Compare Plans

Compare Plans

Your healthcare coverage is important to us. 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. This summary will help you understand your plan and its coverage.

Questions about your benefits?

Advocates@CrumdalePartners.com

Register your myHealthEZ account

>>Click here


Summary of Medical Benefits

PPO 3 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Family Coverage

 

$1,500

$3,000

 

$3,000

$6,000

Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

$6,000

$12,000

 

$12,000

$24,000

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$5,000

$10,000

 

$5,000

$10,000

Preventive Care

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Services

Urgent Care Services

 

$30 Copay

$60 Copay

25%*

$40 Copay

 

25%*

25%*

50%*

25%*

Complex Imaging: MRI/CT/PET Scans

$300 Copay

25%*

Inpatient Hospital Care

Facility Fee

Physicians Fee

 

0%*

0%*

 

25%*

25%*

Outpatient Procedures

Facility Fee

Physicians Fee

 

$500 Copay*

0%*

 

25%*

25%*

Emergency Care

Emergency Room Services

Emergency Medical Transportation**

 

$300 Copay*

No Charge

 

$300 Copay*

0%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

$30 Copay

 

25%*

25%*

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

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

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

* After deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

PPO 5 Plan

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

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

Urgent Care Services

 

$20 Copay

$75 Copay

25%*

$50 Copay

 

50% *

50% *

50%*

50%*

Complex Imaging: MRI/CT/PET Scans

$300 Copay*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

$750 Copay*

0%*

 

50%*

50%*

Emergency Services

Emergency Room Services

Emergency Medical Transportation**

 

$300 Copay*

No Charge

 

$300 Copay*

0%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%*

$20 Copay

 

50%*

50%*

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

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

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

*Coinsurance After deductible

** Covered as in-network in true-emergency

 

 

 

 

 

 

HDHP 5 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Family Coverage

 

$6,900

$13,800

 

$10,000

$20,000

Embedded Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

$7,000

$14,000

 

$15,000

$30,000

Preventive Care

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

Urgent Care Services

 

20%*

20%*

20%*

20%*

 

50%*

50%*

50%*

50%*

Complex Imaging: MRI/CT/PET Scans

20%*

50%*

Inpatient Hospital Care

Facility Fee

Physicians Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physicians Fee

 

20%*

20%*

 

50%*

50%*

Emergency Services

Emergency Room Services

Emergency Medical Transportation

 

20%*

20%*

 

20%*

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

20%*

 

50%*

50%*

Prescription Drug Coverage

Expanded Preventive Generic

Expanded Preventive Preferred Brand

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

20% Coinsurance

20% Coinsurance

20%*

20%*

50%*

20%*

Mail Order 90 Day Supply

20% Coinsurance

20% Coinsurance

20%*

20%*

50%*

Not Available

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

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

* After deductible

 

 

 

 

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