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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.

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Summary of Medical Benefits

Minimum Essential Coverage (MEC) Enhanced Plan

In-Network

Out-of-Network

Deductible

Individual

Family

 

N/A

N/A

 

N/A

N/A

Out-of-Pocket Maximum

Individual

Family

 

N/A

N/A

 

N/A

N/A

Preventative Care Services- Children

Preventive Care Services- Women

Preventive Care Services- Adults

No Charge

No Charge

No Charge

No Coverage

No Coverage

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$25 Copay

$50 Copay

$75 Copay

 

No Coverage

No Coverage

No Coverage

Labs/X-Rays

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

 

No Charge

$50 Copay

$100 Copay

$500 Copay

 

No Coverage

No Coverage

No Coverage

No Coverage

Urgent Care Services

$75 Copay

No Coverage

Inpatient Hospital Care

$2,000 Benefit Limit Per Day

No Coverage

Outpatient Procedures

$2,000 Benefit

No Coverage

Emergency Room Services**

Emergency Medical Transportation**

$500 Copay

$500 Benefit Limit Per Use

No Coverage

No Coverage

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

No Coverage

$75 Copay

 

No Coverage

No Coverage

Teladoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

Preventative Prescription Drug Coverage

Non-Preventative Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

No Charge

 

$10 Copay

No Coverage

No Coverage

No Coverage

Mail Order 90 Day Supply

No Charge

 

No Coverage

No Coverage

No Coverage

No Coverage

**Covered as in-network in true-emergency

 

 

If you prefer talking with a HealthEZ representative, call 844-302-7774