Plan Details

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

Medical Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,500

$13,000

 

N/a

N/a

Coinsurance

0%

N/a

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,500

$13,000

 

N/a

N/a

Preventive Care

100% Covered

Not Covered

Physician Services

Primary

Specialist

Chiropractic

 

$40 Copay

$65 Copay

$50 Copay

 

Not Covered

Not Covered

Not Covered

Hospital Services Inpatients & Outpatient Care

0%*

Not Covered

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$500 Copay

0%*

 

Not Covered

Not Covered

Urgent Care Services

$110 Copay

Not Covered

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

Mental health/Chemical Dependency

Inpatient

Outpatient

 

0%*

$50 Copay

 

Not Covered

Not Covered

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$10 Copay

25% Coinsurance

50% Coinsurance

Not Covered

 

$10 Copay

25% Coinsurance

50% Coinsurance

Not Covered

*After Deductible

 

 

** Covered as in-network in true-emergency

 

 


If you prefer talking with a HealthEZ representative, call 1-844-801-1908