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GAP Insurance

Medical gap insurance is a type of supplemental health plan. This coverage is not major medical insurance, nor is it ACA-compliant. However, it can work in tandem with your ACA-compliant health plan.
​Having major medical insurance doesn’t mean paying your premium and enjoying an all-access pass to healthcare. In reality, you are responsible for coinsurance, copayments and non-covered expenses, as written in your health insurance policy regardless of whether you buy your own health insurance or get it through a parent, partner or employer.
The expenses your health insurance company doesn’t reimburse you for are known as out-of-pocket costs. The amount of out-of-pocket costs you incur is dependent on several factors including your healthcare needs and your health insurance benefits.
A 2014 study by The Commonwealth Fund found that Americans pay more out of pocket for healthcare expenses today than they did 10 years ago.[1] According to the study:

  • More than 1 in 5 adults age 19 to 64 who were insured all year spent 5 percent or more of their income on out-of-pocket costs, not including premiums; 13 percent spent 10 percent or more
  • 3 in 5 low-income adults and half of those with moderate incomes said their deductibles were difficult to afford
  • 2 in 5 adults with private insurance who had high-deductible health plans said they delayed needed care because of their deductible

Because it can be difficult for some of us to pay for our healthcare out of pocket, particularly when an accident or critical illness occurs and medical bills can exceed standard office-visit amounts, there are medical gap insurance plans to help with the bills your health insurance plan doesn’t cover.