Information Provided by a Medicare Supplement Insurance Representative
Medicare with Plan L**
The chart below describes the common Medicare benefits along with gaps left by Medicare for you to pay.
| I. In patient | Gap (you pay) | Plan L** | |
| days 1-60 | deductible* | $1,632.00 | %75 |
| days 61-90 life time reserve | coinsurance | $408.00 | ✔ Paid |
| days 91-150 | coinsurance | $816.00 | ✔ Paid |
| after 150 days Medicare quits paying | next 365 paid in full | ✔ Paid |
| II. Skilled Nursing | Gap (you pay) | Plan L** | |
| Medicare pays 20 days in full | |||
| days 21-100 | $204.00 | %75 |
| Gap (you pay) | Plan L** | |
| Annual Deductible | $240.00 | ✖ Not Paid |
| Medicare Covers 80% | 20% | %75 |
| Part B Excess | 100% | ✖ Not Paid |
| $50,000 emergency medical outside USA $250.00 deductible 80/20 | ✖ Not Paid |
*The hospital benefit period is reset by Medicare 60 days from your previous hospital release date.
**Out of Pocket Limit is $3,110.
Similar to the Medicare Supplement Insurance Plan K the Medicare Supplement Insurance Plan L offers a fair amount of coverage for a wide variety of services if you prefer a lower premium, have low medical expenses, and are willing to share in the cost throughout the year. The annual out-of-pocket limit is set at $2,330. After you reach this limit and pay your Medicare Part B (Medical) deductible the Medicare Supplement Insurance Plan L would then pay 100 percent of your Medicare covered services. Medicare Supplement Insurance Plan L also requires you to pay a percentage for other covered services, instead of covering the entire cost for you. Again this helps to keep your plan premiums low if you have low medical expenses.
Medicare Supplement Insurance Plan L includes basic benefits which include:
- Hospitalization: Medicare Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
- Medical Expenses: Medicare Part B coinsurance (generally 20% of Medicare-approved expenses) or co-payments for hospital outpatient services. Medigap Plans K, L, & N require insured to pay a portion of Medicare Part B coinsurance or co-payments.
- Blood: First 3 pints of blood each year. Hospice: Medicare Part A coinsurance.
Hospice Care will be included in all Medicare Supplement Insurance Plans as of June 2010.
Medicare Supplement Insurance Plan L requires you to pay certain percentages of different Medicare covered services. Like Medicare Supplement Insurance Plan K, this is different than most of the other Medicare Supplement Insurance Plans. After you meet the annual out of pocket limit or cap, your Medicare Supplement Insurance Plan L pays for the Medicare co-payments, coinsurance, and deductibles until the end of the year. Excess charges from Medicare Part B (Medical) aren’t covered and don’t qualify for the out-of-pocket spending cap. You are responsible for financing excess charges and the amount that you are responsible for may increase or vary from year to year.
Specifically included with Medicare Supplement Insurance Plan L benefits, coinsurance for Medicare Part A and expenses after your hospital benefits end are covered 100%. Medicare Preventive Care coinsurance for Part B is also covered for 100% of the Medicare-approved amount. The copay or coinsurance for Medicare Part B (Medical) is covered 75% for services other than preventative. Also covered at 75% are the skilled nursing facility service and hospice care coinsurance or copay and the Medicare Part A (Hospital) deductible. Blood coverage is also covered at 75% after the first 3 pints.
There are services and benefits not covered under Medicare Supplement Insurance Plan L. The Medicare Part B (Medical) deductible is not covered. Any excess charges, as explained above, are also your responsibility. Emergency coverage for travel abroad is not included with this plan, so be aware of this when traveling.
All plans were standardized by the federal government in 1992 for your protection. This means that you are to go by the letter I.D. of the plan to determine what benefits each Medicare Supplement Insurance Plan will cover.
The only 2 things that an insurance company who offers a Medicare Supplement Plan L can have any control of are:
- Underwriting
- Premium price
We have only briefly touched on one Medicare Supplement Insurance Plan, and as you can see it can be very confusing and somewhat overwhelming. We deal with Medicare daily and your Medicare Specialist here at MedicareMall.com can “Take the Mystery Out of Medicare” by walking you through the maze every step of the way. We are committed to you by shopping the best plans from the top companies available. We will do what it takes to make sure you become a very happy, satisfied MedicareMall.com client. To find out more if a Medicare Supplement Insurance Plan L is right for you, contact a Medigap Plan Representative now or talk to one of our licensed Medicare Specialists by entering your zip code and clicking the ‘Go’ button.
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