The Medical Supplement Plan (often referred to as a "gap" plan) pays in addition to any other medical insurance program you may offer your employees. This type of plan is designed to protect the employee from costly out-of-pocket expenses such as deductibles, copayments, and co-insurance that are not covered by their medical plan.
The plan covers three major benefit areas:
- In-Hospital Benefit pays difference between actual hospital expenses and amount paid by primary medical plan up to the maximum benefit selected
- Out-Patient Benefit pays difference between actual hospital expenses and amount paid by primary medical plan for out-patient facilities, emergency rooms or free standing out patient surgical center up to a specified plan maximum per occurrence
- Doctor Bill Benefit – pays a benefit up to plan maximums for treatment received outside of a hospital.