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.

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Summary of Medical Benefits

Copay Plan 1

Tier 1 In-Network

Tier 2 In-Network

Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$1,000

$1,000

$3,000

 

$2,000

$2,000

$6,000

 

$4,000

$4,000

$12,000

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$4,300

$4,300

$9,100

 

$5,900

$5,900

$11,800

 

$10,000

$10,000

$30,000

Preventative Services

No Charge

No Charge

Not Covered

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay

$60 Copay

10%

 

25%*

25%*

25%

 

50%*

50%*

50%

Urgent Care Services

$35 Copay, then 10%*

$35 Copay, then 10%*

50%*

Complex Imaging: MRI/CT/PET Scans

10%*

25%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

10%*

10%*

 

25%*

25%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

10%*

10%*

 

25%*

25%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation

$75 Copay

10%*

$75 Copay

10%*

$75 Copay

10%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

10%*

$30 Copay

 

25%*

$30 Copay

 

50%*

50%*

* Coinsurance after deductible

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

 

 

 

 

 

 

HDHP Plan 1

Tier 1 In-Network

Tier 2 In-Network

Out-of-Network

Deductible

Individual

Individual under Family

Family

 

$1,700

$3,400

$3,400

 

$2,700

$5,400

$5,400

 

$4,700

$9,400

$9,400

Out-of-Pocket Maximum

Individual

Individual under Family

Family

 

$4,300

$8,150

$9,100

 

$5,900

$8,150

$11,800

 

$13,000

$39,000

$39,000

Preventative Services

No Charge

No Charge

Not Covered

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

10%*

10%*

10%

 

25%*

25%*

25%

 

50%*

50%*

50%

Urgent Care Services

10%*

25%*

50%*

Complex Imaging: MRI/CT/PET Scans

10%*

25%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

10%*

10%*

 

25%*

25%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

10%*

10%*

 

25%*

25%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation

10%*

10%*

10%*

10%*

10%*

10%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

10%*

10%*

 

25%*

25%*

 

50%*

50%*

* Coinsurance after deductible

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

 

 

 

 

 

 

If you prefer talking with a HealthEZ representative, call 844-804-8126