What GM Family First is and who it's for

GM Family First is a health insurance plan offered by General Motors to hourly and salaried employees and their families. It is not a government program — it is a private benefit that GM provides as part of employment. If you work for GM or are a dependent on someone's GM health plan, this guide explains how the plan operates, what it typically covers, and how to use it.

The plan is available to GM employees in the United States and covers medical, dental, and vision services. Because GM is a large employer, the plan structure and covered services are more detailed than many smaller employer plans, but the basic idea is the same: you pay a portion of the premium (usually through payroll deduction), and the plan pays a portion of your medical bills.

If you are not a GM employee or dependent, you will not have access to this plan. If you are newly hired or recently became may be able to access, your enrollment window is typically limited, so understanding the plan's structure before you enroll matters.

Key Takeaways

  • GM Family First is an employer health plan for General Motors workers and their dependents, not a government program you can join on your own.
  • The plan includes medical, dental, and vision coverage, with costs shared between you and GM through premiums, deductibles, and copays.
  • You can only enroll during your initial may be able to access window (usually within 30 days of hire) or during the annual open enrollment period in the fall.
  • The plan's coverage details, costs, and network of doctors change year to year, so reviewing your plan documents each fall is important.
  • If you lose GM employment, you may be able to continue coverage temporarily through COBRA, though you will pay the full premium yourself.

How premiums, deductibles, and copays work under GM Family First

GM Family First operates on a shared-cost model. You pay a monthly premium (the amount deducted from your paycheck), and GM pays the rest of the premium. When you use medical services, you also pay a deductible — the amount you must spend out of your own pocket before the plan starts paying — and copays, which are fixed dollar amounts you pay at the time of service.

The exact premium amount depends on which plan option you choose (GM typically offers several tiers), your salary level, and whether you cover just yourself or your family. Deductibles and copays also vary by plan tier. A lower-premium plan usually has a higher deductible and higher copays; a higher-premium plan usually has a lower deductible and lower copays. You choose which tier fits your budget and expected health needs during enrollment.

Once you meet your deductible in a calendar year, the plan begins to share costs with you through coinsurance — for example, the plan might pay 80% of a doctor visit and you pay 20%. Most plans also have an out-of-pocket maximum, a yearly cap on how much you pay in deductibles, copays, and coinsurance. Once you reach that maximum, the plan covers 100% of covered services for the rest of that year.

What medical services GM Family First typically covers

GM Family First covers preventive care at no cost to you — this includes annual physical exams, vaccinations, cancer screenings, and other services the plan classifies as preventive. You do not pay a copay or deductible for these visits if you use an in-network provider.

For other medical services — office visits for illness or injury, emergency room visits, hospital stays, surgery, mental health care, and prescription drugs — you pay your share through copays, deductibles, and coinsurance. The plan covers these services only when you use a provider or facility in the plan's network. If you use an out-of-network provider, you typically pay more, and sometimes the plan covers a smaller percentage of the cost.

Prescription drug coverage is included, but the plan uses a formulary — a list of covered medications organized by tier. Generic drugs are usually the cheapest tier; brand-name drugs are more expensive. Some medications may not be on the formulary at all, meaning the plan does not cover them, or you must get prior approval from the plan before filling the prescription.

Dental and vision coverage under the plan

GM Family First includes dental coverage, though it is often a separate plan within the overall benefit package. Preventive dental care — cleanings, exams, and X-rays — is usually covered at 100% with no copay when you use an in-network dentist. Fillings, root canals, and other restorative work are covered at a lower percentage, often 50% to 80%, and you pay the rest. Major work like crowns or bridges may have annual limits on how much the plan will pay.

Vision coverage typically includes an annual eye exam at no cost and a benefit toward eyeglasses or contact lenses — for example, the plan might cover up to $150 per year toward frames and lenses. Like medical coverage, vision benefits work only with in-network providers, and out-of-network care costs more.

