Along with Medigap Plan K, Medigap Plan L is one of the two Medigap plans that offer only partial coverage of costs not covered by traditional Medicare plans. Nevertheless, the allure of Medigap Plan L lies not only in the coverage that the policy provides but in the plan’s low monthly premiums which are offset by costs shared by policyholders. If you’re in the market for a Medicare supplement, the information below will help you determine if Medigap Plan L is the best option for your needs.
Coverage Provided by Medigap Plan L
Like most other Medigap plans, Medigap Plan L offers coverage to a specific list of health-related services which are regulated by federal guidelines. However, while most plans cover 100% of specific services, Medigap Plan L covers only 75% of the fees for these services. Medigap Plan K, in contrast, covers only 50% of the services. Therefore, seniors in search of a ‘middle ground’ policy may find exactly what they’re looking for in Medigap Plan L.
Medigap Plan L covers all Medicare Part A coinsurance as well as the cost for hospital stays up to 365 days once standard Medicare coverage is exhausted. In addition, Medigap Plan L covers 75% of the following services:
Medigap Part L does not cover any deductibles that are not covered by Medicare Part B, nor does it cover health insurance while traveling. Seniors holding a Medigap Plan L policy will be required to pay out-of-pocket fees up to $2400. Once that limit is reached and the annual Medicare Part B deductible is met, the plan will cover 100% of the services listed above.
Who is Eligible for Medigap Plan K?
Medigap Plan L is available in all states with the exception of Wisconsin, Minnesota and Massachusetts, all of which have slightly different Medicare supplement insurance policies in place. In the remaining 47 states a ‘guaranteed issue’ law is in effect, requiring all insurance companies that offer Medigap Plan L to accept any application for coverage of seniors aged 65 and over, even if pre-existing health conditions are present. Still, in some cases a six month waiting period may be imposed before some services are covered.
As is the case with all Medigap plans, seniors are not covered by Medigap Plan L simply because their spouse owns a policy. Instead, every senior must apply for a Medigap plan independently. Medicare Advantage holders must terminate their existing Medicare supplement policy before their application for Medigap Plan L can be approved.
Enrollment Times for Medigap Plan L
Applications for Medicare coverage can be accepted from the first day of the month in which a senior turns 65, and for six consecutive months afterwards. During this time, all seniors can opt to purchase Medigap Plan L coverage. If this term, referred to as one’s ‘personal enrollment period,’ passes and a Medigap plan has not been chosen, the senior can always register during the nationwide open enrollment period, which falls between October 15 and December 7 annually. Special applications can be submitted by seniors who have Medigap Plan L but move to a new county during a time when registration is not open and need to apply for continuing coverage in their new area when their previous local plan is no longer relevant.
Medigap Plan L Costs
As is the case with most forms of health insurance, the price of Medigap Plan L fluctuates based upon the applicant’s age, health status, geographic location and a host of other factors. Still, because Medigap Plan L only covers 75% of most services and has a $2400 out-of-pocket requirement, its monthly premiums tend to be notably less than the premiums for most other Medigap plans. Recent surveys have shown that the lowest Medigap Plan L premium hovers somewhere around $700, though the price can reach as high as $3000. It is vital to understand that prices vary from insurance agent to insurance agent, and that shopping around is the best way to ensure that you’re paying the lowest possible price for your Medigap Plan L coverage.
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