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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

MEC Plan

In-Network

Out-of-Network

Deductible

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Preventative Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractor Visit

Urgent Care Services

 

No Coverage

No Coverage

No Coverage

No Coverage

 

No Coverage

No Coverage

No Coverage

No Coverage

Inpatient Hospital Care

Outpatient Procedures

No Coverage

No Coverage

No Coverage

No Coverage

Emergency Room Services

Emergency Medical Transportation

No Coverage

No Coverage

No Coverage

No Coverage

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

No Coverage

No Coverage

No Coverage

No Coverage

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

 

Prescription Drug Coverage

Preventive

Non-Preventive Generic

Non-Preventive Preferred Brand

Non-Preventive Non-Preferred Brand

Non-Preventive Specialty

Retail 30 Day Supply

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

Mail Order 90 Day Supply

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

MEC Plus Plan

In-Network

Out-of-Network

Deductible

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Preventative Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractor Visit

Urgent Care Services

 

$25 Copay

$50 Copay

No Coverage

$75 Copay

 

$25 Copay

$50 Copay

No Coverage

$75 Copay

Inpatient Hospital Care

Outpatient Procedures

No Coverage

No Coverage

No Coverage

No Coverage

Emergency Room Services

Emergency Medical Transportation

No Coverage

No Coverage

No Coverage

No Coverage

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

No Coverage

$50 Copay

No Coverage

$50 Copay

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

No Coverage

$50 Copay

$100 Copay

No Coverage

No Coverage

$50 Copay

$100 Copay

No Coverage

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

Prescription Drug Coverage

Preventive

Non-Preventive Generic

Non-Preventive Preferred Brand

Non-Preventive Non-Preferred Brand

Non-Preventive Specialty

Retail 30 Day Supply

No Charge

$10 Copay

$30 Copay

$50 Copay or 50% Coinsurance, whichever is greater

No Coverage

Mail Order 90 Day Supply

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

MEC Enhanced Plan

In-Network

Out-of-Network

Deductible

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Out-of-Pocket Maximum

Individual Coverage

Family Coverage

 

N/A

N/A

 

N/A

N/A

Preventative Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractor Visit

Urgent Care Services

 

$25 Copay

$50 Copay

No Coverage

$75 Copay

 

$25 Copay

$50 Copay

No Coverage

$75 Copay

Inpatient Hospital Care

Outpatient Procedures

$1,000 Benefit Per Day, then Not Covered

$1,000 Benefit Per Day, then Not Covered

$1,000 Benefit Per Day, then Not Covered

$1,000 Benefit Per Day, then Not Covered

Emergency Room Services

Emergency Medical Transportation

$500 Copay

No Coverage

$500 Copay

No Coverage

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

$1,000 Benefit Per Day, then Not Covered

$50 Copay

$1,000 Benefit Per Day, then Not Covered

$50 Copay

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

No Coverage

$1,000 Benefit Per Year, then Not Covered

$1,000 Benefit Per Year, then Not Covered

$1,000 Benefit Per Year, then Not Covered

No Coverage

$1,000 Benefit Per Year, then Not Covered

$1,000 Benefit Per Year, then Not Covered

$1,000 Benefit Per Year, then Not Covered

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

Prescription Drug Coverage

Preventive

Non-Preventive Generic

Non-Preventive Preferred Brand

Non-Preventive Non-Preferred Brand

Non-Preventive Specialty

Retail 30 Day Supply

No Charge

$10 Copay

$30 Copay

$50 Copay or 50% Coinsurance, whichever is greater

No Coverage

Mail Order 90 Day Supply

No Charge

No Coverage

No Coverage

No Coverage

No Coverage

MVP Plan

In-Network

Out-of-Network

Deductible

Individual Coverage

Individual under Family

Family Coverage

 

$6,500

$6,500

$13,000

 

N/A

N/A

N/A

Out-of-Pocket Maximum

Individual Coverage

Individual under Family

Family Coverage

 

$6,500

$6,500

$13,000

 

N/A

N/A

N/A

Preventative Care Services

No Charge

No Coverage

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractor Visit

Urgent Care Services

 

0%*

0%*

0%*

0%*

 

0%*

0%*

0%*

0%*

Inpatient Hospital Care

Outpatient Procedures

0%*

0%*

0%*

0%*

Emergency Room Services

Emergency Medical Transportation

0%*

0%*

0%*

0%*

Mental Health/Chemical Dependency - Inpatient

Mental Health/Chemical Dependency - Office Visit

0%*

0%*

0%*

0%*

Office Visit Lab

Outpatient Lab

Outpatient X-Ray

Outpatient Major Diagnostic

0%*

0%*

0%*

0%*

0%*

0%*

0%*

0%*

Teledoc Benefits

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, Initial Evaluation

Mental Health - Psychiatrist, Ongoing Session

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

 

No Charge

$85 Copay

No Charge

No Charge

No Charge

Prescription Drug Coverage

Preventive

Non-Preventive Generic

Non-Preventive Preferred Brand

Non-Preventive Non-Preferred Brand

Non-Preventive Specialty

Retail 30 Day Supply

No Charge

0%*

$30 Copay

0%*

No Coverage

Mail Order 90 Day Supply

No Charge

0%*

0%*

0%*

No Coverage

* After Deductible

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

 

 

 

 

If you prefer talking with a HealthEZ representative, call 844-302-7774