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

Deluxe / Freedom Platinum Plans

In-Network

Out-Of-Network

Deluxe / Freedom Clarification:

Deluxe Platinum Plan utilizes a medical network

Freedom Platinum Plan utilizes Reference Based Pricing

 

 

 

 

 

 

Calendar Year Deductible

Employee Only

Family

 

$100

$200

 

N/a - covered as in-network

N/a - covered as in-network

Out-Of-Pocket Maximum

Employee Only

Family

 

$3,000

$6,000

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$20 Copay

$30 Copay

$40 Copay

 

$20 Copay

$30 Copay

$40 Copay

Inpatient Hospital Services

Facility - Days 1-5

Facility - After Day 5

Physician

 

$150 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$150 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

$150 Copay / Procedure

Deductible, then 100% Covered

 

$150 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$150 Copay

$40 Copay

 

$150 Copay

$40 Copay

Mental Health / Chemical Dependency

Inpatient Facility - Days 1-5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

$150 Copay / Day

100% Covered

Deductible, then 100% Covered

$30 Copay

 

$150 Copay / Day

100% Covered

Deductible, then 100% Covered

$30 Copay

Choice / Freedom Gold Plans

In-Network

Out-Of-Network

Choice / Freedom Gold Plans Clarification:

Choice Gold Plan utilizes a medical network

Freedom Gold Plan utilizes Reference Based Pricing

 

 

 

 

 

 

Calendar Year Deductible

Employee Only

Family

 

$500

$1,000

 

N/a - covered as in-network

N/a - covered as in-network

Out-Of-Pocket Maximum

Employee Only

Family

 

$5,000

$10,000

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$35 Copay

$50 Copay

$50 Copay

 

$35 Copay

$50 Copay

$50 Copay

Inpatient Hospital Services

Facility - Days 1 - 5

Facility - After Day 5

Physician

 

$200 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$200 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

$200 Copay / Procedure

Deductible, then 100% Covered

 

$200 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$200 Copay

$50 Copay

 

$200 Copay

$50 Copay

Mental Health / Chemical Dependency

Inpatient Facility - Days 1 - 5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

$200 Copay / Day

100% Covered

Deductible, then 100% Covered

$50 Copay

 

$200 Copay / Day

100% Covered

Deductible, then 100% Covered

$50 Copay

Basic Gold Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$1,000

$2,000

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee Only

Family

 

$6,000

$12,000

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$40 Copay

$60 Copay

$60 Copay

 

$40 Copay

$60 Copay

$60 Copay

Inpatient Hospital Services

Facility - Days 1- 5

Facility - After day 5

Physician

 

$250 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$250 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

$250 Copay / Procedure

Deductible, then 100% Covered

 

$250 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$250 Copay

$60 Copay

 

$250 Copay

$60 Copay

Mental Health / Chemical Dependency

Inpatient Facility - Days 1 - 5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

$250 Copay / Day

100% Covered

Deductible, then 100% Covered

$60 Copay

 

$250 Copay / Day

100% Covered

Deductible, then 100% Covered

$60 Copay

Preferred / Freedom Silver Plans

In-Network

Out-Of-Network

Preferred / Freedom Silver Plans Clarification:

Preferred Silver Plan utilizes a medical network

Freedom Silver Plan utilizes Reference Based Pricing

 

 

 

 

 

 

Calendar Year Deducitble

Employee Only

Family

 

$2,000

$4,000

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee Only

Family

 

$6,350

$12,700

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$40 Copay

$60 Copay

$60 Copay

 

$40 Copay

$60 Copay

$60 Copay

Inpatient Hospital Services

Facility - Days 1 - 5

Facility - After Day 5

Physician

 

$300 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$300 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

$300 Copay / Procedure

Deductible, then 100% Covered

 

$300 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$300 Copay

$60 Copay

 

$300 Copay

$60 Copay

Mental Health/Chemical Dependency

Inpatient Facility - Days 1 - 5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

$300 Copay / Day

100% Covered

Deductible, then 100% Covered

$60 Copay

 

