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.

You can find more detailed plan information by reviewing your Summary Plan Description here.


Summary of Medical Benefits

Copay Plan

Big Tree Medical

Health Cooperative of Missouri

Healthlink

Deductible

Individual

Family

 

N/A

N/A

 

$0

$0

 

$3,000

$7,000

Out-of-Pocket Maximum

Individual

Family

 

N/A

N/A

 

$4,500

$9,000

 

$4,500

$9,000

Preventive Care Services

No Charge

No Charge

No Charge

Office Visits

Primary Office Visit

Specialist Office Visit

Chiropractic Visit

 

$0

N/A

N/A

 

$40 Copay

No Charge

No Charge

 

$60 Copay

$75 Copay

20%*

Urgent Care Services

No Charge

$40 Copay

$60 Copay

Complex Imaging: MRI/CT/PET Scans

N/A

No Charge

20%*

Inpatient Hospital Care

Facility Fee

Physician Fee

 

N/A

N/A

 

0%*

0%*

 

20%*

20%*

Outpatient Procedures

Facility Fee

Physician Fee

 

N/A

N/A

 

0%*

0%*

 

20%*

20%*

Emergency Room

Emergency Medical Transportation

N/A

N/A

$250 Copay (waived if admitted)

20%*

$250 Copay (waived if admitted)

20%*

Mental Health/Chemical Dependency

Inpatient

Office Visit

 

N/A

N/A

 

No Charge

No Charge

 

20%*

$75 Copay

Prescription Drug Coverage

Generic

Preferred Brand

Non-Preferred Brand

Specialty

Retail 30 Day Supply

$5 Copay

$15 Copay

$25 Copay

$100 Copay

Mail Order 90 Day Supply

$10 Copay

$30 Copay

$50 Copay

Not Covered

 

 

 

 

 

NOTE: * Coinsurance After Deductible

Please refer to your Summary Plan Description for actual coverage, limitation, and exclusion provisions, including out of network services.

 

 

 

 

 

 


If you prefer talking with a HealthEZ representative, call 855-290-1411