Learn How to Fill Coverage Gaps With Supplemental Health Insurance

Also known as “gap” health insurance or “secondary” insurance, supplemental health plans help fill the coverage gaps left by primary health insurance.

For many Americans — even those with health insurance — medical care is often too expensive. Even though all ACA-compliant plans cover certain services for free (including immunizations, yearly checkups, depression screenings, HIV screening and more), they come with gaps in other coverage areas.

For example, your insurance company may cover a depression screening, but it may have a high copayment for follow-up counseling sessions. Likewise, you may be able to get a free blood pressure screening at your doctor’s office, but you may have to pay full price for an EKG.

Fortunately, supplemental health plans help fill some of these gaps and may even provide monetary relief if you lose out on income due to a covered health event. Read on to learn how supplemental health insurance works and what kind of plans exist.

How Does Gap Health Insurance Operate?

Even though health insurance covers a large portion of certain medical procedures and treatments, it does not cover everything. Plus, even highly rated insurance plans may avoid paying for certain services, such as X-rays, until after you have met your deductible. And even then, they may only cover a certain percentage of that service (this is known as “coinsurance.”)

Supplemental health insurance plans may help cover some of these out-of-pocket costs. Plus, depending on the type of plan a patient has, supplemental insurance may even help pay for certain expenses that regular medical insurance would never cover.

For example, if you have an unexpected injury outside of the workplace, your health insurance may help pay for a portion of your emergency treatment, but you would likely still end up having to pay some of it yourself. Now, depending on the type of plan you have, this portion could be quite large. Plus, your health insurance will not cover missed paychecks or other non-medical costs of your injury. 

If you happen to have supplemental accident insurance, however, then your policy would pay a lump sum of cash directly to you after a covered event. This could help you offset your loss of income so that you wouldn’t need to worry about being late on the rent, missing a car payment or cutting back on important household expenses.

What Kind of Supplemental Insurance Plans Are Available?

Depending on where you live and certain other factors, there may be several types of medical gap insurance available to you, including but not limited to:

  • Dental and vision insurance. Just as with health insurance, these plans vary in value, with more expensive plans usually offering better coverage. They usually offer certain preventive services for free and provide discounts on many treatments.
  • Short-term health insurance. This type of insurance can be bought outside of open enrollment and helps with emergency medical costs for a limited amount of time. Some people buy these plans while waiting for Medicare or employer-based health insurance to kick in.
  • Accident and emergency plans. There are many types of supplemental health insurance plans that fall into this category. These plans are usually limited in scope and extend certain parts of your healthcare cover. For example, one plan might cover a critical illness such as a stroke while another might cover accidental death and still another might only kick in after you’ve been admitted to a hospital.