With Medicare Supplement Plan L, you’ll be paying a slightly lower premium and receive a maximum out-of-pocket limit of $3,110 (in 2021). Plan L will also cover a specific percentage of your medical expenses.
Coverage for Plan L
Plan L provides 100% coverage for Medicare Part A coinsurance and hospital costs, but only covers 75% of these expenses:
- Part A deductible
- Hospice care coinsurance expenses or copayments for Part A
- Copayment or coinsurance expenses for Medicare Part B
- Skilled nursing facility care coinsurance
- First three pints of blood used in a medical procedure
What is not covered by Plan L?
By choosing Plan L, you will be expected to pay a certain amount for out-of-pocket costs. Since Plan L only covers 75% of the benefits listed above, you will need to pay the remaining 25%, which will be a mixture of coinsurance, copayments, and deductibles. You will also be expected to cover your Medicare Part B deductible, excess charges, and any foreign travel emergencies you might have.
You may or may not receive a bill for excess charges, which can cost up to 15% of costs that Medicare agrees to pay and are only charged if your doctor believes the Medicare amount is not enough. Either way, make sure to confirm with your doctor if they do send out bills and if they accept Medicare assignment. Medicare assignment is what Medicare states it’ll pay for a service.
Maximum Out-of-pocket Limit
Plan L is one of two Medicare Supplement plans that offer a maximum out-of-pocket limit set to \$3,1100 for 2021. The purpose of an out-of-pocket limit is to limit what you can spend on your medical expenses each year. Once you hit that limit, then your supplement plan pays 100% of the covered benefits it offers for the remainder of the calendar year. However, you’ll still be expected to pay your premium, any services that aren’t covered under Plan L, services received from out of the network, and costs that a provider may charge but are over the allowed amount.