Medicare Supplement Insurance Plan L* from Blue Cross and Blue Shield of Texas, A Division of Health Care Service Corporation is a basic benefits plan ideal for seniors looking for a lower monthly premium. By covering less of the coinsurance and copayment expenses than other plans.

Benefits

With Medicare Supplement Insurance Plan L, securing the benefits you need to stay healthy and strong is easier than ever. This plan pays for 75 percent of your Part A hospital deductible, 75 percent of the cost of the first three pints of blood each year and 75 percent of your Medicare coinsurance/copayment for hospice care.

In addition, you can count on an extra 365 days of hospital care once Lifetime Reserve Days are used and the remainder of all Medicare-approved amounts (after your Part B deductible has been paid) for Medicare-covered preventive benefits and the remaining 15 percent of Medicare-approved amounts. Medicare Supplement Insurance Plan L also limits annual out-of-pocket-expenses for Medicare-approved amounts to $3,110 per the calendar year. That means if you get sick and need to visit with your doctor frequently or receive outpatient services often, you can.

Benefits Summary

• 75 percent of Medicare Part A deductible for hospitalization services
• 75 percent of the costs for the first three pints of blood each year
• 75 Percent of Medicare coinsurance for hospice care
• 75 percent of skilled nursing facility coinsurance

What You Can Expect to Pay 

In addition to a reasonable monthly premium, with Medicare Supplement Insurance Plan L you can expect to pay for your Part B deductible and excess charges, 25 percent of your Part A deductible, hospitalization costs beyond the additional 365 days after Lifetime Reserve are used, a percentage of skilled nursing costs after 21 days and all costs after 101 days, and 25 percent of the cost of the first three pints of blood. Medicare Supplement Insurance Plans are guaranteed renewable. As long as you continue to pay your premium, your plan can never be terminated and you can always renew, regardless of your health.

This plan is a good option for Texas seniors looking for a lower premium and a reasonable amount of coverage. With a lower annual out-of-pocket amount than some of the other cost sharing plans.

	Basic Benefit Options	Comprehensive Plan Options		Budget-Conscious Plan Options
Click on each plan to view details**	Plan A	Plan F	Plan G	High Deductible Plan F			Plan N
Reduced Premium Medicare Select Option Available*‡ (eligibility based on ZIP code)
Basic Benefits	100%	100%	100%	100%			copay applies
Skilled Nursing Coinsurance
Part A Deductible
Part B Deductible
Part B Excess		100%	100%
Foreign Travel Emergency Care†
Annual Out of Pocket Limit††

Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.

* Network restrictions apply.
** Policy forms UWMSP(A)-2010, UWMSP(F)-2010, UWMSP(F-HD)-2010, UWMSP(G)-2010, UWMSP(K)-2010, UWMSP(L)-2010, UWMSP(N)-2010, UWMSP-SEL(F)-2010, UWMSP-SEL(G)-2010, UWMSP-SEL(K)-2010, UWMSP-SEL(L)-2010, UWMSP-SEL(N)-2010.

† Plans cover medically necessary emergency care services needed immediately because of an injury or illness of sudden and unexpected onset, beginning during the first 60 days of each trip outside the USA.

†† The out-of-pocket annual limit may increase each year for inflation (2023 limits shown).

‡ You must live within 30 miles of a participating Medicare Select hospital to be eligible.

BCBSTX is not connected with or endorsed by the United States Government, the Federal Medicare Program, or any other governmental agency.
TXMEDWEB02-REV 08/12