Who should get gap insurance?

As high deductible health plan (HDHP) enrollments become more common,[1] many people may find medical gap insurance helpful in covering some out-of-pocket costs not covered by their major medical insurance plan.

For 2020, any plan with a deductible of at least $1,400 for an individual or $2,800 for a family is considered a HDHP.[2] An individual may incur up to $6,900, and a family up to $13,800, in out-of-pocket costs (including deductibles, copayments and coinsurance), before reaching the plan’s annual out-of-pocket maximum, at which point eligible expenses are paid by the insured’s major medical plan.[3]

Because you pay more healthcare costs yourself with an HDHP,[4] gap health insurance can help you cover your portion of expenses until you’re able to access your major medical plan’s benefits.

Footnotes