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What is Medicaid Gap Insurance?

Medigap or Medicare Gap Insurance is a supplemental plan that covers gaps in coverage for the health-insurance plan for older Americans. Although Medicare and Medicaid are part of the same program, a person cannot purchase Medicaid Gap Insurance to cover the items the state-administered plan does not cover. Clients who receive Medicaid have almost full health insurance coverage. Vision and cosmetic surgery are not covered under the latter plan.

No Medicaid Gap Insurance

Because Medicaid Gap insurance does not exist, the reader may wonder how or why they heard of such an item in the first place. Medicaid and Medicare are both federally-funded programs, although individual states administer the first. Medicaid is designed to provide broad health care insurance coverage for people who fall under the income guidelines. Because there are very few gaps in Medicaid coverage, purchasing additional insurance to cover items that the state-run program does not cover is usually not necessary.

Clearing Up the Confusion

Medicare is a federally-run program whose rules are applied the same way in every state. Medicare does not provide the broad level of coverage that state-run Medicaid programs usually offer. Differences in the level of coverage explain the need for Medicare Gap Insurance plans. If Medicaid Gap insurance existed, it would in theory work in a manner similar to the way Medigap plans currently do. Because Medicaid is offered to people with low incomes, offering a Medicaid insurance plan with a premium, even if it is to take care of the gaps in coverage, does not make logical sense. The rules for Medicare assume that a person receiving Medicare has more income than a person receiving Medicaid. Most people either have one plan or the other and do not have Medicaid and Medicare at the same time.



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