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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

PPO 5

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Family Coverage

 

$3,000

$6,000

 

$5,000

$10,000

Embedded Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

$6,750

$13,500

 

$15,000

$30,000

Preventive Care Services

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$20 Copay

$75 Copay

25% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

50% Coinsurance*

Urgent Care Services

$50 Copay

50% Coinsurance*

Complex Imaging: MRI/CT/PET Scans

$300 Copay*

50% Coinsurance*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0% Coinsurance*

0% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Outpatient Procedures

Facility Fee

Physician Fee

 

$750 Copay*

0% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Emergency Room Services

Emergency Medical Transportation**

$300 Copay*

0% Coinsurance*

$300 Copay*

0% Coinsurance*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0% Coinsurance*

$20 Copay

 

50% Coinsurance*

50% Coinsurance*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

50% Coinsurance

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

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

* After deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

HDHP 2

In-Network

Out-of-Network

Non-Embedded Deductible

Individual Coverage

Family Coverage

 

$2,000

$4,000

 

$4,000

$8,000

Non-Embedded Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

$5,000

$10,000

 

$10,000

$20,000

Preventive Care Services

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay*

$75 Copay*

$75 Copay*

 

25% Coinsurance*

25% Coinsurance*

25% Coinsurance*

Urgent Care Services

$50 Copay*

25% Coinsurance*

Complex Imaging: MRI/CT/PET Scans

$300 Copay*

25% Coinsurance*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0% Coinsurance*

0% Coinsurance*

 

25% Coinsurance*

25% Coinsurance*

Outpatient Procedures

Facility Fee

Physician Fee

 

0% Coinsurance*

0% Coinsurance*

 

25% Coinsurance*

25% Coinsurance*

Emergency Room Services

Emergency Medical Transportation

$300 Copay*

0% Coinsurance*

$300 Copay*

0% Coinsurance*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0% Coinsurance*

$30 Copay*

 

25% Coinsurance*

25% Coinsurance*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Expanded Preventive Generic

Expanded Preventive Preferred Brand

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

$10 Copay*

$25 Copay*

50% Coinsurance*

$150 Copay*

Mail Order 90 Day Supply

$20 Copay

$50 Copay

$20 Copay

$50 Copay

50% Coinsurance*

Not Available

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

* After deductible

This health plan has a non-embedded Deductible. This means that the family Deductible must be met before the Plan begins paying benefits that are subject to a Deductible

This health plan(s) has a non-embedded out-of-pocket maximum. This means that the family out-of-pocket maximum must be met before the Plan begins paying in full for all individuals

 

 

 

 

 

 

 

 

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