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

PPO 2 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual

Family

 

$1,000

$2,000

 

$2,000

$4,000

Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,000

$12,000

 

$12,000

$24,000

WellVia (a Recuro Health company)

Telemedicine Services

 

No Charge

 

No Charge

Preventive Care

No Charge

No Charge

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$20 Copay

$50 Copay

25% Coinsurance

 

25%* after Ded

25%* after Ded

50%* after Ded

Urgent Care Services

$40 Copay

25%* after Ded

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$200 Copay

0%* after Ded

 

$200 Copay

0%* after Ded

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

0%* after Ded

$500 Copay after Deductible

 

25%* after Ded

25%* after Ded

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

$40 Copay

$60 Copay

$200 Copay

 

25%* after Ded

25%* after Ded

25%* after Ded

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%* after Ded

$50 Copay

 

25%* after Ded

25%* after Ded

Prescription Drug Coverage

Generic

Preferred brand

Non-Preferred Generics & Brand

Specialty

Retail 30-Day Supply

$10 Copay

$25 Copay

50% Coinsurance

$200 Copay

Mail Order 90-Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

*Coinsurance

 

 

**Covered as In-Network if deemed true emergency

 

 

PPO 5 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual

Family

 

$3,000

$6,000

 

$5,000

$10,000

Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,750

$13,500

 

$15,000

$30,000

WellVia (a Recuro Health company)

Telemedicine Services

 

No Charge

 

No Charge

Preventive Care

No Charge

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$20 Copay

$75 Copay

25%* after Ded

 

50%* after Ded

50%* after Ded

50%* after Ded

Urgent Care Services

$50 Copay

50%* after Ded

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$300 Copay after Deductible

0%* after Ded

 

$300 Copay after Deductible

0%* after Ded

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

0%* after Ded

$750 Copay after Deductible

 

50%* after Ded

50%* after Ded

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

$50 Copay after Deductible

$75 Copay after Deductible

$300 Copay after Deductible

 

50%* after Ded

50%* after Ded

50%* after Ded

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

0%* after Ded

$75 Copay

 

50%* after Ded

50%* after Ded

Prescription Drug Coverage

Generic

Preferred brand

Non-Preferred Generics & Brand

Specialty

Retail 30-Day Supply

$10 Copay

$25 Copay

50% Coinsurance

$200 Copay

Mail Order 90-Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

*Coinsurance

 

 

**Covered as In-Network if deemed true emergency

 

 

HSA 1 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual

Family

 

$3,000

$6,000

 

$5,000

$10,000

Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,750

$13,500

 

$10,000

$20,000

WellVia (a Recuro Health company)

Telemedicine Services

 

No Charge

 

No Charge

Preventive Care

No Charge

50%* after Ded

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

10%* after Ded

10%* after Ded

10%* after Ded

 

50%* after Ded

50%* after Ded

50%* after Ded

Urgent Care Services

10%* after Ded

50%* after Ded

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

10%* after Ded

10%* after Ded

 

10%* after Ded

10%* after Ded

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

10%* after Ded

10%* after Ded

 

50%* after Ded

50%* after Ded

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

10%* after Ded

10%* after Ded

10%* after Ded

 

50%* after Ded

50%* after Ded

50%* after Ded

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

10%* after Ded

10%* after Ded

 

50%* after Ded

50%* after Ded

Prescription Drug Coverage

Generic

Preferred brand

Non-Preferred Generics & Brand

Specialty

Expanded Preventive

Retail 30-Day Supply

$10 Copay after Deductible

$25 Copay after Deductible

50%* after Ded

$200 Copay after Deductible

Applicable copay above, no Deductible

 

Mail Order 90-Day Supply

$20 Copay after Deductible

$50 Copay after Deductible

50%* after Ded

Not Available

Applicable coinsurance above, no Deductible

 

*Coinsurance

 

 

**Covered as In-Network if deemed true emergency

 

 

HSA 2 Plan

In-Network

Out-of-Network

Embedded Deductible

Individual

Family

 

$5,000

$10,000

 

$10,000

$20,000

Embedded Out-of-Pocket Maximum

Individual

Family

 

$6,750

$13,500

 

$15,000

$30,000

WellVia (a Recuro Health company)

Telemedicine Services

 

No Charge

 

No Charge

Preventive Care

No Charge

50%* after Ded

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

20%* after Ded

20%* after Ded

20%* after Ded

 

50%* after Ded

50%* after Ded

50%* after Ded

Urgent Care Services

20%* after Ded

50%* after Ded

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%* after Ded

20%* after Ded

 

20%* after Ded

20%* after Ded

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

20%* after Ded

20%* after Ded

 

50%* after Ded

50%* after Ded

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

20%* after Ded

20%* after Ded

20%* after Ded

 

50%* after Ded

50%* after Ded

50%* after Ded

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%* after Ded

20%* after Ded

 

50%* after Ded

50%* after Ded

Prescription Drug Coverage

Generic

Preferred brand

Non-Preferred Generics & Brand

Specialty

Expanded Preventive

 

20%* after Ded

20%* after Ded

50%* after Ded

20%* after Ded

Applicable coinsurance above, no Deductible

 

 

20%* after Ded

20%* after Ded

50%* after Ded

20%* after Ded

Applicable coinsurance above, no Deductible

 

*Coinsurance

 

 

**Covered as In-Network if deemed true emergency

 

 


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