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

Copay Plan 1

In-Network

Out-of-Network

Calendar Year Accumulation

Embedded Deductible

Employee only

Family

 

 

$2,500

$5,000

 

 

$5,000

$15,000

Coinsurance

0%

50%

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$5,500

$11,000

 

$15,000

$45,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%* After Deductible

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$30 Copay

$60 Copay

$60 Copay

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

Urgent Care Services

$75 Copay

50%* After Deductible

Emergency Services

Emergency Room

Emergency Medical Transportation

 

$500 Copay

0%* After Deductible

 

$500 Copay

0%* After Deductible

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

0%* After Deductible

0%* After Deductible

 

50%* After Deductible

50%* After Deductible

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

0%* After Deductible

0%* After Deductible

0%* After Deductible

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%* After Deductible

No Charge

 

50%* After Deductible

50%* After Deductible

Summary of Pharmacy Benefits

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

Retail 30 Day Supply

$10 Copay

$45 Copay

$75 Copay

20% Coinsurance up to $250/Prescription

 

Mail Order 90 Day Supply

$20 Copay

$90 Copay

$150 Copay

Not Available

*Coinsurance

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

An Embedded Deductible means that each individual will only have to meet the individual Deductible before the Plan begins paying benefits for such individual that are subject to a Deductible.

An Embedded Out-of-Pocket Maximum means that each individual will only have to meet the individual out-of-pocket maximum before the Plan begins paying in full for such individual.

 

 

 

 

 

 

 

 

Copay Plan 2

In-Network

Out-of-Network

Calendar Year Accumulation

Embedded Deductible

Employee only

Family

 

 

$5,000

$10,000

 

 

$10,000

$30,000

Coinsurance

0%

50%

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$7,150

$14,300

 

$25,000

$75,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%* After Deductible

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$35 Copay

$70 Copay

$70 Copay

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

Urgent Care Services

$75 Copay

50%* After Deductible

Emergency Services

Emergency Room

Emergency Medical Transportation

 

$500 Copay

0%* After Deductible

 

$500 Copay

0%* After Deductible

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

0%* After Deductible

0%* After Deductible

 

50%* After Deductible

50%* After Deductible

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

0%* After Deductible

0%* After Deductible

0%* After Deductible

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%* After Deductible

No Charge

 

50%* After Deductible

50%* After Deductible

Summary of Pharmacy Benefits

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

Retail 30 Day Supply

$10 Copay

$50 Copay

$80 Copay

20% Coinsurance up to $250/Prescription

 

Mail Order 90 Day Supply

$20 Copay

$100 Copay

$160 Copay

Not Available

*Coinsurance

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

An Embedded Deductible means that each individual will only have to meet the individual Deductible before the Plan begins paying benefits for such individual that are subject to a Deductible.

An Embedded Out-of-Pocket Maximum means that each individual will only have to meet the individual out-of-pocket maximum before the Plan begins paying in full for such individual.

 

 

 

 

 

 

 

 


If you prefer talking with a HealthEZ representative, call 855-255-7060