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

HSA Plan

In-Network

Out-Of-Network

Deductible

Individual

Family

 

$4,000

$8,000

 

$8,000

$16,000

Out-Of-Pocket Maximum

Individual

Family

 

$4,000

$8,000

 

$8,000

$16,000

Preventive Care Services

No Charge

Not Covered

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 Services**

Emergency Room

Emergency Medical Transportation

 

0%*

0%*

 

50%*

50%*

Mental Health / Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Speciality

Retail 30 Day Supply

0%*

0%*

0%*

0%*

Mail Order 90 day Supply

0%*

0%*

0%*

Not Available

NOTE: * Coinsurance After Deductible

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

 

 

 

 

PPO Plan

In-Network

Out-Of-Network

Deductible

Individual

Family

 

$2,000

$4,000

 

$4,000

$8,000

Out-Of-Pocket Maximum

Individual

Family

 

$4,500

$9,000

 

$9,000

$18,000

Preventive Care Services

No Charge

Not Covered

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay

$60 Copay

$60 Copay

 

50%*

50%*

50%*

Urgent Care Services

$30 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 Services**

Emergency Room

Emergency Medical Transportation

 

$500 Copay After Deductible

20%*

 

50%*

50%*

Mental Health / Chemical Dependency

Inpatient

Office Visit

 

20%*

$30 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Speciality

Retail 30 Day Supply

$15 Copay

$30 Copay

$60 Copay

25% Coinsurance up to $500

Mail Order 90 day Supply

$15 Copay

$60 Copay

$180 Copay

Not Available

NOTE: * Coinsurance After Deductible

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

 

 

 

 


If you prefer talking with a HealthEZ representative, call 1-844-302-7781