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

$500 Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$2,000

$4,000

 

 

 

Coinsurance

10%

 

Out-Of-Pocket Maximum

Employee Only

Family

 

$2,000

$4,000

 

 

 

Preventive Care

100% Covered

 

Physician Services

Primary

Specialist

Chiropractic Services

 

$30 Copay

$45 Copay

$40 Copay

 

 

 

 

Hospital Services Inpatients & Outpatient Care

10%*

 

Emergency Services

$250 Copay

 

Urgent Care Services

$50 Copay

 

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

 

 

 

 

 

 

Mental health/Chemical Dependency

Inpatient

Outpatient

 

10%*

$45 Copay

 

 

 

Retail 30 Day Supply

 

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty (Mail order available for a 30 day supply

 

$5 Copay

$15 Copay

$30 Copay

25%*

 

 

 

 

 

*After Deductible

 

 

$1,000 Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

 

 

Coinsurance

20%

 

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

 

 

Preventive Care

100% Covered

 

Physician Services

Primary

Specialist

Chiropractic

 

$40 Copay

$75 Copay

$45 Copay

 

 

 

 

Hospital Services Inpatients & Outpatient Care

20%*

 

Emergency Services

$250 Copay

 

Urgent Care Services

$75 copay

 

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

 

 

 

 

 

 

Mental health/Chemical Dependency

Inpatient

Outpatient Office Visits

 

20%*

$75 Copay

 

 

 

Retail 30 Day Supply

 

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty (Mail order available for a 30 day supply)

 

$5 Copay

$25 Copay

$45 Copay

25%*

 

 

 

 

 

*After Deductible

 

 

$1,500 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Individual on Family Plan

Family

 

$1,500

$2,800

$3,000

 

 

 

 

Coinsurance

20%

 

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$8,000

 

 

 

Preventive Care

100% Covered

 

Physician Services

Primary

Specialist

Chiropractic

 

20%*

20%*

20%*

 

 

 

 

Hospital Services Inpatients & Outpatient Care

20%*

 

Emergency Services

20%*

 

Urgent Care Services

20%*

 

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 fee until deductible is met, then 20% coinsurance

$85 fee until deductible is met, then 20% coinsurance

$200 fee until deductible is met, then 20% coinsurance

$95 fee until deductible is met, then 20% coinsurance

 

 

 

 

 

 

Mental health/Chemical Dependency

20%*

 

Retail 30 Day Supply

 

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty (Available for 30 day mail order)

 

20%*

20%*

20%*

20%*

 

 

 

 

 

*After Deductible

 

 

$2,800 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$2,800

$5,300

 

 

 

Coinsurance

20%

 

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$8,000

 

 

 

Preventive Care

100% Covered

 

Physician Services

Primary

Specialist

Chiropractic

 

20%*

20%*

20%*

 

 

 

 

Hospital Services Inpatients & Outpatient Care

20%*

 

Emergency Services

20%*

 

Urgent Care Services

20%*

 

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 fee until deductible is met, then 20% coinsurance

$85 fee until deductible is met, then 20% coinsurance

$200 fee until deductible is met, then 20% coinsurance

$95 fee until deductible is met, then 20% coinsurance

 

 

 

 

 

 

Mental health/Chemical Dependency

20%*

 

Retail 30 Day Supply

 

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty (Available for 30 day mail order)

 

20%*

20%*

20%*

20%*

 

 

 

 

 

*After Deductible

 

 

$1,500 Dental Plan Benefit

In-Network

Out-Of-Network

Deductible

Employee Only

Family

 

$50

$150

 

 

 

Annual Maximum

Non-Orthodontics

Orthodontics

 

$1,500/person/year

$1,500/person/lifetime

 

 

 

Preventive Health Care

No Member Responsibility

 

Diagnostic Services

No Member Responsibility

 

Basic Dental Services

20%*

 

Major Dental Services

50%*

 

Orthodontic Services

50%*

 

*After Deductible

 

 

$2,500 Dental Plan Benefit

In-Network

Out-Of-Network

Deductible

Employee Only

Family

 

$50

$150

 

 

 

Annual Maximum

Non-Orthodontics

Orthodontics

 

$2,500/person/year

$2,500/person/lifetime

 

 

 

Preventive Health Care

No Member Responsibility

 

Diagnostic Services

No Member Responsibility

 

Basic Dental Services

10%*

 

Major Dental Services

30%*

 

Orthodontic Services

20%*

 

*After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 1-844-288-5703