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.

Summary Of Medical Benefits

$750 Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$750

$1,500

 

$2,250

$4,500

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,150

$14,300

 

$21,450

$42,900

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$25 Copay

$40 Copay

 

50%*

50%*

Hospital Services- Inpatient & Outpatient Care

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$500 Copay

20%*

 

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Chiropractic Services

$40 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$40 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$45 Copay

$90 Copay

25% Coinsurance (deductible does not apply)

Mail Order 90 day Supply

$20 Copay

$90 Copay

$180 Copay

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

$1,750 Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,750

$3,500

 

$5,250

$10,500

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,150

$14,300

 

$21,450

$42,900

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$35 Copay

$50 Copay

 

50%*

50%*

Hospital Services- Inpatient & Outpatient Care

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$500 Copay

20%*

 

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Chiropractic Services

$50 Copy

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$50 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

Retail 30 Day Supply

$10 Copay

$45 Copay

$90 Copay

25% Coinsurance

Mail Order 90 day Supply

$20 Copay

$90 Copay

$180 Copay

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$5,000

$10,000

 

$15,000

$30,000

20%

50%

Employee Only

Family

 

$6,650

$13,300

 

$21,450

$42,900

Preventative Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

20%*

20%*

 

50%*

50%*

Hospital Services Inpatient & Outpatient Care

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

50%*

50%*

Urgent Care Services

20%*

50%*

Chiropractic Services

20%*

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

20%*

20%*

20%*

20%*

Mail Order 90 Day Supply

20%*

20%*

20%*

Not available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

Contact your HR rep to choose your plan.

If you prefer talking with a HealthEZ representative, call 1-844-281-5222