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.

Summary Of Medical Benefits

Reference Based Pricing Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$3,500

$7,000

 

N/A

N/A

Coinsurance

20%

N/A

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,900

$15,800

 

N/A

N/A

Preventive Care

100% Covered

No Coverage

Office Visits

Primary Services

Specialist Services

 

$40 Copay

$60 Copay

 

No Coverage

No Coverage

Hospital Services

20%*

No Coverage

Emergency Services

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

No Coverage

No Coverage

Urgent Care Services

$75 Copay

No Coverage

Chiropractic Services

20%*

No Coverage

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

50%*

$60 Copay

 

No Coverage

No Coverage

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$20 Copay

$50 Copay

$75 Copay

20% Coinsurance

 

$40 Copay

$100 Copay

$150 Copay

Not Available

* After deductible

 

 

 

 


If you prefer talking with a HealthEZ representative, call 844-801-1912