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 3 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual

Family

 

$1,500

$3,000

 

$3,000

$6,000

Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,000

$12,000

 

$12,000

$24,000

Preventative Services

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$30 Copay

$60 Copay

25% Coinsurance*

 

25% Coinsurance*

25% Coinsurance*

50% Coinsurance*

Urgent Care Services

$40 Copay

25% Coinsurance*

Complex Imaging: MRI/CT/PET Scans

$300 Copay*

25% Coinsurance*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0% Coinsurance*

0% Coinsurance*

 

25% Coinsurance*

25% Coinsurance*

Outpatient Procedures

Facility Fee

Physician Fee

 

$500 Copay*

0% Coinsurance*

 

25% Coinsurance*

25% Coinsurance*

Emergency Room Services**

Emergency Medical Transportation**

$300 Copay*

0% Coinsurance*

$300 Copay*

0% Coinsurance*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0% Coinsurance*

$30 Copay

 

25% Coinsurance*

25% Coinsurance*

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% Coinsurance

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

*After Deductible

** Covered as in-network if true emergency

 

 

 

 

PPO 9 Plan

In-Network

Out-of-Network

Non-Embedded Deductible

Individual

Family

 

$3,000

$6,000

 

$5,000

$10,000

Non-Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,750

$13,500

 

$15,000

$30,000

Preventative Services

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$20 Copay

$50 Copay

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

50% Coinsurance*

Urgent Care Services

$40 Copay

50% Coinsurance*

Complex Imaging: MRI/CT/PET Scans

20% Coinsurance*

50% Coinsurance*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Outpatient Procedures

Facility Fee

Physician Fee

 

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Emergency Room Services**

Emergency Medical Transportation**

$300 Copay*

0% Coinsurance*

$300 Copay*

0% Coinsurance*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20% Coinsurance*

$20 Copay

 

50% Coinsurance*

50% Coinsurance*

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% Coinsurance

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

*After Deductible

** Covered as in-network in true emergency

 

 

 

 

HDHP 4 Plan

In-Network

Out-of-Network

Non-Embedded Deductible

Individual

Family

 

$5,000

$10,000

 

$10,000

$20,000

Non-Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,750

$13,500

 

$15,000

$30,000

Preventative Services

No Charge

50% Coinsurance

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

20% Coinsurance*

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

50% Coinsurance*

Urgent Care Services

20% Coinsurance*

50% Coinsurance*

Complex Imaging: MRI/CT/PET Scans

20% Coinsurance*

50% Coinsurance*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Outpatient Procedures

Facility Fee

Physician Fee

 

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Emergency Room Services**

Emergency Medical Transportation**

20% Coinsurance*

20% Coinsurance*

20% Coinsurance*

20% Coinsurance*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20% Coinsurance*

20% Coinsurance*

 

50% Coinsurance*

50% Coinsurance*

Recuro Benefits

General Consultations

 

No Charge

 

No Charge

Prescription Drug Coverage

Expanded Preventive

Expanded Preventive Preferred Brand

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

20% Coinsurance

20% Coinsurance

20% Coinsurance*

20% Coinsurance*

50% Coinsurance*

20% Coinsurance*

Mail Order 90 Day Supply

20% Coinsurance

20% Coinsurance

20% Coinsurance*

20% Coinsurance*

50% Coinsurance*

Not Available

*After Deductible

** Covered as in-network in true emergency

 

 

 

 


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