Medigap Plan L is a federally standardized Medicare Supplement plan that covers 75% of most out-of-pocket costs under Original Medicare. Ten lettered Medigap plans exist today. They range from basic coverage under Plan A to comprehensive protection under Plan G. Medigap Plan L sits between these extremes.
It offers stronger coverage than Plan K, which only pays 50% of cost-sharing. However, it costs less each month than full-coverage options like Plan G or Plan N. This plan features an annual out-of-pocket limit of $4,000 in 2026. Once you reach that cap, it pays 100% of covered services for the rest of the calendar year. For beneficiaries who want solid protection without the highest premiums, Plan L is worth a careful look.
What Does Medigap Plan L Cover?
Medigap Plan L pays 75% of several important Medicare cost-sharing expenses. Part A coinsurance for hospital stays is covered at 75%. Part B coinsurance for doctor visits and outpatient services is also covered at 75%. Skilled nursing facility coinsurance receives the same 75% coverage. The Part A deductible, hospice care coinsurance, and first three pints of blood are all included at the 75% rate. You pay the remaining 25% out of pocket.
However, this plan has notable coverage gaps. It does not pay the annual Part B deductible, which is $283 in 2026. Part B excess charges are also excluded. These charges apply when a doctor bills above the Medicare-approved amount. Foreign travel emergency care is not covered either. As a result, beneficiaries who travel outside the United States may want a separate travel medical policy.
The standout feature of Plan L is its annual out-of-pocket maximum. In 2026, that limit is $4,000. Once your 25% cost-sharing payments reach this amount, the plan covers 100% of remaining eligible expenses for the year. This cap resets each January. In most cases, beneficiaries with moderate healthcare needs will not reach this limit.
Medigap Plan L Benefits Table
The table below shows how Medigap Plan L compares to Plan G and Plan N across all standard benefit categories.
| Coverage Area | Plan L | Plan G | Plan N |
|---|---|---|---|
| Part A Coinsurance | 75% | 100% | 100% |
| Part B Coinsurance | 75% | 100% | 100% (with copays) |
| Part A Deductible | 75% | 100% | 100% |
| Part B Deductible ($283 in 2026) | Not Covered | Not Covered | Not Covered |
| Part B Excess Charges | Not Covered | 100% | Not Covered |
| Skilled Nursing Facility Coinsurance | 75% | 100% | 100% |
| Hospice Care Coinsurance | 75% | 100% | 100% |
| First 3 Pints of Blood | 75% | 100% | 100% |
| Foreign Travel Emergency | Not Covered | 80% | 80% |
| Annual Out-of-Pocket Limit | $4,000 | None | None |
How Much Does Medigap Plan L Cost?
Plan L typically costs less per month than Plan G or Plan N. The tradeoff is higher out-of-pocket spending when you use medical services. Premiums vary based on your insurance company, age, and location. However, the monthly savings compared to Plan G can be meaningful for healthy beneficiaries who rarely need care.
Insurance companies use three pricing methods for all Medigap policies. Community-rated plans charge the same premium regardless of your age. Issue-age-rated plans base the premium on your age when you first buy the policy. Attained-age-rated plans increase your premium as you get older. Typically, community-rated and issue-age-rated options offer more predictable long-term costs.
When comparing total costs, look beyond the monthly premium alone. Plan L requires you to pay 25% of covered services until you hit the $4,000 cap. For example, a multi-day hospital stay could mean several hundred dollars in cost-sharing. Plan G would cover that same stay in full. The right choice depends on how frequently you use healthcare services each year.
Who Should Choose Medigap Plan L?
This plan works best for Medicare beneficiaries who are relatively healthy. If you rarely visit the hospital, the lower premiums can save money over time. You accept more financial risk in exchange for reduced monthly costs. For example, someone who sees their doctor only a few times per year may benefit from this cost-sharing approach.
However, Plan L is not ideal for everyone. Beneficiaries with chronic conditions or frequent hospitalizations may pay more overall. The 25% cost-sharing on every covered service adds up quickly with regular use. In most cases, these individuals are better served by Plan G. It covers nearly all out-of-pocket costs for a predictable monthly premium.
