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 1500 Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,500

$3,000

 

$4,500

$9,000

Coinsurance

20%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,800

$7,600

 

$11,400

$22,800

WellVia Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$30 Copay

$60 Copay

$60 Copay

 

50%*

50%*

50%*

Hospital Services

20%*

50%*

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

100% Covered

100% Covered

20%*

 

50%*

50%*

50%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$350 Copay, then 20%

20%*

 

$350 Copay, then 20%

20%*

Urgent Care Services

$75 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

$30 Copay

 

50%*

50%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$40 Copay

$70 Copay

25% up to $350/Rx

 

$25 Copay

$120 Copay

$210 Copay

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

HDHP 3500

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$3,500

$7,000

 

$10,500

$21,000

Coinsurance

0%

30%

Out-Of-Pocket Maximum

Employee Only

Family

 

$4,500

$9,000

 

$13,500

$27,000

WellVia Telemedicine

100% Covered

100% Covered

Preventive Care

100% Covered

20%*

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

0%*

0%*

0%*

 

30%*

30%*

30%*

Hospital Services

0%*

30%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

0%*

0%*

 

30%*

30%*

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

0%*

0%*

0%*

 

30%*

30%*

30%*

Urgent Care Services

0%*

30%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

0%*

0%*

 

30%*

30%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay*

$40 Copay*

$70 Copay*

25% up to $350/Rx*

 

$25 Copay*

$120 Copay*

$210 Copay*

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 


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