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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

$1,500 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,500

$3,000

 

$3,000

$6,000

Coinsurance

20%

40%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,000

$6,000

 

$6,000

$12,000

Preventive Care

100% Covered

25%*

Office Visits

Primary Services

Specialist Services

 

20%*

20%*

 

40%*

40%*

Hospital Services Inpatients & Outpatient Care

20%*

40%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

$250 Copay*, then 40%

40%*

Urgent Care Services

20%*

40%*

Chiropractic Services

20%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

20%*

20%*

20%*

20%*

 

20%*

20%*

20%*

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

$6,550 HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,550

$13,100

 

$10,000

$20,000

Coinsurance

0%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,550

$13,100

 

$15,000

$30,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

0%*

0%*

 

50%*

50%*

Hospital Services Inpatients & Outpatient Care

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

Formulary

Non-Formulary

Specialty

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$2,000

$4,000

 

$4,000

$8,000

Coinsurance

20%

40%

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,000

$8,000

 

$8,000

$16,000

Preventive Care

100% Covered

25%*

Office Visits

Primary Services

Specialist Services

 

$25 Copay

$45 Copay

 

25%*

25%*

Hospital Services Inpatients & Outpatient Care

20%*

40%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$250 Copay then 20%

20%*

 

$250 Copay then 40%

40%*

Urgent Care Services

$25 Copay

40%*

Chiropractic Services

20%*

40%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$25 Copay

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$5 Copay

$25 Copay

$50 Copay

20% up to $250

 

$15 Copay

$75 Copay

$150 Copay

Not available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 


If you prefer talking with a HealthEZ representative, call 1-844-302-7776