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

High Deductible Health Plan

In-Network

Out-Of-Network

Calendar Year Deductible (non-embedded)

Employee Only

Family

 

$1,500

$3,000

 

$3,000

$6,000

Coinsurance

20%

40%

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,000

$6,000

 

$7,000

$13,000

Preventive Care

100% Covered

40%*

Office Visits

Primary Services

Specialist Services

 

20%*

20%*

 

40%*

40%*

Hospital Services

20%*

40%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

20%*

20%*

 

20%*

20%*

Urgent Care Services

20%*

40%*

Chiropractic Services

20%*

40%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

20%*

20%*

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Life Style Drugs

 

20%*

20%*

20%*

20%*

20%*

 

20%*

20%*

20%*

Not Available

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

Traditional PPO Plan

In-Network

Out-Of-Network

Calendar Year Deductible (embdedded)

Employee Only

Family

 

$300

$600

 

$1,200

$2,200

Coinsurance

15%

40%

Out-Of-Pocket Maximum

Employee Only

Family

 

$1,800

$3,600

 

$6,000

$10,800

Preventive Care

100% Covered

40%*

Office Visits

Primary Services

Specialist Services

 

$15 Copay

$25 Copay

 

40%*

40%*

Hospital Services

15%*

40%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$200 Copay

15%*

 

$200 copay

15%*

Urgent Care Services

$40 Copay

40%*

Chiropractic Services (24 visit limit)

$25 Copay

40%*

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

15%*

$25 Copay

 

40%*

40%*

Retail 30 Day Supply

Mail Order 90 day Supply

Prescription Drug Coverage

Generic

Formulary

Non-Formulary

Specialty

Life Style Drugs

 

$10 Copay

$20 Copay

$50 Copay

$10/$20/$50 Copay

50%*

 

$20 Copay

$40 Copay

$100 Copay

Not Available

Not Available

* After deductible

 

 

** True emergencies covered at in-network level

 

 

Dental Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee only

Family

 

$50

$150

 

$50

$150

Calendar Year Benefit Maximum (per individual)

$2,000

$2,000

Lifetime Orthodontic Maximum

$2,000

$2,000

Preventive Services

Cleanings (one/6 months)

Topical fluoride treatments (under 18, two/year)

Space maintainers (Up to age of 15)

Sealants (Up to age of 16, one/36 months)

 

100% Covered

100% Covered

100% Covered

100% Covered

 

100% Covered

100% Covered

100% Covered

100% Covered

Diagnostic Services

Oral exams (one/6 months)

Full-mouth & Panoramic / panorex X-rays (one/36 consecutive months)

Bitewing X-rays (one/6 months)

Emergency oral exams

Palliative treatment for relief of dental pain

 

100% Covered

100% Covered

100% Covered

100% Covered

100% Covered

 

100% Covered

100% Covered

100% Covered

100% Covered

100% Covered

Basic Services

Restorative fillings

Preformed stainless steel crowns

Endodontics

Periodontics

Periodontal maintenance (one/3 consecutive months)

Occlusal guard (one/5 years)

Occlusal adjustment (one/24 consecutive months)

Oral surgery

Local and General anesthesia

Rebase procedures for denture or bridges (one/36 consecutive months)

Reline procedures for dentures or bridges (one/12 consecutive months)

 

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

 

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

80%*

Major Services

Inlays or onlays

Crowns

Implants and implant-related services

Installation of removable or fixed bridgework

Installation of partial and complete dentures

 

50%*

50%*

50%*

50%*

50%*

 

50%*

50%*

50%*

50%*

50%*

Orthodontic Services

Orthodontic Diagnosis, Treatment, And Appliances

 

50%*

 

50%*

* After deductible

 

 

No dental network

 

 


If you prefer talking with a HealthEZ representative, call 844-839-6741