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Medigap Plan L

Medigap Plan L Policy Coverage
Basic Benefits 75%
Part A Deductible 75%
Part B Deductible
Part B Excess
Skilled Nursing Coinsurance 75%
Foreign Travel Emergency
At Home Recovery
Additional Preventative Care


Quick Introduction to Medigap Plans

Medigap is a private health insurance policy that is designed to cover medical costs not covered by Medicare programs. It covers many of the costs that people would otherwise have to pay individually such as copayments, coinsurance, and deductibles. There are twelve different Medigap plans ranging from A to L. Any insurance company offering Medigap plans is required to offer Plan A, other plan availability will vary by insurance company and by state. Medigap policies do not cover long-term care such as nursing homes, vision or dental care, hearing aids, eyeglasses or private-duty nursing. This article will deal exclusively with Medigap Plan L policies covering some of the benefits and other considerations.

More on Medigap Plan L Policies

Medigap Plan L is designed to cover seventy-five percent of basic and other common costs. Some benefits may be used often while others may not be needed at all. Keep in mind that without the Medigap coverage you would have to pay out of pocket for these expenses.

Medigap Plan L policies provide Basic coverage in addition to other benefits.

  • Medicare Part A Coinsurance, and all costs after hospital benefits are exhausted
  • 75% of Medicare Part B Coinsurance or Copayment for other than preventative services
  • 75% of Blood (first 3 pints). Medicare typically covers all costs associated with blood after the first 3 pints.
  • Medicare Preventative Care Part B Coinsurance

In addition, Medigap Plan K policies provide the following additional benefits:

75% of Medicare Part A Deductible

75% Hospice care Coinsurance

75% Skilled nursing facility coinsurance

Not Covered by Medigap Plan L Policies

Medicare Part B Excess Charges - The difference between what Medicare pays to doctors versus the actual amount of the bill. Medicare will typically only cover part of the bill while the patient must pay out of pocket for the remaining amount.

Foreign Travel Emergencies - Medicare does not cover healthcare coverage for its beneficiaries outside of the United States. Medigap Plan L does not provide any assistance in this area either. Medical emergencies in foreign countries requiring treatment or travel by patients must be paid in full out of pocket.

At Home Recovery - After a patient leaves the hospital they may still need to recuperate from surgery or other injuries. There may still be several health related costs applied to the recovery effort. Doctors will often provide strict instructions to patients that they must follow in order to get back to normal. Often these instructions will incur additional expenses. Medigap Plan L policies do not cover these expenses that aren't covered by Medicare.

Source: Centers for Medicare & Medicaid Services, Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare (2009).

These may or may not be important expenses and limitations, depending on your situation. If a Medigap Plan L policy doesn't meet your needs, consider Medigap Plan A policies.