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

$8,200 PPO Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$8,200

$16,400

 

N/A

N/A

Out-Of-Pocket Maximum

Employee Only

Family

 

$8,200

$16,400

 

N/A

N/A

Preventive Care

100% Covered

N/A

Office Visits

Primary Services

Specialist Services

 

$30 Copay

$60 Copay

 

N/A

N/A

Hospital Services

Inpatient

Outpatient

 

0%*

$1,500 Copay

 

N/A

N/A

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$650 Copay

0%*

 

N/A

N/A

Urgent Care Services

$25 Copay*

N/A

Chiropractic Services

$60 Copay

N/A

Mental health/Chemical Dependency

Inpatient

Outpatient

 

0%*

$60 Copay

 

N/A

N/A

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$15 Copay

$45 Copay

$85 Copay

$250 Copay

 

$30 Copay

$90 Copay

$170 Copay

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 

Medical PPO Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$0

$0

 

$500

$1,000

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,500

$7,000

 

$5,500

$11,000

Preventive Care

No Charge

30%*

Office Visits

Primary Services

Specialist Services

 

$30 Copay

$50 Copay

 

30%*

30%*

Hospital Services

Inpatient

Outpatient

 

$500 Copay per day, up to 3 days, then 100% Covered

0%

 

30%*

30%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$650 Copay

0%

 

30%*

30%*

Urgent Care Services

$25 Copay

30%*

Chiropractic Services

$50 Copay

30%*

Mental health/Chemical Dependency

Inpatient

Outpatient

 

0%

$50 Copay

 

30%*

30%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 Copay

$45 Copay

$70 Copay

$150 Copay

 

$30 Copay

$80 Copay

$140 Copay

Not Available

*After Deductible

 

 

**Covered as in-network in true emergency

 

 


If you prefer talking with a HealthEZ representative, call 1-844-288-5704