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

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

$5,000

$10,000

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,000

$8,000

 

$10,000

$20,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$25 Copay

$25 Copay

20%*

 

50%*

50%*

50%*

Hospital Services

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$250 Copay

20%*

 

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$25 Copay

100% Covered

100% Covered

100% Covered

 

100% Covered

$25 Copay

100% Covered

100% Covered

100% Covered

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$25 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$35 Copay

$60 Copay

$250 Copay

 

$25 Copay

$87.50 Copay*

$150 Copay

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

Copay Plan 2

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$4,000

$8,000

 

$5,000

$10,000

Coinsurance

0%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,350

$12.700

 

$10,000

$20,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$25 Copay

$75 Copay

0%*

 

50%*

50%*

50%*

Hospital Services

0%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$650 Copay

0%*

 

50%*

50%*

Urgent Care Services

$50 Copay

50%*

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 Copay

100% Covered

100% Covered

100% Covered

 

100% Covered

$75 Copay

100% Covered

100% Covered

100% Covered

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

0%*

$75 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$35 Copay

$60 Copay

$250 Copay

 

$25 Copay

$87.50 Copay*

$150 Copay

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

Copay Plan 3

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,000

$12,000

 

$10,000

$20,000

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,150

$14,300

 

$20,000

$40,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$15 Copay

$50 Copay

20%*

 

50%*

50%*

50%*

Hospital Services

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$300 Copay

20%*

 

50%*

50%*

Urgent Care Services

$25 Copay

50%*

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$50 Copay

100% Covered

100% Covered

100% Covered

 

100% Covered

$50 Copay

100% Covered

100% Covered

100% Covered

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$50 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$35 Copay

$60 Copay

$250 Copay

 

$25 Copay

$87.50 Copay*

$150 Copay

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

HSA Plan 1

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,000

$12,000

 

$12,000

$24,000

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,000

$12,000

 

$20,000

$40,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

0%*

0%*

0%*

 

50%*

50%*

50%*

Hospital Services

0%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

0%*

0%*

 

50%*

50%*

Urgent Care Services

0%*

50%*

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered*

$75 Copay*

100% Covered*

100% Covered*

100% Covered*

 

100% Covered*

$75 Copay*

100% Covered*

100% Covered*

100% Covered*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

0%*

0%*

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 


If you prefer talking with a HealthEZ representative, call 1-844-679-7739