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

Gold Medical Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$2,000

$3,500

 

$10,000

$20,000

Coinsurance

10%

50%

Out-Of-Pocket Maximum

Employee Only

Family

 

$7,000

$13,000

 

$20,000

$40,000

Preventive Care

100% Covered

50%*

Physician Services

Primary

Specialist

 

$25 Copay

$45 Copay

 

50%*

50%*

Hospital Services- Inpatient & Outpatient Care

10%*

50%*

Emergency Services

Emergency Room

Ground Ambulance ($5,000 max per event)

Air Ambulance ($15,000 max per event)

 

10%*

10%*

10%*

 

10%*

10%*

10%*

Urgent Care Services

$55 Copay

50%*

Chiropractic Services

$45 Copay

50%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

10%*

$25 Copay

 

50%*

50%*

NOTE: *After Deductible

 

 

Gold Full Rx

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

$35 Copay

$55 Copay

20% up to $200

 

$20 Copay

$70 Copay

$110 Copay

Not Available

Gold Generic Only

Retail 30 Day supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 Copay

Not Available

Not Available

Not Available

 

$30 Copay

Not Available

Not Available

Not Available

NOTE: *After Deductible

 

 

Silver Medical Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$3,500

$6,500

 

$10,000

$20,000

Coinsurance

20%

50%

Out-of-Pocket Maximum

Employee Only

Family

 

$8,000

$15,000

 

$20,000

$40,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$30 Copay

$50 Copay

 

50%*

50%*

Hospital Services

20%*

50%*

Emergency Services

Emergency Room

Ground Ambulance ($5,000 max per event)

Air Ambulance ($15,000 max per event)

 

20%*

20%*

20%*

 

20%*

20%*

20%*

Urgent Care Services

$80 Copay

50%*

Chiropractic Services

$50 Copay

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$30 Copay

 

50%*

50%*

Silver Full Rx

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$15 Copay

$40 Copay

$60 Copay

20% up to $250

 

$30 Copay

$80 Copay

$120 Copay

Not Available

Silver Generic Only

Retail 30 Day Supply

Mail Order 90 Day Supply

Generic

Preferred brand

Non-preferred brand

Specialty

$20 Copay

Not Available

Not Available

Not Available

$40 Copay

Not Available

Not Available

Not Available

NOTE: *After Deductible

 

 

Bronze Medical Plan

In-Network

Out-Of-Network

Plan Year Deductible

Employee Only

Family

 

$5,500

$10,500

 

$10,000

$20,000

Coinsurance

30%

50%

Out-of-Pocket Maximum

Employee Only

Family

 

$9,000

$17,000

 

$20,000

$40,000

Preventive Care

100% Covered

50%*

Office Visits

Primary Services

Specialist Services

 

$40 Copay

$55 Copay

 

50%*

50%*

Hospital Services

30%*

50%*

Emergency Services

Emergency Room

Ground Ambulance ($5,000 max per event)

Air Ambulance ($15,000 max per event

 

30%*

30%*

30%*

 

30%*

30%*

30%*

Urgent Care Services

30%*

50%*

Chiropractic Services

$55 Copay

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

30%*

$40 Copay

 

50%*

50%*

Bronze Full Rx

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$25 Copay

$45 Copay

$65 Copay

30% up to $350

 

$50 Copay

$90 Copay

$130 Copay

Not Available

Bronze Generic Only

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$25 Copay

Not Available

Not Available

Not Available

 

$50 Copay

Not Available

Not Available

Not Available

NOTE: *After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 1-877-241-6310