Medicare recipients who have specific medical concerns may find that Original Medicare, Parts A and B, do not cover enough of their expenses and they need to utilize a supplemental plan to help offset their out of pocket costs. There are a range of options available, and as each includes their own monthly premiums and sets of benefits, any number of plans may be appropriate. One option is Part L, an additional piece of coverage that can help you to better estimate your annual medical expenses.
Exploring Part L
Original Medicare offers participants coverage for both hospital and medical care, however, it is considered to be a rather basic set of benefits that usually leaves individuals with a bill. Instances of hospital care, physical therapy, durable medical equipment, and more may be eligible under Parts A and B, but if you find that you utilize these services often, Part L could be a smart option.
Medicare Part L is designed to pick up some of the remaining costs after Original Medicare pays their portion. In general, Part L pays 100% of Part A hospital costs and coinsurance for up to one year after your benefits have been exhausted. It also pays 75% of the fees associated with a range of other plan charges, including but not limited to your Part A deductible, Part B copayments, and coinsurance related to skilled nursing facility care.
Some items are not covered under your Part L plan including the deductible you pay for Part B, which is based on your income and tax status, as well as your Part B excess charges. These costs are the difference between what your physician charges for a specific service and what Medicare will pay toward that expense.
Why Part L?
One of the more attractive reasons for enrolling in Medicare Part L has to do with its cap on out of pocket expenses. With Original Medicare, an individual may end up frequently using their benefits for emergencies and be subject to a large amount of copayments and coinsurance expenses. With Part L, your annual spending is capped at a very reasonable rate, and while this amount may change each year, it is typically about half of the cap that’s associated with Part K.
Additionally, premiums for Part L are often very reasonable, although since this supplemental plan is offered through private insurance companies rather than the federally funded greater Medicare program, those numbers are subject to change.
Enrolling in Medicare Part L is easy, however, your timing does need to be specific. Generally, individuals can enroll in this supplement during their Original Enrollment Period, which is the same time they would opt for coverage under Part B. It’s recommended that you take the time to estimate your annual medical expenses to determine if the additional premium for Part L will be worth its benefits. Remember, you can select a number of supplemental plans to meet your specific needs, and changes to your coverage can be made every year.