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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 750

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$750

$1,500

 

$5,000

$10,000

Coinsurance

20%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,000

$8,000

 

$10,000

$20,000

Preventive Care

100% covered

50%*

Physician Services

$40 copay

50%*

Hospital Services- Inpatient & Outpatient Care

20%*

50%*

Emergency Services

$300 copay

$300 copay

Urgent Care Services

$75 copay

50%*

Chiropractic Services

$40 copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$40 copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 copay

$35 copay

$65 copay

$100 copay

 

$37.50 copay

$87.50 copay

$162.50 copay

30 day supply only

* After Deductible

 

 

Copay Plan 1500

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,500

$3,000

 

$3,000

$6,000

Coinsurance

20%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

$9,000

$18,000

Preventive Care

100% covered

No coverage

Physician Services

$40 copay

50%*

Hospital Services- Inpatient & Outpatient Care

20%*

50%*

Emergency Services

$300 copay

$300 copay

Urgent Care Services

$75 copay

$75 copay

Chiropractic Services

$40 copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$40 copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

 

$15 copay

$35 copay

$65 copay

$100 copay

 

$37.50 copay

$87.50 copay

$162.50 copay

30 day supply only

Copay Plan 3000

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$3,000

$6,000

 

$6,000

$12,000

Coinsurance

20%*

50%*

Out-Of-Pocket Maximum

Employee Only

Family

 

$6,250

$12,500

 

$18,000

$36,000

Preventative Care

100% covered

50%*

Physician Services

$40 copay

50%*

Hospital Services Inpatient & Outpatient Care

20%*

50%*

Emergency Services

$300 copay

$300 copay

Urgent Care Services

$75 copay

50%*

Chiropractic Services

$40 copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$40 copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

 

$15 copay

$35 copay

$65 copay

$100 copay

 

$37.50 copay

$87.50 copay

$162.50

30 day supply only

* After Deductible

 

 

If you prefer talking with a HealthEZ representative, call 1-844-449-5550