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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.

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Summary of Medical Benefits

$4,000 25% Coinsurance Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

$4,000

$4,000

$8,000

 

$8,000

$8,000

$16,000

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

$8,000

$8,000

$16,000

 

$16,000

$16,000

$32,000

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

25%*

25%*

25%*

 

50%*

50%*

50%*

Urgent Care Services

25%*

25%*

Complex Imaging: MRI/CT/PET Scans

25%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

25%*

25%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

25%*

25%*

 

50%*

50%*

Emergency Room

Emergency Medical Transportation

25%*

25%*

25%*

25%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

25%*

25%*

 

50%*

50%*

Prescription Drug Coverage

Preventive

Expanded Preventive - Generic

Expanded Preventive - Preferred Brand

Generic

Preferred brand

Non-preferred brand

Specialty Drugs

Retail 30 Day Supply

No Charge

No Charge

No Charge

0%*

0%*

0%*

Not Covered

Mail Order 90 Day Supply

No Charge

No Charge

No Charge

0%*

0%*

0%*

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

NOTE: * Coinsurance after deductible

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

 

 

 

 

$4,000 0% Coinsurance Plan

In-Network

Out-of-Network

Deductible

Individual

Individual Under Family

Family

 

$4,000

$4,000

$8,000

 

$8,000

$8,000

$16,000

Out-of-Pocket Maximum

Individual

Individual Under Family

Family

 

$4,000

$4,000

$8,000

 

$16,000

$16,000

$32,000

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%*

0%*

Complex Imaging: MRI/CT/PET Scans

0%*

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 Medical Transportation

0%*

0%*

0%*

0%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

50%*

50%*

Prescription Drug Coverage

Preventive

Expanded Preventive - Generic

Expanded Preventive - Preferred Brand

Generic

Preferred brand

Non-preferred brand

Specialty Drugs

Retail 30 Day Supply

No Charge

No Charge

No Charge

0%*

0%*

0%*

Not Covered

Mail Order 90 Day Supply

No Charge

No Charge

No Charge

0%*

0%*

0%*

Not Covered

Teladoc Benefits

General Consutlations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, IOngoing Session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

NOTE: * Coinsurance after deductible

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

 

 

 

 

If you prefer talking with a HealthEZ representative, call 855-290-1414