Plan Details

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?

Advocates@CrumdalePartners.com

Register your myHealthEZ account

>>Click here


Summary of Medical Benefits

HDHP 2 Plan

In-Network

Out-of-Network

Non-Embedded Deductible

Employee only

Family

 

$2,000

$4,000

 

$4,000

$8,000

Coinsurance*

0%

25%

Non-Embedded Out-of-Pocket Maximum

Employee only

Family

 

$5,000

$10,000

 

$10,000

$20,000

Recuro Telemedicne Services

100% Covered

100% Covered

Preventive Care

100% Covered

50% Coinsurance

Office Visits

Primary Services

Specialist Services

Walk In Clinics

Chiropractic Services

 

Deductible, then $30 Copay

Deductible, then $75 Copay

Deductible, then $50 Copay

Deductible, then $75 Copay

 

Deductible, then 25%*

Deductible, then 25%*

Deductible, then 25%*

Deductible, then 25%*

Urgent Care Services

Deductible, then $75 Copay

Deductible, then 25%*

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

Deductible, then $300 Copay

Deductible, then 100% Covered

 

Deductible, then $300 Copay

Deductible, then 100% Covered

Hospital Services

Inpatient Hospital Facility

Outpatient Surgery

 

Deductible, then 100% Covered

Deductible, then 100% Covered

 

Deductible, then 25%*

Deductible, then 25%*

Diagnostic Testing & Imaging

Labs

X-rays

CT/PET/MRI

 

Deductible, then $50 Copay

Deductible, then $75 Copay

Deductible, then $300 Copay

 

Deductible, then 25%*

Deductible, then 25%*

Deductible, then 25%*

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

Deductible, then 100% Covered

Deductible, then $75 Copay

 

Deductible, then 25%*

Deductible, then 25%*

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30 Day Supply

Deductible, $10 Copay

Deductible, $25 Copay

Deductible, $75 Copay

Deductible, $150 Copay

Mail Order 90 Day Supply

Deductible, $20 Copay

Deductible, $50 Copay

Deductible, $150 Copay

Not Available

*Coinsurance

**True emergencies covered at in-network level

 

 

 

 

If you prefer talking with a HealthEZ representative, call 855-255-7060