Plan Details

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.

Questions about your benefits?

service@healthez.com

Register your myHealthEZ account

>>Click here


Summary of Medical Benefits

Copay Plan

In-Network

Out-Of-Network

Deductible

Individual

Individual under Family

Family

 

$6,000

$6,000

$13,700

 

$10,000

$10,000

$20,000

Out-Of-Pocket Maximum

Individual

Individual under Family

Family

 

$6,000

$6,000

$13,700

 

$12,000

$12,000

$27,400

Preventive Care

No Charge

10%*

Vision Benefits

Eye Exam

One exam per Deductible year

Frames

One set of frames every two years. Maximum of $125 per two years

Lenses

One set of lenses per Deductible year

Contacts

One set of lenses per Deductible year

 

 

$10 Copay

 

$25 Copay

 

$25 Copay

 

Elective: $25 Copay (Maximum of $150 per Deductible year) Medically Necessary: $25 Copay

 

 

$10 Copay

 

$25 Copay

 

$25 Copay

 

Elective: $25 Copay (Maximum of $150 per Deductible year) Medically Necessary: $25 Copay

Physician Services

Specialist Services

$50 Copay

$75 Copay

10%*

10%*

Hospital Services - Inpatient & Outpatient Care

0%*

10%*

Emergency Services

Facility Charges

Physician Charges

 

$500 Copay, then 0%* (Copay waived if admitted)

0%*

 

$500 Copay, then 0%* (Copay waived if admitted)

0%*

Urgent Care Services

$150 Copay

10%*

Chiropractic Services

$50 Copay

10%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

10%*

$50 Copay

 

10%*

10%*

Prescription Drug Coverage

Generic

Preferred Brand

Brand Non-Formulary

Specialty Drugs

Retail 30 Day Supply

$5 Copay

$50 Copay

$100 Copay

$150 Copay

Mail Order 90 Day Supply

$10 Copay

$100 Copay

$200 Copay

$300 Copay

Dental Plan

Dental Plan

Deductible

Individual

Family

 

$50

$150

Maximums

Deductible Year Maximum Benefit Per Person Age 19 and Over

 

$1,500

Class I-Diagnostic and Preventive Procedures

No Charge

Class II-Basic Procedures

20% Coinsurance After Deductible

Class III – Major Procedures

50% Coinsurance After Deductible


If you prefer talking with a HealthEZ representative, call 800-948-7369