The central tradeoff is simple. Plan L pays 75% of certain Medicare cost-sharing, caps your annual out-of-pocket spending on covered services, and leaves some expenses entirely to you. It is also uncommon: AHIP's April 2026 report puts Plan L at less than 0.5% of standardized-plan enrollment, so availability is worth checking early.
This guide covers what Plan L pays, what it leaves out, what drives cost, how it compares with Plans K, G, and N, and what to consider before enrolling.
Key Takeaways
- Plan L works only with Original Medicare, never with Medicare Advantage.
- It pays 100% of some costs, 75% of others, and nothing for several gaps.
- The 2026 out-of-pocket limit is $4,000, plus the $283 Part B deductible.
- Your health needs, savings, travel plans, and enrollment rights should drive the choice.
What Is Medicare Supplement Plan L?
Medicare Supplement Insurance, or Medigap, is private insurance that helps pay deductibles, coinsurance, and copayments left by Original Medicare Parts A and B. You generally need both Part A and Part B to buy one.
In most states, Plan L is standardized. The core benefits are the same whichever insurer sells it. Massachusetts, Minnesota, and Wisconsin standardize differently. Premiums, service, discounts, and availability still vary by company.
How Plan L cost-sharing works
Medicare pays its share of the Medicare-approved amount first. Plan L then pays its percentage of what remains. It does not pay 75% of the provider's whole bill.
Here is a hypothetical example, not a prediction of your costs. Say Medicare-approved Part B coinsurance left after Medicare's payment is $1,000:
- Plan L pays 75%, or $750
- You pay the remaining $250
- Your $250 counts toward the annual limit
Plan L suits people willing to accept more cost-sharing in exchange for a potentially lower premium.
What Does Medicare Supplement Plan L Cover?
Percentages apply to specific cost-sharing benefits, not the full bill.
| Benefit | Plan L pays |
|---|---|
| Part A coinsurance and hospital costs, plus up to 365 extra days after Medicare benefits are used | 100% |
| Part B coinsurance for Medicare-covered preventive services | 100% |
| Part A deductible | 75% |
| Part A hospice coinsurance or copayment | 75% |
| Other Part B coinsurance or copayment | 75% |
| Skilled nursing facility coinsurance | 75% |
| First three pints of blood | 75% |
Benefits covered at 75%
You owe the other 25% until you reach the annual limit. The Part A deductible works per benefit period, not per year.
A benefit period begins on the day you are admitted as an inpatient and ends after 60 consecutive days without inpatient hospital or skilled nursing care. Two hospital stays in one year can mean two Part A deductibles.
2026 Original Medicare amounts:
- Part A deductible: $1,736 per benefit period
- Hospital days 61-90: $434 per day
- Lifetime reserve days: $868 per day
- Skilled nursing facility days 21-100: $217 per day
Annual out-of-pocket limit
CMS's October 2025 announcement sets the 2026 Plan L limit at $4,000. Once you meet it and the $283 Part B deductible, Plan L pays 100% of covered services for the rest of the calendar year.
The limit applies to Medicare-approved cost-sharing. Part B excess charges and other non-covered expenses do not count toward it, and they don't disappear once you hit it.
What Does Medicare Supplement Plan L Not Cover?
Plan L-specific gaps
- Part B deductible: $283 in 2026. Plan L does not cover it, and plans sold to people newly eligible on or after January 1, 2020 cannot cover it either.
- Part B excess charges: Plan L pays none of them.
- Foreign-travel emergencies: Not covered. Plans G and N pay 80%, up to plan limits.
An excess charge is the gap between the Medicare-approved amount and a higher amount a provider is legally allowed to bill. A provider who accepts assignment takes the Medicare-approved amount as payment in full.
Providers who don't accept assignment can often charge up to 15% more, and you owe the difference. Ask each doctor whether they accept assignment.
Gaps common to most Medigap plans
Plans generally don't cover:
- Prescription drugs (Medigap sold after 2005 excludes them; Part D is separate)
- Dental care, eyeglasses, and hearing aids
- Long-term care
- Private-duty nursing
The hearing-aid exclusion doesn't rule out every hearing-related medical service.
How Much Does Plan L Cost?
Monthly premium factors
Private insurers set premiums. They vary by:
- State and insurer
- Rating method
- Age and tobacco use
- Discounts, such as for non-smokers, married couples, or electronic payments
- Medical underwriting, when it applies
Standardized benefits don't mean identical prices. No authoritative national average for Plan L exists, so get current quotes for your state and age.
