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.

Questions about your benefits?

service@healthez.com

Register your myHealthEZ account

>>Click here


Summary of Medical Benefits- Effective 1/1/2024

Copay Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$1,500

$1,500

$3,000

 

$4,500

$4,500

$9,000

Out-of-Pocket Maximum

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$4,500

$4,500

$9,000

 

$13,500

$13,500

$27,000

Preventive Care

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$35 Copay

$35 Copay

$35 Copay

 

40%*

40%*

40%*

Urgent Care Services

$65 Copay

40%*

Complex Imaging

MRI/CT/PET scans- Free standing Facility

MRI/CT/PET scans- Hospital or outpatient hospital

 

20%*

40%*

 

40%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Outpatient Procedure

Facility Fee

Physician Fee

 

40%*

40%*

 

50%*

50%*

Emergency Room Services**

Emergency Medical Transportation**

20%*

20%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$35 Copay

 

40%*

40%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$20 Copay

$80 Copay

$150 Copay

30% Coinsurance (Prudent Rx)

Mail Order 90 Day Supply

$40 Copay

$160 Copay

$300 Copay

Not Available

* Coinsurance after deductible

** Covered as in-network in true-emergency

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

 

 

 

 

 

 

HSA Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$3,200

$3,200

$6,400

 

$6,400

$6,400

$12,800

Out-of-Pocket Maximum

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$4,000

$4,000

$8,000

 

$8,000

 

$16,000

Preventive Care

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

20%*

20%*

20%*

 

40%*

40%*

40%*

Urgent Care Services

20%*

40%*

Complex Imaging

MRI/CT/PET scans- Free standing Facility

MRI/CT/PET scans- Hospital or outpatient hospital

 

20%*

40%*

 

40%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

40%*

40%*

 

50%*

50%*

Emergency Room Services**

Emergency Medical Transportation**

20%*

20%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

20%*

 

40%*

40%*

Prescription Drug Coverage

Preventative Generic

Preventative Preferred Brand

Preventative Non-Preferred Brand

Non-Preventative Generic

Non-Preventative Preferred brand

Non-Preventative Non-preferred brand

Non-Preventative Specialty

Retail 30 Day Supply

$10 Copay

$125 Copay

$250 Copay

20%*

20%*

20%*

20%*

Mail Order 90 Day Supply

$20 Copay

$250 Copay

$500 Copay

20%*

20%*

20%*

Not Available

* Coinsurance after deductible

** Covered as in-network in true-emergency

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

 

 

 

 

 

 

High Value / Elite Network Plan

In-Network

Out-of-Network

Calendar Year Deductible

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$3,200

$3,200

$6,400

 

$6,400

$3,200

$12,800

Out-of-Pocket Maximum

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$5,000

$5,000

$10,000

 

$10,000

$10,000

$20,000

Preventive Care

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

20%*

20%*

20%*

 

40%*

40%*

40%*

Urgent Care Services

20%*

40%*

Complex Imaging

MRI/CT/PET scans- Free standing Facility

MRI/CT/PET scans- Hospital or outpatient hospital

 

20%*

40%*

 

40%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

40%*

40%*

 

50%*

50%*

Emergency Room Services**

Emergency Medical Transportation**

20%*

20%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

20%*

 

40%*

40%*

Prescription Drug Coverage

Preventative Generic

Preventative Preferred Brand

Preventative Non-Preferred Brand

Non-Preventative Generic

Non-Preventative Preferred brand

Non-Preventative Non-preferred brand

Non-Preventative Specialty

Retail 30 Day Supply

$10 Copay

$125 Copay

$250 Copay

20%*

20%*

 

20%*

Mail Order 90 Day Supply

$20 Copay

$250 Copay

$500 Copay

20%*

20%*

20%*

Not Available

* Coinsurance after deductible

** Covered as in-network in true-emergency

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

The High Value Plan / Elite Network Plan utlizes a specific network. All scheduled surgeries should be through Fariview Health System or Twin Cities Orthopedics.

 

 

 

 

 

 

 

 

If you prefer talking with a HealthEZ representative, call 1-800-948-5988