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.

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Summary Of Medical Benefits

MEC Plus Plan

In-Network

Out-Of-Network

Calendar Year Deductible

Employee only

Family

 

None

None

 

None

None

Out-of-Pocket Maximum

Employee Only

Family

 

None

None

 

None

None

Preventive Care

100% Covered

No Coverage

Office Visits

Primary Services

Specialist Services

CVS Minute Clinic

Urgent Care

Chiropractic Services - 10 visit limit

 

$20 Copay

$50 Copay

$10 Copay

$50 Copay

$75 Copay

 

No Coverage

No Coverage

No Coverage

No Coverage

No Coverage

Labs & Scans

Diagnostic Lab & X-Ray - In Office

CT/MRI or Outpatient Testing

 

$60 Copay

$200 Copay

 

No Coverage

No Coverage

Durable Medical Equipment

$50 Copay

No Coverage

HealthiestYou Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

 

100% Covered

$75 Copay

$85 Copay

$200 Copay

$95 Copay

Emergency Services

Emergency Room

Emergency Medical Transportation

 

No Coverage

No Coverage

 

No Coverage

No Coverage

Hospital Services

No Coverage

No Coverage

Mental Health

Inpatient

Outpatient - 10 visit limit

 

No Coverage

$75 Copay

 

No Coverage

No Coverage

Retail 30 Day Supply

Mail Order 90 Day Supply

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay

100% Copay

Not available

Not available

 

Not available

Not available

Not available

Not available


If you prefer talking with a HealthEZ representative, call 888-701-2975