$300 Copay / Day

100% Covered

Deductible, then 100% Covered

$60 Copay

Classic Silver Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$4,000

$8,000

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee Only

Family

 

$8,150

$16,300

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Care

Specialist Services

Urgent Care

 

$40 Copay

$70 Copay

$70 Copay

 

$40 Copay

$70 Copay

$70 Copay

Inpatient Hospital Services

Facility - Days 1-5

Facility - After Day 5

Physician

 

$450 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$450 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Outpatient Hospital Services

Facility

Physician

 

$450 Copay / Procedure

Deductible, then 100% Covered

 

$450 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$450 Copay

$70 Copay

 

$450 Copay

$70 Copay

Mental Health/Chemical Dependency

Inpatient Facility - Days 1-5

Inpatient Facility - After day 5

Inpatient Physician

Outpatient

 

$450 Copay / Day

100% Covered

Deductible, then 100% Covered

$70 Copay

 

$450 Copay / Day

100% Covered

Deductible, then 100% Covered

$70 Copay

Enhanced Silver Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$3,000

$6,000

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee Only

Family

 

$7,900

$15,800

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$40 Copay

$65 Copay

$65 Copay

 

$40 Copay

$65 Copay

$65 Copay

Inpatient Hospital Services

Facility - Days 1 - 5

Facility - After Day 5

Physician

 

$400 Copay / Day

100% Covered

Deductible, then 100% Covered

 

$400 Copay / Day

100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

$400 Copay / Procedure

Deductible, then 100% Covered

 

$400 Copay / Procedure

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

$400 Copay

$65 Copay

 

$400 Copay

$65 Copay

Mental Health/Chemical Dependency

Inpatient Facility - Days 1 - 5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

$400 Copay / Day

100% Covered

Deductible, then 100% Covered

$65 Copay

 

$400 Copay / Day

100% Covered

Deductible, then 100% Covered

$65 Copay

Saver HSA Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$6,450

$12,900

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee only

Family

 

$6,450

$12,900

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

Inpatient Hospital Services

Facility - Days 1 - 5

Facility - After Day 5

Physician

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

Outpatient Hospital Services

Facility

Physician

 

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Mental Health/Chemical Dependency

Inpatient Facility - Days 1 - 5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

Deductible, then 100% Covered

Freedom Bronze Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

$8,550

$17,100

 

N/a - covered as in-network

N/a - covered as in-network

Out-of-Pocket Maximum

Employee Only

Family

 

$8,550

$17,100

 

N/a - covered as in-network

N/a - covered as in-network

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

MRI & Advanced Imaging

 

$35 Copay

$50 Copay

Deductible, then 100% Covered

Deductible, then 100% Covered

 

$35 Copay

$50 Copay

Deductible, then 100% Covered

Deductible, then 100% Covered

Inpatient Hospital Services

Facility - Days 1-5

Facility - After Day 5

Physician

 

Deductible, then 100% Covered

100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

100% Covered

Deductible, then 100% Covered

Outpatient Services

Facility

Physician

 

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Emergency Room

Facility

Physician

 

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 100% Covered

Deductible, then 100% Covered

Mental Health / Chemical Dependency

Inpatient Facility - Days 1-5

Inpatient Facility - After Day 5

Inpatient Physician

Outpatient

 

Deductible, then 100% Covered

100% Covered

Deductible, then 100% Covered

$50 Copay

 

Deductible, then 100% Covered

100% Covered

Deductible, then 100% Covered

$50 Copay

Value Essential Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee Only

Family

 

N/a

N/a

 

N/a

N/a

Out-of-Pocket Maximum

Employee Only

Family

 

N/a

N/a

 

N/a

N/a

Preventive Care

100% Covered

100% Covered

Office Visits

Primary Services

Specialist Services

Urgent Care

 

$25 Copay

$50 Copay

$75 Copay

 

$25 Copay

$50 Copay

$75 Copay

Inpatient Hospital Services

No Coverage

No Coverage

Outpatient Hospital Services

No Coverage

No Coverage

Emergency Room

$350 Copay

$350 Copay

Mental Health / Chemical Dependency

No Coverage

No Coverage


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