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
EPO Plan
In-Network
Out-of-Network
Deductible
Individual
Family
N/A
Out-of-Pocket Maximum
$2,000
$6,000
Preventive Care Services
No Charge
No Coverage
Office Visits
Primary Office Visit
Specialist Office Visit
Chiropractic Visit
$20 Copay
Urgent Care Services
Complex Imaging: MRI/CT/PET Scans
Inpatient Hospital Care
Facility Fee
Physician Fee
Outpatient Procedures
Emergency Room
Emergency Medical Transportation
$50 Copay (waived if admitted)
Mental Health/Chemical Dependency
Inpatient
Office Visit
Prescription Drug Coverage
Generic
Preferred Brand
Non-Preferred Brand
Specialty
Retail 30 Day Supply
$10 Copay
$40 Copay
$60 Copay
$1,000 Copay
Mail Order 90 Day Supply
$80 Copay
$120 Copay
Not Covered
NOTE: * Coinsurance After Deductible
Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions
PPO Plan
$1,000
$,3500
$10,500
10%*
30%*
$75 Copay (waived if admitted)
If you prefer talking with a HealthEZ representative, call 844-204-3766