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.


PPO 1 Plan

Summary of Medical Benefits

In-Network

Out-of-Network

Calendar Year Accumulation

Embedded Deductible

Employee only

Family

 

 

$0

$0

 

 

$2,000

$4,000

Coinsurance

0%

25%

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$5,000

$10,000

 

$5,000

$10,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Walk In Clinics

Chiropractic Services

 

$20 Copay

$50 Copay

$40 Copay

25% Coinsurance

 

25%* After Deductible

25%* After Deductible

25%* After Deductible

50%* After Deductible

Urgent Care Services

$40 Copay

25%* After Deductible

Emergency Services

Emergency Room

Emergency Medical Transportation

 

$200 Copay

0%* After Deductible

 

$200 Copay

0%* After Deductible

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

$250 Copay / Day (5 Days Max)

$500 Copay

 

25%* After Deductible

25%* After Deductible

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

$40 Copay

$60 Copay

$200 Copay

 

25%* After Deductible

25%* After Deductible

25%* After Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%* After Deductible

$50 Copay

 

25%* After Deductible

25%* After Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

$75 Copay

$150 Copay

Mail Order 90 Day Supply

$20 Copay

$50 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.

 

 

 

 

 

 

 

 

HDHP 4

In-Network

Out-of-Network

Calendar Year Accumulation

Embedded Deductible

Employee only

Family

 

 

$5,000

$10,000

 

 

$10,000

$20,000

Coinsurance

20%

50%

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$6,750

$13,500

 

$15,000

$30,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%* After Deductible

Office Visits

Primary Services

Specialist Services

Walk In Clinics

Chiropractic Services

 

20%* After Deductible

20%* After Deductible

20%* After Deductible

20%* After Deductible

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

50%* After Deductible

Urgent Care Services

20%* After Deductible

50%* After Deductible

Emergency Services

Emergency Room

Emergency Medical Transportation

 

20%* After Deductible

20%* After Deductible

 

20%* After Deductible

20%* After Deductible

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

20%* After Deductible

20%* After Deductible

 

50%* After Deductible

50%* After Deductible

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

20%* After Deductible

20%* After Deductible

20%* After Deductible

 

50%* After Deductible

50%* After Deductible

50%* After Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%* After Deductible

20%* After Deductible

 

50%* After Deductible

50%* After Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

20%* After Deductible

20%* After Deductible

50%* After Deductible

20%* After Deductible

Mail Order 90 Day Supply

20%* After Deductible

20%* After Deductible

50%* After Deductible

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 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