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.

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Summary of Medical Benefits

Copay 1 Plan

APPO Elite Network

APPO Network (Tier 2)

Out of Network

Embedded Deductible

Individual

Family

 

$1,500

$4,500

 

$2,500

$6,000

 

$7,500

$15,000

Out-of-Pocket Maximum

Individual

Family

 

$3,000

$6,000

 

$4,500

$8,000

 

$15,000

$30,000

Preventive Care

No Charge

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$35 Copay

$35 Copay

$35 Copay

 

$50 Copay

$50 Copay

$50 Copay

 

50%*

50%*

50%*

Urgent Care Services

$35 Copay

$75 Copay

50%*

Complex Imaging: MRI/CT/PET Scans

15%*

25%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

15%*

15%*

 

25%*

25%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

15%*

15%*

 

25%*

25%*

 

50%*

50%*

Emergency Services**

Emergency Room

Medical Transportation

 

15%*

15%*

 

25%*

25%*

 

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

15%*

$35 Copay

 

25%*

$50 Copay

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

$10 Copay

$50 Copay

$90 Copay

20% Coinsurance up to $200

Mail Order 90 Day Supply

$20 Copay

$100 Copay

$180 Copay

Not Available

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

NOTE: * Coinsurance After Deductible

**Covered as in-network in true-emergency

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

 

 

 

 

 

 

 

 

 

HSA 1 Plan

APPO Elite Network

APPO Network (Tier 2)

Out of Network

Embedded Deductible

Individual

Individual under Family

Family

 

$3,000

$3,300

$6,000

 

$4,500

$4,500

$9,000

 

$7,500

$7,500

$15,000

Out-of-Pocket Max

Individual

Individual under Family

Family

 

$3,000

$3,300

$6,000

 

$4,500

$4,500

$9,000

 

$15,000

$15,000

$30,000

Preventive Care

No Charge

No Charge

50%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

0%*

0%*

0%*

 

0%*

0%*

0%*

 

50%*

50%*

50%*

Urgent Care Services

0%*

0%*

50%*

Complex Imaging: MRI/CT/PET Scans

0%*

0%*

50%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

0%*

0%*

 

0%*

0%*

 

50%*

50%*

Outpatient Procedures

Facility Fee

Physician Fee

 

0%*

0%*

 

0%*

0%*

 

50%*

50%*

Emergency Services*

Emergency Room

Medical Transportation

 

0%*

0%*

 

0%*

0%*

 

50%*

50%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

0%*

0%*

 

0%*

0%*

 

50%*

50%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

0%*

0%*

0%*

0%*

Mail Order 90 Day Supply

0%*

0%*

0%*

Not Available

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Not Applicable

NOTE: * Coinsurance After Deductible

**Covered as in-network in true-emergency

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

 

 

 

 

 

 

 

 

 

If you prefer talking with a HealthEZ representative, call 866-490-6177