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Medical Gap Insurance for Employees

Cover the gap. Ease your employees’ minds.

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Spotlight on: Medical Gap Insurance

Also known as “medical gap insurance,” gap health insurance is a supplemental protection designed to work in tandem with a group health plan, many of which have high out-of-pocket expenses when accessing certain types of care.

Fortunately, a supplemental gap insurance policy can help close this gap, paying for medical costs that occur before employees meet their deductible. These plans are often relatively affordable and help bring the total cost of health care down to a manageable level in comparison to similar low deductible coverage.

With Higginbotham, you get:

  • A local broker who takes the time to get to know your needs
  • A seasoned service team that delivers year-round value
  • An insurance partner that puts you first


Why Higginbotham?

Everything we do is in the interest of you.

That’s why we start with listening—so we can end with customized solutions.

If you tell us that your group health plan has high out-of-pocket expenses for certain types of care that your employees need, we may recommend exploring medical gap health insurance.

If you’re an individual looking to increase your medical coverage and reduce your financial risks, we’re standing by to answer your questions.

No matter what coverage you’re considering, our approach to finding solutions is more individual and less institutional. By making our advice personal, we help you worry less and accomplish more. Because when our values lead, your business can succeed.

To learn more about how our values-based approach drives value for you and your employees, click here.

Or visit our Insights page to learn more about what gap health insurance covers.


Talk to a seasoned employee benefits professional who starts with listening.

We take great pride in getting you the coverage you want at a price that makes sense for your budget.

At Higginbotham, we start with listening and end with customized solutions.

Find out more about what we can do for your business.

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What does gap health insurance cover?

Functioning as a deductible bridge, this coverage pays off the group plan’s Explanation of Benefits directly to the provider.

Gap health insurance can also help pay the benefits described in the Schedule of Benefits up to the maximum benefit outlined in the policy documents.

Some gap plans require employees to pay a small deductible or coinsurance before they’re eligible for plan reimbursement.

In most cases, a medical gap policy covers the same expenses as a major medical plan, with some exclusions.

Some examples of expenses not typically covered by one of these policies include:

  • Clinic Professional Fees
  • Outpatient Prescriptions
  • Dental Services
  • Vision Services
  • Certain Outpatient Services

This list isn’t exhaustive, and some gap plans may extend coverage to items on this list.


Do I really need gap insurance?

It depends.

For those worried about their ability to meet the deductible on their medical insurance or group health plan, gap health insurance can be a great option. This supplemental coverage is also a good choice for relatively healthy people looking for creative ways to reduce their out-of-pocket medical costs.

If you’re an employer that offers health insurance as an employee benefit, gap insurance may be able to save you money too. In some cases, adding gap coverage to an existing plan can save employers up to 20 percent on their group medical premiums. 

Others who would likely benefit from gap coverage include:

  • People Having a Baby
  • People Planning to Have Surgery

How much does gap insurance cost?

Like most other coverages, the premium cost on a gap policy depends on several factors, including age, gender, location and health history.

While premiums between $30 and $40 are not uncommon for employee-only coverage, it’s difficult to quote an exact price without first learning more about your situation.

At Higginbotham, we believe every client deserves coverage tailored to their unique situation.

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Not sure where to start? Talk to someone who wants to listen.

Higginbotham is here to make your life easier and give your employees peace of mind. We’re on your side.

Talk to Employee Benefits SpecialistRequest a Quote