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Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.

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Summary Of Medical Benefits

Copay plan

In-Network

Out-Of-Network

Deductible

Individual Coverage

Individual under Family Coverage

Family Coverage

 

$2,000

$2,000

$6,000

 

$4,500

$4,500

$13,500

Out-Of-Pocket Maximum

Individual Coverage

Individual under Family Coverage

Family Coverage

 

$4,000

$4,000

$12,000

 

$9,000

$9,000

$18,000

Preventive Care

100% Covered

40%*

Office Visits

Primary Services

Specialist Services

Chiropractic Visit

Urgent Care Services

 

$25 Copay

$45 Copay

$45 Copay

$75 Copay

 

40%*

40%*

40%*

40%*

Complex Imaging: MRI/CT/PET Scans

20%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Emergency Services

Emergency Room **

Emergency Medical Transportation **

 

$250 Copay

20%*

 

$250 Copay

20%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$45 Copay

 

40%*

40%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$5 Copay

$25 Copay

$50 Copay

20% Coinsurance up to $200

Mail Order 90 day Supply

$10 Copay

$50 Copay

$100 Copay

Not Available

* After Deductible

** Covered as in-network in true-emergency

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

 

 

 

 

HSA Plan

In-Network

Out-Of-Network

Deductible

Individual Coverage

Individual under Family Coverage

Family Coverage

 

$6,350

$6,350

$12,700

 

$12,700

$12,700

$25,400

Out-Of-Pocket Maximum

Individual Coverage

Family Coverage

Family Coverage

 

$6,350

$6,350

$12,700

 

$13,900

$13,900

$27,800

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Visit

Urgent Care Services

 

0%*

0%*

0%*

0%*

 

50%*

50%*

50%*

50%*

Complex Imaging: MRI/CT/PET Scans

0%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

50%*

50%*

Emergency Services

Emergency Room**

Emergency Medical Transportation**

 

0%*

0%*

 

50%*

0%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

0%*

0%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

Retail 30 Day Supply

0%*

0%*

0%*

0%*

Mail Order 90 day Supply

0%*

0%*

0%*

Not Available

* After Deductible

** Covered as in-network in true-emergency

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions

 

 

 

 

 

 


If you prefer talking with a HealthEZ representative, call 1-844-449-5547