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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.

Summary Of Medical Benefits

HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Individual Under Family

Family

 

$4,000

$4,000

$8,000

 

$12,700

$12,700

$25,400

Out-Of-Pocket Maximum

Individual

Individual Under Family

Family

 

$6,350

$6,350

$12,700

 

$25,400

$25,400

$50,800

Preventive Care

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

30%*

30%*

30%*

 

50%*

50%*

50%*

Urgent Care Services

30%*

50%*

Complex Imaging: MRI/CT/PET Scans

30%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

30%*

30%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

30%*

30%*

 

50%*

50%*

Emergency Services

Emergency Room

Ground Ambulance

Air Ambulance

 

30%*

30%*

30%*

 

50%*

50%*

30%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

30%*

30%*

 

50%*

50%*

Prescription Drug Coverage

Preventive Prescriptions

Generic

Preferred Brand

Non-Preferred Brand

Specialty Drugs

Retail 30 Day Supply

No Charge

30%*

30%*

30%*

30%*

Mail Order 90 Day Supply

No Charge

30%*

30%*

30%*

Not Covered

Teladoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

* Coinsurance After Deductible

 

 

Copay Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Individual Under Family

Family

 

$3,000

$3,000

$6,000

 

$10,000

$10,000

$20,000

Out-Of-Pocket Maximum

Individual

Individual Under Family

Family

 

$4,000

$4,000

$8,000

 

$30,000

$30,000

$60,000

Preventive Care

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay

$60 Copay

30%*

 

50%*

50%*

50%*

Urgent Care Services

$100 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

30%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

30%*

30%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

30%*

30%*

 

50%*

50%*

Emergency Services

Emergency Room

Ground Ambulance

Air Ambulance

 

30%*

30%*

30%*

 

50%*

50%*

30%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

30%*

$60 Copay

 

50%*

50%*

Prescription Drug Coverage

Preventive Prescriptions

Generic

Preferred Brand

Non-Preferred Brand

Specialty Drugs

Retail 30 Day Supply

No Charge

$15 Copay

$50 Copay

$90 Copay

20% Coinsurance

Mail Order 90 Day Supply

No Charge

$30 Copay

$100 Copay

$180 Copay

Not Covered

Teladoc Benefits

General Consultations

Dermatology

Mental Health - Therapy

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

* Coinsurance After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 1-888-592-6223