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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

HDHP 8 Plan

In-Network

Out-of-Network

Calendar Year Accumulation

Non-Embedded Deductible

Individual only

Individual under Family

Family

 

 

$3,000

$6,000

$6,000

 

 

$5,000

$10,000

$10,000

Coinsurance

20%

50%

Non-Embedded Out-of-Pocket Maximum

Individual only

Individual under Family

Family

 

$6,750

$13,500

$13,500

 

$10,000

$20,000

$20,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Walk In Clinics

Chiropractic Services

 

20%*

20%*

20%*

20%*

 

50%*

50%*

50%*

50%*

Urgent Care Services

20%*

50%*

Emergency Services

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

20%*

20%*

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

20%*

20%*

 

50%*

50%*

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MR

 

20%*

20%*

20%*

 

50%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay After Deductible

$35 Copay After Deductible

50%*

$200 Copay After Deductible

Mail Order 90 Day Supply

$20 Copay After Deductible

$50 Copay After Deductible

50%*

Not Available

* Coinsurance after Deductible

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions.

 

 

 

 

PPO 9 Plan

In-Network

Out-of-Network

Calendar Year Accumulation

Embedded Deductible

Individual only

Individual under Family

Family

 

 

$3,000

$3,000

$6,000

 

 

$5,000

$5,000

$10,000

Coinsurance

20%

50%

Non-Embedded Out-of-Pocket Maximum

Individual only

Individual under Family

Family

 

$6,750

$6,750

$13,500

 

$15,000

$15,000

$30,000

Recuro Telemedicine Services

100% Covered

100% Covered

Preventive Care

100% Covered

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Walk In Clinics

Chiropractic Services

 

$20 Copay

$50 Copay

$40 Copay

20%*

 

50%*

50%*

50%*

50%*

Urgent Care Services

$40 Copay

50%*

Emergency Services

Emergency Room

Emergency Medical Transportation

 

$300 Copay After Deductible

20%*

 

$300 Copay After Deductible

20%*

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

20%*

20%*

 

50%*

50%*

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MR

 

20%*

20%*

20%*

 

50%*

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20%*

$20 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay After Deductible

$25 Copay After Deductible

50% Coinsurance

$200 Copay

Mail Order 90 Day Supply

$20 Copay

$50 Copay

50% Coinsurance

Not Available

* Coinsurance after Deductible

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions.

 

 

 

 


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