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

PPO 5

In-Network

Out-of-Network

Calendar Year Deductible

Employee only

Family

 

$3,000

$6,000

 

$5,000

$10,000

Out-of-Pocket Maximum

Employee only

Family

 

$6,750

$13,500

 

$15,000

$30,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$20 Copay

$75 Copay

 

50%*

50%*

Hospital Services

Emergency Room Services

Emergency Medical Transportation**

 

$300 Copay*

0%*

 

$300 Copay*

0%*

Urgent Care Services

$50 Copay

50%*

Chiropractic Services

25%*

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%*

$20 Copay

 

50%*

50%*

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

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

 

 

* Coinsurance After deductible

 

 

** Covered as in-network in true-emergency

 

 

HDHP 5 Plan

In-Network

Out-of-Network

Calendar Year Deductible

Employee only

Family

 

$6,900

$13,800

 

$10,000

$20,000

Out-of-Pocket Maximum

Employee only

Family

 

$7,000

$14,000

 

$15,000

$30,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

No Charge

20%*

 

50%*

50%*

Hospital Services

Emergency Room Services**

Emergency Medical Transportation

20%*

20%*

20%*

 

20%*

20%*

Urgent Care Services

20%*

50%*

Chiropractic Services

20%*

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

20%*

20%*

20%*

20%*

Mail Order 90 Day Supply

20%*

20%*

20%*

20%*

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

 

 

* Coinsurance After deductible

 

 

** Covered as in-network in true-emergency

 

 

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