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 1 Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual

Individual under Family

Family

 

$2,000

$2,000

$6,000

 

$2,000

$2,000

$6,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$5,000

$5,000

$10,000

 

$10,000

$10,000

$20,000

Preventative Services

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$40 Copay

$40 Copay

20%*

 

40%*

40%*

40%*

Urgent Care Services

$40 Copay

40%*

Complex Imaging: MRI/CT/PET Scans

20%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Emergency Room Services

Emergency Medical Transportation

20%*

20%*

20%*

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$40 Copay

 

40%*

40%*

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

* Coinsurance after deductible

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

 

 

 

 

PPO 2 Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual

Individual under Family

Family

 

$5,500

$5,500

$11,000

 

$5,500

$5,500

$11,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$5,500

$5,500

$11,000

 

$11,000

$11,000

$22,000

Preventative Services

No Charge

20%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay/initial 5 visits, 0%*

$30 Copay/initial 5 visits, 0%*

0%*

 

20%*

20%*

20%*

Urgent Care Services

$30 Copay/initial 5 visits, 0%*

20%*

Complex Imaging: MRI/CT/PET Scans

0%*

20%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

20%*

20%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

20%*

20%*

Emergency Room Services

Emergency Medical Transportation

0%*

0%*

0%*

0%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

$30 Copay/initial 5 visits, 0%*

 

20%*

20%*

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

* Coinsurance after deductible

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

 

 

 

 

HSA 1 Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual

Individual under Family

Family

 

$3,500

$3,500

$7,000

 

$3,500

$3,500

$7,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$5,000

$5,000

$10,000

 

$10,000

$10,000

$20,000

Preventative Services

No Charge

30%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

10%*

10%*

10%*

 

30%*

30%*

30%*

Urgent Care Services

10%*

30%*

Complex Imaging: MRI/CT/PET Scans

10%*

30%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

10%*

10%*

 

30%*

30%*

Outpatient Procedures

Facility Fee

Physician Fee

 

10%*

10%*

 

30%*

30%*

Emergency Room Services

Emergency Medical Transportation

10%*

10%*

10%*

10%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

10%*

10%*

 

30%*

30%*

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

 

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

* Coinsurance after deductible

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

 

 

 

 

If you prefer talking with a HealthEZ representative, call 844-839-6739