Plan N is another alternative worth considering. It offers much fuller coverage than Plan L but costs less than Plan G each month. Plan N requires a $20 copay for some office visits. It also charges a $50 copay for emergency room visits that do not result in hospital admission. For beneficiaries who want strong coverage at a moderate price, Plan N often provides better overall value.
Medigap Plan L vs Plan G vs Plan N
Plan G is the most comprehensive Medigap option available to new Medicare enrollees. It covers 100% of Part A and Part B cost-sharing after the annual Part B deductible. The only out-of-pocket expense each year is $283. Plan G also covers Part B excess charges and foreign travel emergencies. As a result, your total healthcare costs are highly predictable with this plan.
Medigap Plan L takes a fundamentally different approach. It trades lower monthly premiums for 25% cost-sharing on most covered benefits. The $4,000 annual cap limits your worst-case financial exposure. Plan N falls between these two options. It covers most costs in full but includes small copays for certain visits.
| Feature | Plan L | Plan G | Plan N |
|---|---|---|---|
| Coverage Approach | 75% cost-sharing | Near-complete | Near-complete with copays |
| Monthly Premium | Lowest of the three | Highest of the three | Moderate |
| Out-of-Pocket Maximum | $4,000 per year | $283 (Part B deductible only) | No annual cap |
| Doctor Visit Cost | 25% coinsurance | $0 after deductible | Up to $20 copay |
| ER Visit (No Admission) | 25% coinsurance | $0 after deductible | $50 copay |
| Part B Excess Charges | Not Covered | Covered at 100% | Not Covered |
| Foreign Travel Emergency | Not Covered | Covered at 80% | Covered at 80% |
| Best For | Healthy, budget-conscious enrollees | Maximum cost predictability | Balance of coverage and cost |
Typically, Plan G is the better choice for beneficiaries who want to minimize financial surprises. Plan N suits those comfortable with small copays in exchange for lower premiums. Plan L appeals to healthy enrollees who want the lowest monthly cost and are willing to share expenses with Medicare up to a defined annual limit.
How to Buy Medigap Plan L
The best time to buy any Medigap plan is during your Medigap Open Enrollment Period. This window lasts six months. It starts the month you turn 65 and are enrolled in Medicare Part B. During this period, insurance companies cannot deny you coverage. They also cannot charge more based on pre-existing health conditions.
If you miss this window, you may still qualify through guaranteed issue rights. These rights apply in specific situations. For example, you gain guaranteed issue rights when your Medicare Advantage plan leaves your service area. You also qualify if your employer group health coverage ends. In these cases, insurers must sell you a Medigap policy without medical underwriting.
Plan L is available in most states but not all 50. Massachusetts, Minnesota, and Wisconsin use their own state-specific Medigap plan structures. Beneficiaries in those three states should check with their State Health Insurance Assistance Program (SHIP) for equivalent options. In all other states, multiple insurance companies typically offer Plan L. Comparing quotes from several carriers is essential. Premiums vary widely for the same standardized benefits.
Frequently Asked Questions About Medigap Plan L
Does Medigap Plan L cover prescription drugs?
No. No Medigap plan sold today covers prescription drugs. You need a separate Medicare Part D plan for drug coverage. You can enroll in Part D alongside any Medigap policy without affecting your supplement benefits.
What happens after I reach the $4,000 out-of-pocket limit?
Once your cost-sharing payments total $4,000 in a calendar year, Plan L pays 100% of all covered services for the remainder of that year. This limit resets on January 1. Only your 25% share of covered benefits counts toward the total.
Can I switch from Plan L to Plan G later?
You can apply to switch Medigap plans at any time during the year. However, outside of your Open Enrollment Period, the insurance company may require medical underwriting. If you have health issues at that point, you could be denied coverage or charged a higher premium.
Is Plan L available from every insurance company?
Not every Medigap insurer offers Plan L. It is less widely sold than Plan G or Plan N. However, most states have at least a few carriers that provide it. Contact your local SHIP counselor for free help finding carriers in your area.
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Official Sources & Resources
For verified Medicare information and enrollment help:
- Medicare.gov: medicare.gov
- CMS.gov: cms.gov
- NAIC Medigap Guide: naic.org
- KFF Medicare Research: kff.org/medicare
- Find Your SHIP: medicare.gov/contacts
Content last reviewed April 2026. If you notice any outdated information, please contact us.