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 Plan 1

In-Network

Out-of-Network

Embedded Deductible

Employee only

Famil

 

$0

$0

 

$2,000

$4,000

Coinsurance

0%

25%

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$5,000

$10,000

 

$5,000

$10,000

WellVia (a Recuro Health company) Telemedicine Services

No Charge

No Charge

Preventative Care

No Charge

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$25 Copay

$50 Copay

25% Coinsurance

 

25%* after Deductible

25%* after Deductible

50%* after Deductible

Urgent Care Services

$40 Copay

25%* after Deductible

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$200 Copay

0%* after Deductible

 

$200 Copay

0%* after Deductible

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

$250 Copay / Day (5 Days Max)

$500 Copay

 

25% * after Deductible

25% * after Deductible

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

$40 Copay

$60 Copay

$200 Copay

 

25%* after Deductible

25%* after Deductible

25%* after Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

$250 Copay / Day (5 Days Max)

$50 Copay

 

25%* after Deductible

25%* after Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$25 Copay

$75 Copay

$150 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

$150 Copay

Not Available

*Coinsurance

 

 

**Covered as in-network in true emergency

 

 

Copay Plan 1

In-Network

Out-of-Network

Embedded Deductible

Employee only

Family

In-Network

$5,000

$10,000

Out-of-Network

N/a

N/a

Coinsurance

30%

N/a

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$6,350

$12,700

 

N/a

N/a

WellVia (a Recuro Health company) Telemedicne Services

No Charge

No Charge

Preventive Care

No Charge

Not Covered

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$30 Copay

$55 Copay

$30 Copay

 

Not Covered

Not Covered

Not Covered

Urgent Care Services

$60 Copay

Not Covered

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$300 Copay

30%* after Deductible

 

Not Covered

Not Covered

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

30%* after Deductible

30%* after Deductible

 

Not Covered

Not Covered

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

30%* after Deductible

30%* after Deductible

30%* after Deductible

 

Not Covered

Not Covered

Not Covered

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

30%* after Deductible

$55 Copay

 

Not Covered

Not Covered

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$60 Copay

$150 Copay

$500 Copay

Mail Order 90 Day Supply

$25 Copay

$150 Copay

$750 Copay

Not Available

*Coinsurance

 

 

**Covered as in-network in true emergency

 

 

Copay Plan 2

In-Network

Out-of-Network

Embedded Deductible

Employee only

Family

In-Network

$6,000

$12,000

Out-of-Network

N/a

N/a

Coinsurance

30%

N/a

Embedded Out-of-Pocket Maximum

Employee only

Family

 

$8,500

$17,000

 

N/a

N/a

WellVia (a Recuro Health company) Telemedicne Services

No Charge

No Charge

Preventive Care

No Charge

Not Covered

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$30 Copay

$55 Copay

$30 Copay

 

Not Covered

Not Covered

Not Covered

Urgent Care Services

$60 Copay

Not Covered

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$350 Copay

30%* after Deductible

 

Not Covered

Not Covered

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

30%* after Deductible

30%* after Deductible

 

Not Covered

Not Covered

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

30%* after Deductible

30%* after Deductible

30%* after Deductible

 

Not Covered

Not Covered

Not Covered

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

30%* after Deductible

$55 Copay

 

Not Covered

Not Covered

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$60 Copay

$150 Copay

$500 Copay

Mail Order 90 Day Supply

$25 Copay

$150 Copay

$750 Copay

Not Available

*Coinsurance

 

 

**Covered as in-network in true emergency

 

 

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