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

In-Network

Out-Of-Network

Embedded Plan Year Deductible

Employee Only

Family

 

$1,500

$3,000

 

Not Covered

Not Covered

Coinsurance

20%

Not Covered

Embedded Out-Of-Pocket Maximum

Employee Only

Family

 

$2,800

$5,600

 

Not Covered

Not Covered

Preventive Care

100% Covered

Not Covered

Physician Services

Specialist Services

$25 Copay

$50 Copay

Not Covered

Not Covered

Hospital Services - Inpatient & Outpatient Care

20%*

Not Covered

Emergency Services

$300 Copay then 20%*

Not Covered

Urgent Care Services

$50 Copay

Not Covered

Chiropractic Services

Life Clinic Chiropractic Services

$50 Copay

$15 Copay

Not Covered

Not Covered

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$50 Copay

 

Not Covered

Not Covered

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

 

$15 Copay

$60 Copay

$90 Copay

30% Coinsurance

 

$45 Copay

$180 Copay

$270 Copay

Not available

NOTE: *After Deductible

 

 

$2,300 HSA Plan

In-Network

Out-Of-Network

Non-Embedded Plan Year Deductible

Employee Only

Family

 

$2,300

$3,700

 

Not Covered

Not Covered

Coinsurance

0%*

Not Covered

Non-Embedded Out-Of-Pocket Maximum

Employee Only

Family

 

$2,300

$3,700

 

Not Covered

Not Covered

Preventive Care

100% covered

No coverage

Physician Services

0%*

Not Covered

Hospital Services - Inpatient & Outpatient Care

Outpatient Surgery

0%*

0%*

Not Covered

Not Covered

Emergency Services

0%*

Not Covered

Urgent Care Services

0%*

Not Covered

Chiropractic Services

0%*

Not Covered

Mental health/Chemical Dependency

0%*

Not Covered

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Preventative Drugs per PBM List

Generic

Formulary

Non-Formulary

Specialty

 

No Charge

0%*

0%*

0%*

0%*

 

No Charge

0%*

0%*

0%*

Not available

*After Deductible

 

 

$5,500 HSA Plan - Embedded

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$5,500

$11,000

 

Not Covered

Not Covered

Coinsurance

10%*

Not Covered

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,900

$13,800

 

Not Covered

Not Covered

Preventive Care

100% covered

Not Covered

Physician Services

10%*

Not Covered

Hospital Services - Inpatient & Outpatient Care

Outpatient Surgery

10%*

10%*

Not Covered

Not Covered

Emergency Services

10%*

Not Covered

Urgent Care Services

10%*

Not Covered

Chiropractic Services

10%*

Not Covered

Mental health/Chemical Dependency

10%*

Not Covered

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Preventative Drugs per PBM List

Generic

Formulary

Non-Formulary

Specialty

 

No Charge

10%*

10%*

10%*

30%*

 

No Charge

10%*

10%*

10%*

Not available

*After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 1-800-948-3253