Compare Plans

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 1

In-Network

Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$2,000

$2,000

$4,000

 

$4,500

$4,500

$9,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$6,900

$6,900

$13,800

 

$13,800

$13,800

$27,600

Preventative Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$25 Copay

$75 Copay

20%*

 

50%*

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

20%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation

20%*

20%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

20%*

 

50%*

50%*

Telemedicine Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$35 Copay

$70 Copay

$350 Copay

Mail Order 90 Day Supply

$20 Copay

$70 Copay

$140 Copay

Not Available

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

* Coinsurance after deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

Copay Plan 2

In-Network

Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$4,000

$4,000

$8,000

 

$7,500

$7,500

$15,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$6,000

$6,000

$12,000

 

$15,000

$15,000

$30,000

Preventative Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$15 Copay

$75 Copay

20%*

 

50%*

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

20%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation

20%*

20%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

20%*

 

50%*

50%*

Telemedicine Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$35 Copay

$70 Copay

$350 Copay

Mail Order 90 Day Supply

$20 Copay

$70 Copay

$140 Copay

Not Available

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

* Coinsurance after deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

HSA Plan 1

In-Network

Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$4,000

$4,000

$8,000

 

$7,500

$7,500

$15,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$4,000

$4,000

$8,000

 

$15,000

$15,000

$30,000

Preventative Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

50%*

50%*

50%*

Urgent Care Services

0%*

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 Room Services

Emergency Medical Transportation

0%*

0%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

50%*

50%*

Telemedicine Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

 

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

0%*

0%*

0%*

0%*

Mail Order 90 Day Supply

0%*

0%*

0%*

Not Available

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

* Coinsurance after deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

If you prefer talking with a HealthEZ representative, call 844-302-7773