Medicare Supplement Plan L: 2026 Coverage, Costs, and Out-of-Pocket Limit

How Plan L works: 75% now, 100% after the cap

Medigap Plan L is one of ten federally standardized Medicare Supplement plans sold by private insurers. Unlike plans that pay nearly all of your Original Medicare cost gaps, Plan L is a 'cost-sharing' design: for most benefits it pays 75% and leaves you responsible for the remaining 25% until you reach an annual out-of-pocket maximum.

For 2026, CMS set Plan L's out-of-pocket limit at $4,000. Once your share of covered Part A and Part B cost-sharing reaches that amount in a calendar year — and once you have paid the annual Part B deductible ($283 in 2026) — Plan L pays 100% of covered services for the rest of the year. The limit resets every January 1.

Because you take on more cost-sharing than with a plan like G, monthly premiums for Plan L are typically lower. The actual premium varies by insurer, your age, location, and other factors, so two people with identical coverage can pay very different rates.

What Plan L covers in 2026

Plan L's benefits are standardized, so the coverage percentages are identical no matter which insurer sells it. What changes between companies is the premium, not the benefits.

• Part A hospital coinsurance and costs — covered 100%, including up to 365 extra days after Original Medicare benefits run out.
• Part A deductible ($1,736 per benefit period in 2026) — covered 75%, leaving roughly $434 of that deductible to you.
• Skilled nursing facility coinsurance (the $217/day charge for days 21–100 in 2026) — covered 75%.
• Part B coinsurance or copayment (normally your 20% share after the Part B deductible) — covered 75%.
• First 3 pints of blood — covered 75%.
• Part A hospice care coinsurance and copayments — covered 75%.
• Not covered: the Part B deductible, Part B excess charges, and foreign travel emergency care.
• Not covered: prescription drugs — you would add a separate Part D drug plan for that.

Plan L costs you should plan for in 2026

Plan L does not replace your Original Medicare premiums. You still pay the standard Part B premium of $202.90 per month in 2026 (higher if IRMAA applies to your income), plus your Plan L premium on top.

Your potential cost-sharing under Plan L is capped. In a heavy-use year you could pay up to the $4,000 out-of-pocket limit in covered Part A and Part B cost-sharing, plus the $283 Part B deductible, before the plan begins paying 100%. In a low-use year you may pay far less than the cap.

Premiums for the Plan L policy itself vary by plan and insurer and are not set by the government, so compare quotes from multiple companies for the same standardized benefits. If you also want drug coverage, budget separately for a Part D plan; its national base premium is $38.99 per month in 2026, with actual premiums varying by plan.

Plan L vs. Plan K and fuller plans

Plan L sits between Plan K and the more comprehensive plans. Plan K uses the same cost-sharing structure but pays only 50% of those benefits and has a higher 2026 out-of-pocket limit of $8,000. So Plan L pays more of each bill and caps your spending at a lower point than Plan K, usually for a somewhat higher premium.

Compared with a fuller plan such as Plan G — which pays nearly all Original Medicare gaps except the Part B deductible and has no out-of-pocket cap because it rarely needs one — Plan L trades lower predictable premiums for more out-of-pocket exposure in a high-cost year. The right choice depends on your health, budget, and how much premium-versus-risk trade-off you are comfortable with.

Plan L may not be offered by every insurer in every state, and it is generally less widely sold than plans like G or N. Availability varies, so confirm what is sold in your area before assuming you can enroll.

Eligibility and when to enroll

To buy any Medigap policy, including Plan L, you generally need to be enrolled in both Medicare Part A and Part B. The best time to buy is during your Medigap Open Enrollment Period — the six months that begin the month you are 65 or older and enrolled in Part B. During that window you have a guaranteed-issue right, meaning insurers cannot deny you or charge more based on your health.

Outside that period, in most states insurers can use medical underwriting and may decline coverage or raise your premium for pre-existing conditions, except in limited guaranteed-issue situations. Rules differ by state, so check your state's specific Medigap protections.

Medigap works only with Original Medicare, not with Medicare Advantage. You cannot use a Plan L policy to pay costs under a Medicare Advantage plan.