Both dental and vision have separate deductibles and annual maximums from your medical coverage. Check your plan documents to see the exact limits, because they vary by plan tier and change year to year.

When you can enroll and how to make changes

If you are newly hired by GM, you have a limited window — usually 30 days from your hire date — to enroll in health coverage. If you miss this window, you cannot enroll until the next annual open enrollment period, which typically runs in the fall (September or October). Missing the important date can leave you uninsured for months, so mark the date on your calendar.

During open enrollment, all employees can review their current plan, switch to a different plan tier, add or remove family members, or make changes to dental and vision coverage. This is the time to compare what you are paying now against what you could pay in the new year, because plan costs and coverage details change annually.

Outside of open enrollment, you can make changes only if you experience a may have access to life event — marriage, divorce, birth of a child, loss of other health coverage, or a significant change in income. You typically have 30 to 60 days from the event to notify GM's benefits office and make your changes.

How to find doctors and use your plan

GM Family First uses a network of doctors, hospitals, and specialists. To find in-network providers, you use the plan's online directory or call the customer service number on your insurance card. Searching the directory before scheduling an appointment is important, because using an in-network provider saves you money.

When you visit an in-network doctor, you present your insurance card. The doctor's office checks your coverage and tells you what you owe — your copay, or your deductible if you have not met it yet. You pay that amount at the visit. The doctor bills the plan for the rest, and the plan pays its share directly to the provider.

If you need a specialist or a procedure, some plans require you to get a referral from your primary care doctor first. Other plans allow you to see a specialist without a referral. Check your plan documents or call customer service to understand your plan's rules, because this affects how smoothly your care flows.

What happens to your coverage if you leave GM

If you leave your job at GM, your health coverage typically ends on the last day of the month in which you separate. You do not automatically keep the plan. However, you may be able to continue coverage temporarily through COBRA (Consolidated Omnibus Budget Reconciliation Act), a federal law that lets you keep your employer plan for up to 18 months after you leave, though you pay the full premium yourself — both the employee and employer portions — plus a small administrative fee.

COBRA is expensive because you are paying the entire cost, but it can be useful if you are between jobs or waiting for a new employer's coverage to start. You must request COBRA within 60 days of losing coverage, and you have 45 days to pay your first premium. If you miss these important date, you lose the option.

If COBRA is too expensive or you do not may have access to, you can look for coverage through the Health Insurance Marketplace (Healthcare.gov) or through a new employer if you find work. Losing employer coverage is a may have access to event for Marketplace enrollment, so you can enroll outside the normal open enrollment period.

Frequently Asked Questions

Can I use my GM Family First plan at any doctor?

No. You must use in-network providers to get the plan's full coverage. If you use an out-of-network doctor, you pay a higher percentage of the cost, and sometimes the plan covers very little. Always check the online directory or call customer service before scheduling to confirm a provider is in-network.

What if my prescription drug is not on the formulary?

If your medication is not covered, you can pay for it out of pocket, or you can ask your doctor to request a prior authorization from the plan. Sometimes the plan will cover a non-formulary drug if your doctor explains why you need that specific medication instead of a formulary alternative. This process takes a few days, so plan ahead.

Do I have to pay anything for preventive care?

Preventive services like annual physicals, vaccinations, and cancer screenings are covered at 100% with no copay or deductible when you use an in-network provider. However, if the visit turns into treatment for a specific condition, that treatment may not be preventive and you may owe a copay or deductible.

What is the difference between in-network and out-of-network?

In-network providers have a contract with your plan and charge negotiated rates. You pay less and the plan pays more. Out-of-network providers do not have a contract, charge higher rates, and the plan pays a smaller percentage. Using out-of-network care costs you significantly more, so staying in-network is important.

Can I change my plan outside of open enrollment?

Only if you have a may have access to life event — marriage, birth, adoption, loss of other coverage, or significant income change. You must report the event to GM's benefits office within 30 to 60 days and provide documentation. Outside of these events and annual open enrollment, you cannot change your plan until the next fall.