Compare Plans

Not all coverage is the right coverage.

Your healthcare coverage is important to us. 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. This summary will help you understand your plan and its coverage.

Questions about your benefits?

service@healthez.com

Register your myHealthEZ account

>>Click here


Summary of Medical Benefits

Option 1 Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

$2,000

$2,000

$4,000

 

$5,000

$5,000

$10,000

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

$6,000

$6,000

$12,000

 

$15,000

$15,000

$30,000

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit – Dependents under age 19

Primary Office Visit – All other Covered Persons

Specialist Office Visit

Chiropractic Visit

 

No Charge

$10 Copay

$80 Copay

20%*

 

50%*

50%*

50%*

50%*

Urgent Care Services

$25 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

$500 Copay

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room

Emergency Room – Facility Charges**

Emergency Room - Physician Charges**

Emergency Medical Transportation**

 

$500 Copay, then 20% Coinsurance

20% Coinsurance

20%*

 

$500 Copay, then 20% Coinsurance

20% Coinsurance

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$10 Copay

 

50%*

50%*

Telemedicine Services Through Teladoc

General Consultations

Dermatology

Therapist

Psychiatrist, initial evaluation

Psychiatrist, ongoing session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$35 Copay

$75 Copay

$250 Copay

 

$20 Copay

$70 Copay

$150 Copay

$500 Copay

*Coinsurance After Deductible

**Covered at in-network benefit level if determined medically necessary.

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

 

 

 

 

 

 

Option 2 Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

$1,000

$1,000

$2,000

 

$5,000

$5,000

$10,000

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

$5,000

$5,000

$10,000

 

$15,000

$15,000

$30,000

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit – Dependents under age 19

Primary Office Visit – All other Covered Persons

Specialist Office Visit

Chiropractic Visit

 

No Charge

$10 Copay

$80 Copay

20%*

 

50%*

50%*

50%*

50%*

Urgent Care Services

$25 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

$500 Copay

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room

Emergency Room – Facility Charges**

Emergency Room - Physician Charges**

Emergency Medical Transportation**

 

$500 Copay, then 20% Coinsurance

20% Coinsurance

20%*

 

$500 Copay, then 20% Coinsurance

20% Coinsurance

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$10 Copay

 

50%*

50%*

Telemedicine Services Through Teladoc

General Consultations

Dermatology

Therapist

Psychiatrist, initial evaluation

Psychiatrist, ongoing session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 Copay

$35 Copay

$75 Copay

$250 Copay

 

$30 Copay

$70 Copay

$150 Copay

$500 Copay

*Coinsurance After Deductible

**Covered at in-network benefit level if determined medically necessary.

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

 

 

 

 

 

 

Option 3 (HSA) Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

$6,300

$6,300

$12,600

 

$12,600

$12,600

$25,200

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

$6,300

$6,300

$12,600

 

$37,800

$37,800

$75,600

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

50%*

50%*

50%*

Urgent Care Services

0%*

50%*

Complex Imaging: MRI/CT/PET Scans

$500 Copay

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

50%*

50%*

Emergency Room

Emergency Room – Facility Charges**

Emergency Room - Physician Charges**

Emergency Medical Transportation**

 

0%*

0%*

0%*

 

50%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

50%*

50%*

Telemedicine Services Through Teladoc

General Consultations

Dermatology

Therapist

Psychiatrist, initial evaluation

Psychiatrist, ongoing session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

0%*

*Coinsurance After Deductible

**Covered at in-network benefit level if determined medically necessary.

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

 

 

 

 

 

 

If you prefer talking with a HealthEZ representative, call 888-701-3022