Rating method matters over time:
- Community-rated: Premiums are not based on age.
- Issue-age-rated: Premiums are based on age at purchase.
- Attained-age-rated: Premiums rise as you age.
Inflation can raise premiums under any of them.
Total annual cost framework
Budget with this formula:
Plan L premium + Part B premium + any Part D premium + Part B deductible + expected cost-sharing + non-covered services
The 2026 standard Part B premium is $202.90 a month, and the deductible is $283. Prescription costs run through Part D. Your Plan L premium is paid separately and is not part of the covered-service cost-sharing that the annual limit addresses.
Best-case and high-use scenarios
These are hypothetical, not quotes. Assume a $4,000 limit.
- Light use: A few office visits and preventive care. You pay the $283 deductible plus a small 25% share. Plan L's lower premium likely wins.
- Heavy use: A hospital stay and follow-up care. You could reach the full $4,000, plus the $283 deductible. A pricier plan with smaller cost-sharing might cost less overall.
A low premium doesn't always mean the lowest total spending. Check your insurer's current rates and plan documents. Medicare amounts and CMS limits change yearly.
Is Plan L Right for You?
Who may prefer Plan L
- You want a lower premium than a comprehensive plan.
- You're comfortable sharing costs and value a cap on eligible spending.
- You have savings or steady income to absorb cost-sharing.
- You don't need foreign-travel emergency coverage.
Who may prefer another option
- You see doctors often, have chronic conditions, or expect a procedure.
- You have limited savings or want predictable costs. Compare Plan G.
- You travel abroad or use providers who bill excess charges.
Comparing Plan L with Plans K, G, and N
| Feature | K | L | G | N |
|---|---|---|---|---|
| Part A deductible, hospice, SNF, blood | 50% | 75% | 100% | 100% |
| General Part B coinsurance | 50% | 75% | 100% | 100%, with copays |
| Part B deductible | No | No | No | No |
| Excess charges | No | No | Yes | No |
| Foreign emergency | No | No | 80% | 80% |
| 2026 out-of-pocket limit | $8,000 | $4,000 | None | None |
Plan K covers less but, per CMS, has the higher $8,000 limit. Plan N covers more coinsurance than L, with copays of up to $20 for some office visits and up to $50 for ER visits without admission. High-deductible Plan G, in some states, has a $2,950 deductible in 2026.
Enrollment and eligibility
You generally need Parts A and B, and you can't use Plan L with Medicare Advantage.
The one-time six-month Medigap Open Enrollment Period starts the first month you're 65 or older and enrolled in Part B. During it, insurers can't deny you or charge more for health problems. A pre-existing-condition waiting period may still apply.
Outside that window, insurers can use medical underwriting. Federal guaranteed-issue rights don't automatically guarantee Plan L.
People under 65 may have limited options, and state rules differ. Some states add protections, such as Virginia's 60-day birthday rule for same-benefit switches and West Virginia's new protection.
Personalized guidance and next steps
Licensed agents at Muneris Benefits can compare Medicare Supplement options, walk through cost-sharing and exclusions, and explain enrollment rules. Availability depends on your state and circumstances.
Before enrolling:
- Compare total annual costs, not just premiums.
- Confirm your providers accept assignment.
- Identify your drug and travel coverage needs.
- Check that you have emergency savings for the limit.
- Read the official plan documents.
Frequently Asked Questions
What is Medicare Supplement Plan L?
A Medigap plan that works with Original Medicare. It pays 75% of certain covered cost-sharing, 100% of others, and includes a $4,000 annual out-of-pocket limit in 2026.
How much does Medicare Supplement Plan L cost?
Premiums vary by insurer, state, age, tobacco use, rating method, and enrollment timing. Compare total annual costs rather than the premium alone.
What is the out-of-pocket maximum for Medicare Supplement Plan L in 2026?
It is $4,000, once you've also met the $283 Part B deductible. It covers Medicare-approved cost-sharing. Premiums, excess charges, and non-covered services are separate.
Does Medicare Supplement Plan L cover the Part B deductible?
No. The 2026 Part B deductible is $283, and you pay it yourself.
Can I have Medicare Supplement Plan L and Medicare Advantage at the same time?
No. Medigap works only with Original Medicare. Selling it to someone on Medicare Advantage is generally illegal, so review enrollment rules before switching.
What is not covered by Medicare Supplement plans?
Prescription drugs, routine dental, eyeglasses, hearing aids, long-term care, and private-duty nursing are generally excluded. Part D covers prescriptions separately, and specific gaps vary by plan.
