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

HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$7,000

$14,000

 

$14,000

$28,000

Coinsurance

0%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,000

$14,000

 

$21,000

$42,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

0%*

0%*

 

50%*

50%*

Hospital Services

0%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

0%*

0%*

 

50%*

50%*

Urgent Care Services

0%*

50%*

Chiropractic Services

0%*

50%*

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

 

 

Copay Plan 1

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

$3,000

$6,000

Coinsurance

30%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,500

$9,000

 

$13,500

$27,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$45 Copay

$45 Copay

 

50%*

50%*

Hospital Services

30%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

30%*

30%*

 

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Chiropractic Services

$45 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

30%*

$45 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$12 Copay

$50 Copay

$90 Copay

$200 Copay

 

$24 Copay

$100 Copay

$180 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

 

$8,000

$16,000

Coinsurance

20%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

$15,000

$30,000

Preventive Care

100%

50%*

Office Visits

Primary Services

Specialist Services

 

$45 Copay

$45 Copay

 

50%*

50%*

Hospital Services

20%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

50%*

50%*

Urgent Care Services

$75 Copay

50%*

Chiropractic Services

$45 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$45 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

Retail 30 Day Supply

 

$12 Copay

$50 Copay

$90 Copay

$200 Copay

Mail Order 90 day Supply

 

$24 Copay

$100 Copay

$180 Copay

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 


If you prefer talking with a HealthEZ representative, call 844-449-5543