Gap Health Insurance
What is a Gap Plan?
A Gap plan is supplemental coverage to your employees’ main health insurance plan. It’s used to protect policyholders from high out-of-pocket expenses resulting from their major medical plan deductible, coinsurance, and most copays.
Typically, there is no deductible with Gap Plans, and they pay up to a maximum benefit either as a combined or separate inpatient or outpatient benefit. Office visits, dependent on the plan, can be paid on an expense basis against the max, or as a separate rider with a limited number of visits per year and/or expense per visit.
What is Covered in a Gap Plan?
Our Gap insurance plans, and optional riders, cover:
- Inpatient
- Doctor’s Office Visits or Treatment
- Urgent Care Visits or Treatment
- Emergency Room
- Cancer Treatment
- Ambulance
- Outpatient Surgery
- Diagnostic and Radiology
- Labs
- Maternity
- Durable Medical Equipment (DME)
- Mental Health
- Substance Abuse
- Inpatient
- Doctor’s Office Visits or Treatment
- Urgent Care Visits or Treatment
- Emergency Room
- Ambulance
- Outpatient Surgery
- Diagnostic and Radiology
- Labs
- Maternity
- Durable Medical Equipment (DME)
- Mental Health
- Substance Abuse
- Cancer Treatment
Should I Offer a Medical Gap Plan?
Purchasing Gap insurance may save employees money in the long term and provide more peace of mind, considering the major medical plans offered to your group. These plans complement:
- Major medical plans with high deductibles
- Plans with a high probability of costly claims
- Employer facing major medical plan increases
