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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

HDHP Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Individual under Family

Family

 

$3,400

$3,400

$6,000

 

$9,000

$9,000

$18,000

Out-Of-Pocket Maximum

Individual

Individual under Family

Family

 

$4,000

$4,000

$8,000

 

$12,000

$12,000

$24,000

Preventive Care

No Charge

30%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay*

$50 Copay*

$50 Copay*

 

30%*

30%*

30%*

Urgent Care Services

$75 Copay*

30%*

Complex Imaging: MRI/CT/PET Scans

0%*

30%*

Hospital Services Inpatient & Outpatient

0%*

30%*

Emergency Room Services**

Facility Fee

Physician Fee

Emergency Medical Transportation

 

$250 Copay*

0%*

0%*

 

30%*

30%*

30%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

0%*

$30 Copay*

 

30%*

30%*

NOTE: * After deductible

** True emergencies covered at in-network level

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

 

 

 

 

 

 

Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Individual under Family

Family

 

$1,500

$1,500

$3,000

 

$4,500

$4,500

$9,000

Out-Of-Pocket Maximum

Individual

Individual under Family

Family

 

$5,000

$5,000

$10,000

 

$15,000

$15,000

$30,000

Preventive Care

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$25 Copay

$50 Copay

$50 Copay

 

40%*

40%*

40%*

Urgent Care Services

$75 Copay

40%*

Complex Imaging: MRI/CT/PET Scans

20%*

40%*

Hospital Services Inpatient & Outpatient

20%*

40%*

Emergency Room Services**

Facility Fee

Physician Fee

Emergency Medical Transportation

 

$250 Copay*, then 20%*

20%*

20%*

 

40%*

40%*

40%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$25 Copay

 

40%*

40%*

NOTE: * After deductible

** True emergencies covered at in-network level

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

 

 

 

 

 

 


If you prefer talking with a HealthEZ representative, call 1-888-204-7871