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
In-Network
Out-Of-Network
Calendar Year Deductible
Employee Only
Family
$1,500
$3,000
$4,500
$9,000
Coinsurance
20%
50%
Out-Of-Pocket Maximum
$13,500
$27,000
Preventive Care
100% Covered
40%*
Office Visits
Primary Services
Specialist Services
Convenience Clinic
$35 Copay
Hospital Services
Inpatient services
Outpatient Procedures
-Free Standing
-Hospital Based
20%*
50%*
Emergency Services
Emergency Room - True Emergency
Emergency Room - Non Emergency
Emergency Medical Transportation
Urgent Care Services
$65 Copay
Chiropractic Services
Mental health/Chemical Dependency
Inpatient
Outpatient
Retail 30 Day Supply
Mail Order 90 day Supply
Prescription Drug Coverage
Generic
Formulary
Non-Formulary
Specialty
$20 Copay
$80 Copay
$150 Copay
30% Coinsurance
$40 Copay
$160 Copay
$300 Copay
Not Available
*After Deductible
HSA Plan
$6,000
$12,000
40%
$4,000
$8,000
$16,000
Inpatient Services
Outpatient Hospital Procedures
Emergency Room- True Emergency
Emergency Room- Non Emergency
Preferred brand
Non-preferred brand
High Value Plan
$3,200
$6,400
$12,800
$5,000
$10,000
$20,000
Hospital Charges
Emergency Room Care
Emergency Room Care – Not True Emergency
Mail Order 90 Day Supply (CVS Pharmacy Retail or CVS Mail Order)
Prescription Drug Coverage Preventive
$10 Copay
$125 Copay
$250 Copay
Not Covered
$0 Copay
$500 Copay
Prescription Drug Coverage Non-Preventive
Brand Formulary
Brand Non-Formulary
Specialty Drugs
80%*
If you prefer talking with a HealthEZ representative, call 1-800-948-5988