If you are stuck with a high deductible Major Medical health plan
If wondering how to pay for your deductible should you need to use your insurance
Gap health insurance benefits can help cover out-of-pocket expenses (such as deductibles, copayments or coinsurance) that you may incur before your major medical insurance plan begins paying its share of your covered expenses.
Gap insurance refers to a category of supplemental health insurance products. These plans may pay lump sum benefits when you experience a covered accident or illness. These types of plans are designed to supplement your major medical insurance plan coverage, not replace it. Gap health insurance benefits can help cover out-of-pocket expenses (such as deductibles, copayments or coinsurance) that you may incur before your major medical insurance plan begins paying its share of your covered expenses. Please note that the type of supplemental gap insurance described here is not the same thing as a Medicare Supplement (“Medigap”) plan. Individuals those are not eligible for Medicare may still be able to obtain a supplemental GAP policy.
- Broken bones
- Life-threatening cancer
- Heart attack
- Kidney failure
- Stroke
- Coma
- Coronary bypass
- Loss of sight, speech or hearing
- Major organ transplant
- Paralysis
- Severe burn
- Preventive care such as routine physicals
- Any non-medically necessary or experimental procedures
- Injuries or illness related to participating in extreme or dangerous activities (rock climbing, skydiving, private aviation, etc.) or sustained at work or under the influence of drugs or alcohol
- Medical expenses incurred prior to the policy effective date or after the expiration date
No, Gap health plans are not qualified health plans under the terms of the Affordable Care Act (ACA). Rather, they are designed to supplement the benefits you receive from your ACA plan.
Typically, yes. Medical gap plans are designed to help cover out-of-pocket expenses associated with a major medical plan, not as a stand-alone insurance plan.
You may choose to have your medical gap insurance benefits paid to you or to your provider.
No, generally you are not restricted in how you use your benefit payments. Use your payments to cover your deductible, coinsurance or copayments, or personal expenses such as housing, transportation, groceries or childcare – it’s up to you.
Coverplushealth.com is an independent marketplace operated by Health Plans Direct, Inc. National Producer Number 17854932 and is not the Health Insurance Marketplace website. We Invite application for insurance in states where we maintain our agency/broker licenses and appointed for each state that requires a license to conduct health insurance sales and services.We are required to comply with all applicable federal laws, including standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Marketplace plans being offered in your state through our partner websites. To see all available data on Marketplace plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov. If you have questions or concerns, please contact us at support@coverplushealth.com
Copyright © 2023 Health Plans Direct, Inc.