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 1
In-Network
Out-Of-Network
Calendar Year Deductible
Individual Coverage
Individual Under Family Coverage
Family
$500
$1,500
$750
$2,250
Out-of-Pocket Maximum
$2,500
$5,000
$10,000
Preventive Care
No Charge
40%*
Office Visits
Primary Office Visit
Specialist Office Visit
Chiropractic Visit
$20 Copay
$40 Copay
Urgent Care Services
$50 Copay
Complex Imaging: MRI/CT/PET Scans
20%*
Inpatient Hospital Care
Facility Fee
Physician Fee
Outpatient Procedures
$200 Copay
Emergency Services**
Emergency Room
Emergency Medical Transportation
$300 Copay
Mental Health / Chemical Dependency
Inpatient Facility Fee
Office Visit
Prescription Drug Coverage
Generic
Preferred brand
Non-preferred brand
Specialty Drugs
Retail 30 Day Supply
$10 Copay
$80 Copay
$250 Copay
Mail Order 90 day Supply
$100 Copay
$160 Copay
Not Covered
NOTE: * Coinsurance After Deductible
** Covered as in-network in true-emergency
Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions
Copay Plan 2
$3,000
$6,000
$20,000
50%*
$35 Copay
$75 Copay
30%*
$350 Copay
Formulary
Non-Formulary
Specialty
HSA Plan 1
Family Coverage
$3,200
$3,300
$6,400
$12,800
$25,600
Preventive Care Services
0%*
Emergency Room Services**
Emergency Medical Transportation**
Mental Health/Chemical Dependency
Inpatient
Preferred Brand
Non-Preferred Brand
Mail Order 90 Day Supply
If you prefer talking with a HealthEZ representative, call 1-877-840-3874