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.

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Summary of Medical Benefits

Blue Plan

In-Network

Out-of-Network

Deductible

Individual

Family

 

$1,000

$2,000

 

$1,000

$2,000

Out-of-Pocket Maximum

Individual

Family

 

$2,000

$4,000

 

$2,000

$4,000

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$20 Copay

$20 Copay

$20 Copay

 

50%*

50%*

50%*

Urgent Care Services

No Charge

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

Emergency Medical Transportation

$300 Copay (Copay waived if admitted)

20%*

$300 Copay (Copay waived if admitted)

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$20 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$8 Copay

$35 Copay

$50 Copay

$8/$35/$50 Copay

Mail Order 90 Day Supply

$20 Copay

$87.50 Copay

$125 Copay

Not Covered

Teladoc Benefits

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

NOTE: * Coinsurance After Deductible

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

 

 

 

 

Green Plan

In-Network

Out-of-Network

Deductible

Individual

Family

 

$5,000

$10,000

 

$5,000

$10,000

Out-of-Pocket Maximum

Individual

Family

 

$6,850

$13,700

 

$6,850

$13,700

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$20 Copay

$20 Copay

$20 Copay

 

50%*

50%*

50%*

Urgent Care Services

No Charge

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

Emergency Medical Transportation

$300 Copay (Copay waived if admitted)

20%*

$300 Copay (Copay waived if admitted)

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$20 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$8 Copay

$35 Copay

$50 Copay

$8/$35/$50 Copay

Mail Order 90 Day Supply

$20 Copay

$87.50 Copay

$125 Copay

Not Covered

Teladoc Benefits

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

NOTE: * Coinsurance After Deductible

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

 

 

 

 

Yellow Plan

In-Network

Out-of-Network

Deductible

Individual

Family

 

$3,000

$6,000

 

$3,000

$6,000

Out-of-Pocket Maximum

Individual

Family

 

$5,000

$10,000

 

$5,000

$10,000

Preventive Care Services

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$20 Copay

$20 Copay

$20 Copay

 

50%*

50%*

50%*

Urgent Care Services

No Charge

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

Emergency Medical Transportation

$300 Copay (Copay waived if admitted)

20%*

$300 Copay (Copay waived if admitted)

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

20%*

$20 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$8 Copay

$35 Copay

$50 Copay

$8/$35/$50 Copay

Mail Order 90 Day Supply

$20 Copay

$87.50 Copay

$125 Copay

Not Covered

Teladoc Benefits

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

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 844-288-5701