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.


Summary of Medical Benefits

PPO 8 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Individual under Family Coverage

Family

 

$2,000

$2,000

$4,000

 

$4,000

$4,000

$8,000

Embedded Out-of-Pocket Maximum

Individual Coverage

Individual under Family Coverage

Family

 

$6,000

$6,000

$12,000

 

$12,000

$12,000

$24,000

Preventive Care Services

No Charge

50%

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

Urgent Care Services

 

$20 Copay

$50 Copay

20%*

$40 Copay

 

50%*

50%*

50%*

50%*

Complex Imaging: MRI/CT/PET Scans

20%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation**

$300 Copay*

No Charge

$300 Copay*

No Charge

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

20%*

$50 Copay

50%*

50%*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

50%

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50%

Not Available

* After deductible

 

 

** Covered as in-network in true-emergency

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

 

 

 

 

PPO 9 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Individual under Family Coverage

Family

 

$3,000

$3,000

$6,000

 

$5,000

$5,000

$10,000

Embedded Out-of-Pocket Maximum

Individual Coverage

Individual under Family Coverage

Family

 

$6,750

$6,750

$13,500

 

$15,000

$15,000

$30,000

Preventive Care Services

No Charge

50%

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

Urgent Care Services

 

$20 Copay

$50 Copay

20%*

$40 Copay

 

50%*

50%*

50%*

50%*

Complex Imaging: MRI/CT/PET Scans

20%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

20%*

20%*

 

50%*

50%*

Emergency Room Services

Emergency Medical Transportation**

$300 Copay*

No Charge

$300 Copay*

No Charge

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

20%*

$20 Copay

50%*

50%*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

50%

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50%

Not Available

* After deductible

 

 

** Covered as in-network in true-emergency

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

 

 

 

 

PPO 11 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual Coverage

Individual under Family Coverage

Family

 

$6,000

$6,000

$12,000

 

$10,000

$10,000

$20,000

Embedded Out-of-Pocket Maximum

Individual Coverage

Individual under Family Coverage

Family

 

$8,000

$8,000

$16,000

 

$20,000

$20,000

$40,000

Preventive Care Services

No Charge

50%

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

Urgent Care Services

 

$20 Copay

$50 Copay

30%*

$40 Copay

 

50%*

50%*

50%*

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 Room Services

Emergency Medical Transportation**

30%*

No Charge

30%*

No Charge

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

30%*

$20 Copay

50%*

50%*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

50%

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50%

Not Available

* After deductible

 

 

** Covered as in-network in true-emergency

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

 

 

 

 


If you prefer talking with a HealthEZ representative, call 855-255-7060