HOW DOES GAP INSURANCE WORK?

Wednesday, May 11, 2022 9:47 AM


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For many, navigating all the different insurance needed can be an uphill battle. And often, as a result, we don’t look into all of our options when it comes to coverage. However, gap insurance is worth an extra look. So, what is gap insurance, and is it insurance coverage you should consider?

Gap insurance helps to pay medical costs that occur before reaching your deductible. It is a plan that may cover some or even all of the amount owed and is not paid by primary medical insurance. A gap plan works with your medical plan to help reduce your out-of-pocket expenses for sickness or accidents. 

Gap insurance is becoming more popular as high deductible insurance plans become more prevalent. The IRS defines a High Deductible Health Plan (HDHP) as a plan that has a deductible of at least $1,300 for an individual and $2,600 for a family. The gap insurance plans cover the same expenses as your medical plan with a few exceptions, such as outpatient prescription drugs, vision, dental, and plan copayments. Like other forms of insurance, there is a monthly premium for the gap insurance plan. However, even with this premium, you will likely find that you will still reduce your overall maximum out-of-pocket costs. 

Gap Insurance Can Include:

  • Critical Illness Insurance. Receive a lump sum if you are diagnosed with a critical illness such as cancer, heart attack, kidney failure, or stroke.
  • Accident Medical Insurance. Covers medical expenses resulting from any covered accident.
  • Accidental Death and Dismemberment. Pays a lump sum for death or specific injuries following a covered accident.

So how do you know if gap health insurance is right for you? You will likely benefit from a low-cost gap insurance plan if you have ongoing medical issues and high out-of-pocket expenses. However, if you are relatively healthy, with no planned medical needs in the foreseeable future, you might pass on the gap insurance. 

Not sure you need gap insurance? You don’t have to make the decision alone. Tom Miroballi, Independent BCBS Agent, will help you decide and select the right insurance package to make your healthcare work for you. He will explain the terms, rules, or whether the plan will cover something before signing up. 

Affordable health insurance is just one call away. Give Tom a call at 630-863-3477 or email him today!