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

HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$2,500

$3,300

$5,000

 

N/A

N/A

N/A

Out-Of-Pocket Maximum

Individual Coverage

Individual Under Family Coverage

Family Coverage

 

$2,500

$3,300

$5,000

 

N/A

N/A

N/A

Preventive Care

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

No Coverage

No Coverage

No Coverage

Hospital Services Inpatients & Outpatient Care

0%*

No Coverage

Emergency Services**

0%*

No Coverage

Urgent Care Services

0%*

No Coverage

Mental health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

No Coverage

No Coverage

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

0%*

0%*

0%*

0%*

Mail Order 90 Day Supply

0%*

0%*

0%*

Not Available

NOTE: * Coinsurance After Deductible

 

 

**Covered as in-network in true emergency

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

 

 

 

 

Dental Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$50

$150

 

N/A

N/A

Annual Maximum per Individual

Orthodontic Maximum per Individual

$1,500

$1,000

N/A

N/A

Preventive Care & Diagnostic Care

No Charge

Not Covered

Basic Services

20%*

Not Covered

Major Services

50%*

Not Covered

Prosthetics

50%*

Not Covered

Orthodontics (For Dependents Under Age 18)

50%*

Not Covered

NOTE: * Coinsurance After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 866-768-9684