Guarantee Trust Life Complete PPO Health Insurance Plan

Guarantee Trust Life Assure Care Complete PPO Health Insurance Plan

The "Complete" P.P.O. comprehensive Health Insurance plan is underwritten by Guarantee Trust Life Insurance Company of Glenview, Illinois (www.gtlic.com) licensed in 49 states and founded in 1936. The Complete plan provides multiple calendar year deductible choices to choose from, ranging from $1,500 or $7,500. The plan offers $40 unlimited outpatient doctor office sick visit co pays. The outpatient doctor co pay benefit is a "first dollar" benefit. This means that with this option added to the plan, each time you are sick you will pay your $40 outpatient doctor office co pay and the rest of the doctor's office charges will be paid at 100% with no deductible required.

80/20, and 50/50 "co-insurance" plans are available with "stop loss" numbers ranging from as low as $5,000 to as high as $40,000. The terms "co-insurance" and "stop loss" are very rarely if ever discussed with a prospective insured. This is because they have a direct effect on how much you as the insured will pay in the event of a worse case scenario. This being the case, it is crucial to understand these two important health insurance terms prior to purchasing a health insurance plan. Please ask your agent to clarify these clearly before deciding on a plan.

The definition of "co-insurance" is the percentage of a predetermined annual dollar amount of medical bills (known as the "stop loss" number) that you agree to share with the insurance company after you have satisfied your calendar year deductible before the insurance company pays 100%. To better illustrate let's use the example of an 80/20 of $10,000 split. With this arrangement, after you have satisfied your calendar year deductible the insurance company will pay 80% ($8,000) and you will pay 20% ($2,000) of the first $10,000 in medical bills that you incur each calendar year. This $10,000 amount is known as the "stop loss number". After this brief cost sharing arrangement is over the insurance company pays 100% per insured for the rest of that calendar year. Everything starts over again on the first of each subsequent calendar year.

The "Complete" plan also offers a "first dollar" outpatient prescription co pay card with $15 co pays for generic prescription drugs and $30 co pays for formulary brand name prescription drugs. Afterwards GTL will pay 50%. Their is no deductible required for Generic medications. Brand name medications require a separate $500 outpatient prescription drug card calendar year deductible to be satisfied before Brand name medications will be covered for a co pay. For a significantly lower monthly premium the insured can choose an outpatient Generic drug card only. If this option is chosen, outpatient Generic drugs will be covered for a $20 co pay with no deductible required first. However, Brand name outpatient medications would not be covered with this option. Since conditions such as Rheumetoid Arthritis and Multiple Sclerosis (and a whole host of others) require very expensive outpatient medications. One needs to carefully weigh the additional risk when considering this Generic only outpatient prescription drug card option.

Routine Physical Exams are also covered after the first 12 months of policy ownership on a "first dollar" basis up to $100 per examination. The exam includes coverage for lab tests (blood/urine) associated with the same routine physical exam. No co pay or deductible is required. Benefits will be paid at the same co-insurance level you chose for your health plan. In addition with both plans, Mammograms Pap Smears, Prostate Cancer Screening tests as well as Colorectal cancer screenings are also covered from day one with no deductible required with the "Enhanced Preventative Care" benefit selected.

4th Quarter Deductible Carry over is also included with both plans as well as an Accident Medical Expense plan that will waive your calendar year deductible in the event of an accident injury. Treatment for hernia; tonsils; adenoiditis; any disease or disorder of the reproductive system; any rectal disease or disorder; gall bladder; varicose veins; or laminectomy, discectomy or spinal fusion will not be covered for the first six months of policy ownership. This waiting period shall not apply when treatment for these conditions is needed in an emergency situation nor when a covered person is receiving treatment due to a malignancy (cancer).

Guarantee Trust Life Insurance Company Complete Health Insurance Plan

Guarantee Trust Life Insurance Company (www.gtlic.com)
Licensed in 49 states. Founded in 1936.
Administered by Insurers Administrative Corporation (www.iacusa.com)
$5 million in lifetime benefits per insured with both plans.
Optional unlimited "first dollar" outpatient $40 doctor office sick visit co pays available.
Routine Physical Exams are covered after 12 months of policy ownership on a "first dollar" basis up to $100 per examination. The exam includes coverage for lab tests (blood/urine) associated with the same routine physical exam. No co pay is required. Benefits will be paid at the same co-insurance level you chose for your health plan.
Mammograms Pap Smears, Prostate Cancer Screening tests as well as Colorectal cancer screenings are covered from day one on a "first dollar" basis (no deductible required) with the "Enhanced Routine Preventative Care" benefit.
Pre-existing conditions such as controlled Hypertension & Hyperlipidimia covered from day one with no waiting period.
Optional outpatient R/X card with $15 co pays for Generic and $30 co pays for formulary brand name prescriptions after a $500 annual deductible is satisfied.
Lower priced outpatient no deductible Generic prescription only co pay card available.
Fourth quarter deductible carry over included.
$1,500 or $2,500 calendar year health plan deductibles to choose from.
Deductible of $100 required for outpatient testing not performed in a doctor's office.
Deductible of $100 required for E.R. visits (waived if you are admitted)
Deductible of $200 required for hospital admissions.
Deductible of $200 required for outpatient ambulatory surgical facility.
Deductible of $200 required for MRI's, CAT scans, Pet scans, & Nuclear Imaging tests.
80/20 of $10,000 or 50/50 of $5,000, $10,000, $20,000 or $40,000 co-insurance options to choose.
Largest Nationwide P.P.O. network in the country. Are your doctors in network? www.phcs.com
$5,000 Accident Medical Expense (AME) benefit that also includes these ancillary benefits (www.ameribenefits.com)
Organ transplants covered the same as any other illness.

Guarantee Trust Life "Complete" Health Insurance Plan Brochure ( PDF)
See last 4 pages of the brochure for your State's Specific Mandated Benefits.

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Guarantee Trust Life Insurance Company Complete Health Insurance Plan