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

Copay Plan 1

In-Network

Deductible

Individual

Individual under Family

Family

 

$2,500

$2,500

$5,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$5,000

$5,000

$10,000

Preventative Services

No Charge

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$40 Copay

$40 Copay

30%*

Urgent Care Services

$75 Copay

Complex Imaging: MRI/CT/PET Scans

$300 Copay

Inpatient Hospital Care

Facility Fee

Physician Fee

 

$1,500 Copay

30%*

Outpatient Procedures

Facility Fee

Physician Fee

 

$1,500 Copay

30%*

Emergency Room Services

Emergency Medical Transportation

$500 Copay

30%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

30%*

$40 Copay

* Coinsurance after deductible

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

 

 

Prescription Drug Coverage

Retail 30 Day Supply

Mail Order 90 Day Supply

Generic

Preferred Brand

Non-Preferred Brand

Specialty

$25 Copay

$75 Copay

$95 Copay

$200 Copay

$50 Copay

$150 Copay

$190 Copay

Not Available


If you prefer talking with a HealthEZ representative, call 844-839-6746