Health

No one plans to get sick or hurt, but at some point we all need medical care. GLM Insurance can help you find options to cover these costs and protect you from potentially high medical bills.

What kinds of health insurance are there?

There are essentially two kinds of health insurance: Fee-for-Service and Managed Care. Although these plans differ, they both cover an array of medical, surgical and hospital expenses. Most cover prescription drugs as well.

Fee-for-Service

These plans generally assume that the medical professional will be paid a fee for each service provided to the patient. Patients are seen by a doctor of their choice and the claim is filed by either the medical provider or the patient.

Managed Care

More than half of all americans have some form of a managed-care plan. Health Maintance Organizations (HMOs), Exclusive Provider Organizations (EPOs), Preferred Provider Organizations (PPOs), and Point-of-Service (POS) plans are the primary types. These plans provide comprehensive health services to their members and offer financial incentives to patients who use the providers in the plan.

Under both of these types of insurance, you may find coverage for Long Term Care, Dental and Vision Coverage.

Long-Term Care

Because of old age, mental or physical illness, or injury, some people find themselves in need of help performing normal daily tasks or ADLs (Activities of Daily Living) If you have a cognitive impairment or you can’t do two or more tasks - eating, bathing, dressing, toileting or continence you may need long-term care. This care could be provided in your home or an assisted living facility for a few months or a lifetime.

Dental

These plans provide you with certain benefits, usually including regular checkups, cleanings, x-rays, and other services required to promote general dental health. Some plans will provide broader coverage than others and some will require a greater financial contribution on your part when services are rendered. Some plans may also provide coverage for certain types of oral surgery, dental implants, or orthodontia.

Vision

A Vision Policy can help defray the cost of associated with eye surgeries, specific eye diseases, and permanent visual impairment. They also can help you pay for eye exams and vision correction materials.

 

Common Health Insurance Terms

Premium

The amount you pay to your insurance plan, usually every month. You pay this even if you don't use medical care that month.

Deductible

The amount you pay for care before the insurance company starts to pay its share. Once you meet your deductible, your insurance company begins to cover some costs of your care. Some plans have lower deductibles, like $250. Some have higher deductibles, like $2000. Many plans provide preventive services, such as a physical exam or a dental cleaning, and sometimes other care, before you've met your deductible.you are entitled to certain dental benefits, usually including regular checkups, cleanings, x-rays, and certain services required to promote general dental health. Some plans will provide broader coverage than others and some will require a greater financial contribution on your part when services are rendered. Some plans may also provide coverage for certain types of oral surgery, dental implants, or orthodontia.

Copayment

The amount you'll pay for a medical service after you've met your deductible. For example, after meeting your deductible you may pay $25 for a visit to the doctor's office that would cost $150 if you didn't have coverage. The health plan pays the rest.

Coinsurance

Similar to copayment, except it's a percentage of costs you pay. For example, you may pay 20% of the cost of a $100 medical bill. You would pay $20 and the health plan would pay the rest.

 

Are you properly covered?

There are a lot of changes happening in health care. Contact us and we can help you navigate through the changes and make sure you have a coverage plan that is right for you.