for them.
Pros and Cons of Medigap Plan L
Medicaid Plan L is a supplement plan that helps cover Part A and Part B hospitalization expenses. However, this means it covers all the costs related to your stay in a hospital, including emergency services, inpatient care, surgical care, and inpatient rehabilitation. Medicare Plan L is not an insurance plan but a supplement to the original HMO, EPO, or PPO plans. But, on the other hand, they can only purchase it in addition to another plan.
- Low premiums
- High monthly benefits
- No time limit
- Covered medical expenses
- Only 75% coverage
- No coverage for Part B excess charges or foreign travel emergencies
Medigap Plan L is one of the most comprehensive supplement plans. It covers the expenses related to inpatient care, including surgery, inpatient rehabilitation, emergency transportation, and home health care. It also covers many other medical services that do not require hospital stays but are still very important. However, this plan still needs to cover certain critical services like skilled nursing care, which must be paid by the client out-of-pocket.
If you qualify for Medicare but don’t know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.