What is Health Insurance Gap Coverage? Check Types and Importance

Health insurance offers protection to you and your family from unexpected medical expenses. Some comprehensive health insurance plans leave coverage gaps that lead to unexpected costs. 

If you don’t know what the health insurance gap is, let's find out; Gap is a supportive health plan that works with your primary medical plan. It helps to pay medical costs before reaching the deductible amount. It is designed to fill these gaps or spaces where you do not have coverage and provide financial protection. Sometimes, it's called “insurance on insurance’’.

This article will discuss the importance of gap coverage and its types and benefits. Also, it gives you in-depth knowledge about how to choose the right plan according to your needs. So, let’s discuss!

Importance of Gap Coverages in Health Insurance

Gap coverage plays a significant role in our medical emergencies  These keep us protected from medical expenses that are usually not covered under our health insurance plan. Gap coverage is essential because-

• They bridge the essential gaps in primary health insurance. 
• Keep us protected by covering high deductibles, co-payments, and coinsurance. 
• They make sure you are financially stable even in worse medical situations and keep your family safe from mishaps. 

It would help if you clearly understood gap coverage to make an informed decision about your health insurance needs. For any query, you can contact an InsuranceDekho relationship manager via email at support@insurancedekho.com or on call at +91-755 1196 989. 

Types of Health Insurance Gap Coverage

Health insurance gap coverage comes in various forms. Each insurance plan addresses specific gaps in standard health insurance plans. Different types of gap coverage offer different benefits, so let’s discuss the types:

1. Deductible Gap Insurance

Deductible gap insurance is specially designed to cover the high deductibles. It is extremely beneficial when you must pay a significant portion of your medical costs. This insurance protects you from unexpected costs.

2. Accident Insurance

Accident insurance provides financial protection if any accidental injuries happen. This coverage takes care of all medical costs related to accidents.

3. Critical Illness Insurance

Critical illness insurance is specially designed to cover specific, severe illnesses. It can include cancer, a heart attack, or a stroke. If you are suddenly diagnosed with severe diseases, you will get an adequate amount for medical treatments. Sometimes, it also pays daily living costs during the recovery.

4. Supplemental Insurance for Specific Conditions

Supplemental insurance covers specific conditions or treatments not covered by primary health insurance.

5. Prescription Drug Coverage

Some health insurance does not cover prescription drug coverage. In this time gap, insurance helps with the expenses of prescription drug coverage. 

Key Benefits of Health Insurance Gap Coverage

Gap health insurance offers several significant benefits that protect you from uncertain medical expenses. Let's check the benefits  -

• Financial Protection: It covers unexpected costs and helps you with high deduction amounts from primary insurance. 

• Affordability: Gap plans are more affordable than upgrading to a higher-tier primary insurance plan. You can easily opt for any gap plan rather than upgrading. 

• Flexibility: Different gap insurance helps cover certain medical conditions like maternity, accidents, or other medical expenses.

If you have any queries regarding the benefits of gap coverage, InsuranceDekho can answer them. 

How Do You Choose the Right Health Insurance with Gap Coverage?

Choosing the right health insurance with gap coverage is essential. You need to consider several factors before choosing the right one; they are :

1. Evaluate Your Needs: 

The first thing to consider is your personal needs. Navigate your current health insurance coverage to identify gaps and choose gap insurance accordingly. 

2. Compare Plans: 

While choosing a plan, you must look for various gap insurance plans and compare their benefits, costs, and coverage. A perfect comparison helps you choose the right gap plan for you.

3. Check the Network: 

You must check the plans' networks, like connectivity with the hospital, diagnostic centre, etc. The better its connectivity, the better you will benefit from the plan. 

4. Waiting period: 

Waiting is also essential to check when choosing the right health insurance. Look for a plan with a shorter waiting period because long waiting periods can cause uncertain expenses between the waiting periods. 

Evaluating all these factors helps you choose the right gap health insurance for you and offers comprehensive health coverage.

Costs Associated with Gap Coverage

The cost of gap health insurance depends on various factors, such as: 

1. Plan Type: 

Different plans offer different levels of coverage. Your plan’s coverage limits impact your premium cost.

2. Deductibles and Copayments: 

Plans with lower deductibles and copayments have higher premiums.

3. Age and Health Status: 

Health insurance companies opt for higher premiums for older individuals or those with pre-existing illnesses. So, taking a plan at a young age is recommended when you tend to be fit. 

How to Enroll for Gap Coverage? 

There are simple steps to enroll in gap health insurance coverage. Let’s follow the steps below-

Step 1: Enter Your Details 

Visit the health homepage of InsuranceDekho. You can even complete the form on this same page. Enter all the required details, such as your name, contact number, etc. 

Step 2: Compare Health Plans 

Please select the most suitable gap health insurance plan for yourself or your family, comparing it with other plans based on the information you provided in the form. 

Step 3: Confirm Online Payment 

Complete the necessary details in Proposal Form 1, and answer two health-related questions in Proposal Form 2. After this, submit your KYC and proceed to complete the online payment. 

Limitations and Exclusions in Gap Coverages in Healthcare

Gap coverages in health insurance also has some limitations and exclusions. So, let's see what limitations and exclusions you need to check before choosing gap insurance.

1. Pre-Existing Conditions: 

Some plans don’t cover any pre-existing medical conditions. It can cause an unnecessary burden in your pocket. 

2. Coverage Limits: 

There are maximum limits on the payable amount under the gap coverage. Always check the benefits before choosing a plan. 

3. Specific Treatments: 

Some plans do not cover specific treatments or services. 

4. Geographical limitations: 

Some gap plans are limited to specific areas that do not cover if you want treatment from another location. 

All these factors will help you choose the right gap for health insurance. If you have any queries, contact InsuranceDekho. They will solve all your insurance-related doubts. 

FAQs:

Ques 1. What is meant by GAP in medical billing insurance coverage?

Ans. The gap in insurance coverage in medical billing indicates an extra insurance plan that covers your medical expenses over your primary health insurance. It protects you from out-of-pocket costs. According to the report, the Health Protection Gap (HPG) is the highest in India globally. 

Ques 2. Is GAP insurance worth it?

Ans. Gap insurance is worth it because it protects you from sudden medical expenses. Comprehensive health insurance does not cover all costs, so GAP provides many benefits.  

Ques 3. What is the difference between full coverage and GAP insurance?

Ans. Full coverage is your primary insurance that covers most of your medical expenses. Gap insurance is something you purchase in addition to covering all the extra costs related to your medical expenses. 

Ques 4. How does gap cover work?

Ans. The gap is designed to cover the extra amounts that primary health insurance will charge for hospitals and specialists. Gap insurance relieves the extra expense burden when your medical expenses are enormous.