Gap Health Insurance

Spotlight on: Medical Gap Insurance

Also known as “medical gap insurance,” gap health insurance is a supplemental protection designed to work in tandem with a group health plan, many of which have high out-of-pocket expenses when accessing certain types of care.

Fortunately, a supplemental gap insurance policy can help close this gap, paying for medical costs that occur before employees meet their deductible. These plans are often relatively affordable and help bring the total cost of health care down to a manageable level in comparison to similar low deductible coverage.

With Higginbotham, you get:

• A local broker who takes the time to get to know your needs
• A seasoned service team that delivers year-round value
• An insurance partner that puts you first

What does gap health insurance cover?

Functioning as a deductible bridge, this coverage pays off the group plan’s Explanation of Benefits directly to the provider.

Gap health insurance can also help pay the benefits described in the Schedule of Benefits up to the maximum benefit outlined in the policy documents.

Some gap plans require employees to pay a small deductible or coinsurance before they’re eligible for plan reimbursement.

In most cases, a medical gap policy covers the same expenses as a major medical plan, with some exclusions.

Some examples of expenses not typically covered by one of these policies include:

• Clinic Professional Fees
• Outpatient Prescriptions
• Dental Services
• Vision Services
• Certain Outpatient Services

This list isn’t exhaustive, and some gap plans may extend coverage to items on this list.