Medical Gap Insurance for Employees
Cover the gap and ease your employees’ minds.
Medical Gap Insurance Benefits
Also known as “medical gap insurance,” this supplemental protection is designed to complement a group health plan, which may have high out-of-pocket costs for certain types of care.
Gap insurance helps bridge this coverage gap by covering medical expenses incurred before employees reach their deductible. These plans are often affordable and can reduce the overall cost of healthcare, making it more manageable compared to plans with similarly low deductibles.
With Eleos, you get:
A local specialist 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 Eleos?
Everything we do is focused on your needs.
We begin by listening to understand your specific situation, allowing us to provide tailored solutions.
If your group health plan has high out-of-pocket expenses for essential care, we may suggest exploring medical gap insurance to help cover those costs.
For individuals seeking to enhance their medical coverage and minimize financial risk, we’re here to answer your questions.
Our approach is personal, not institutional. By offering customized advice, we help you focus on what matters most. When our values guide us, your success follows.
What Does Gap Health Insurance Cover?
Gap health insurance serves as a bridge to cover costs that aren’t fully met by a primary health plan. It pays directly to the provider based on the group plan’s Explanation of Benefits.
Additionally, gap insurance can cover benefits described in the Schedule of Benefits, up to the maximum limit stated in the policy.
Some plans may require employees to pay a small deductible or coinsurance before they receive reimbursement.
Generally, a medical gap policy covers the same expenses as a major medical plan, though some exclusions may apply.
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 on your situation.
Gap insurance can be an excellent option for those concerned about meeting high deductibles or managing out-of-pocket costs with their current health insurance. It's also a smart choice for relatively healthy individuals looking to reduce their medical expenses creatively.
Employers offering health insurance as an employee benefit may find gap insurance beneficial too. In some cases, adding gap coverage can reduce group medical premiums by up to 20%.
Additionally, gap insurance can be particularly useful for:
Individuals expecting a baby
Those planning to undergo surgery
How Much Does Gap Insurance Cost?
The cost of gap insurance varies based on factors such as age, gender, location, and health history. Typically, premiums for individual coverage range from $30 to $40, but exact pricing can only be determined after understanding your specific needs.
At Eleos, we tailor coverage to fit each client's unique situation, ensuring you get the best possible solution for your needs.
Not sure where to start? Talk to someone who wants to listen.
Eleos is here to make your life easier and give your employees peace of mind. We’re on your side.
