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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

Copay Plan

In-Network

Out-Of-Network

Deductible

Individual

Family

 

$2,500

$5,000

 

$7,500

$15,000

Out of Pocket Maximum

Individual

Family

 

$5,000

$10,000

 

$15,000

$30,000

Preventive Care Services

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$25 Copay

$50 Copay

$50 Copay

 

40%*

40%*

40%*

Urgent Care Services

$75 Copay

40%*

Complex Imaging: MRI/CT/PET Scans

0%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

40%*

40%*

Emergency Room

Emergency Medical Transportation

$350 Copay

0%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

$50 Copay

 

40%*

40%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$40 Copay

$80 Copay

25% Coinsurance up to $300

 

$20 Copay

$80 Copay

$160 Copay

Not Available

Teladoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

$15 Copay

$15 Copay

$15 Copay

$15 Copay

$15 Copay

 

$15 Copay

$15 Copay

$15 Copay

$15 Copay

$15 Copay

NOTE: * Coinsurance After Deductible

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

 

 

 

 

HSA Plan

In-Network

Out-Of-Network

Deductible

Individual

Family

 

$2,500

$5,000

 

$7,500

$15,000

Out of Pocket Maximum

Individual

Family

 

$4,000

$8,000

 

$12,000

$24,000

Preventive Care Services

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

40%*

40%*

40%*

Urgent Care Services

0%*

40%*

Complex Imaging: MRI/CT/PET Scans

0%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

40%*

40%*

Emergency Room

Emergency Medical Transportation

$350 Copay After Deductible

0%*

40%*

40%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

40%*

40%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay After Deductible

$40 Copay After Deductible

$80 Copay After Deductible

25% Coinsurance up to $300*

 

$20 Copay After Deductible

$80 Copay After Deductible

$160 Copay After Deductible

Not Available

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

$15 Copay

$15 Copay

$15 Copay

$15 Copay

$15 Copay

 

$15 Copay

$15 Copay

$15 Copay

$15 Copay

$15 Copay

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 1-855-290-1413