Plan Details

Not all coverage is the right coverage.

Your healthcare coverage is important to us. 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. This summary will help you understand your plan and its coverage.

Questions about your benefits?

service@healthez.com

Register your myHealthEZ account

>>Click here

Summary Of Medical Benefits

HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Family

 

$5,000

$10,000

 

$10,000

$20,000

Out-Of-Pocket Maximum

Individual

Family

 

$6,350

$12,700

 

$12,700

$25,400

Preventive Care

No Charge

40%*

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

30%*

30%*

30%*

 

40%*

40%*

40%*

Urgent Care Services

30%*

40%*

Complex Imaging: MRI/CT/PET Scans

30%*

40%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

30%*

30%*

 

40%*

40%*

Outpatient Procedures

Facility Fee

Physician Fee

 

30%*

30%*

 

40%*

40%*

Emergency Room Services

Emergency Medical Transportation

30%*

30%*

40%*

40%*

Mental health/Chemical Dependency

Inpatient

Office Visit

 

30%*

30%*

 

40%*

40%*

*After Deductible

 

 


If you prefer talking with a HealthEZ representative, call 1-844-204-3763