Group Supplemental Medical Expense (Gap)

Our Supplemental Medical Expense (Gap) insurance reimburses eligible out-of-pocket medical expenses incurred under the group major medical insurance plan, such as deductibles, copays, and coinsurance.

The need

Your employees may need help paying eligible out-of-pocket expenses incurred from major medical insurance.

The solution

Gap insurance reimburses eligible out-of-pocket medical expenses like deductibles, copays, and coinsurance. (Gap insurance is not meant to replace health insurance. It is only available if an employer has a major medical health insurance plan in place.)

No Health Savings Account (HSA)? No problem.

This coverage can be a beneficial supplement for high deductible health insurance plans without HSAs.

Gap insurance features include:

  • Guaranteed issue
  • No medical questions
  • Optional dependent coverage
  • Simplified administration and use

How Gap Insurance Works

Major Medical Plan Benefits

Charges

Hospital: $7,105
Office Visit: $435 (not eligible for reimbursement under Gap plan)

Patient Responsibility
(what patient owes after major medical health insurance has paid)

Deductible: $1,200
Co-Insurance: $1,902
Office Visit Co-Pay: $50
Total Patient Responsibility: $3,152

Gap Plan Benefits

Without Gap Benefit

With Gap Benefit

Inpatient: $5,000
Outpatient: $3,000

Gap reimbursement

$0

$3,102

Net out-of-pocket cost
(paid by insured)

$3,152

$50
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This is a solicitation for insurance. Insurance is underwritten by Globe Life And Accident Insurance Company, 3700 S Stonebridge Dr, McKinney, TX 75070. Globe Life is rated A (Excellent) by A.M. Best. For the latest financial strength rating, access www.ambest.com. This is limited benefit coverage. Coverage is not available in all states. Policy, Certificate and Rider forms: GBSM, GBSMC, GBSMIR, GBSMOSR. Form numbers and benefits may vary by state. Premium will vary based on the plan chosen. A waiting period for late entrants may apply. Policies are renewable at the option of Globe Life Group Benefits. Refer to the Master Policy and Certificate for all terms, conditions, exclusions and limitations. Globe Life Group Benefits uses the services of third party administrators.

The Supplemental Medical Expense plan is not a major medical plan. The product is designed to reimburse certain covered expenses, and is only available if an employer has a group health benefit plan in place. Out-of-pocket expenses submitted for reimbursement must be eligible under the group health benefit plan, and must meet the coverage definitions under the policy (may not include full reimbursement, if benefit year maximums have been met). Riders for outpatient services may not be available in all states.