Medical / Rx
Medical Plan Options
Medical Plan Summary
*Out-of-network coverage is also available. Review your benefits summary for complete details.
**Non-Embedded Deductible: The entire family deductible amount must be met before the plan begins to pay, even if only one family member has medical costs.
***Embedded Deductible: Only a single member of a family needs to meet the individual deductible before coinsurance begins; the entire family deductible does not need to be met.
Prescription Drug Coverage
When you enroll in an isolved medical plan, you automatically receive prescription drug coverage with Drexi.
Drexi is your Pharmacy Benefits Manager. Drexi brings you a transparent prescription program and unique portal for your non-high cost/non-specialty drugs.
Transparency of costs and options for pharmaceuticals allows participants to be smart consumers of their healthcare needs. You have access to all national pharmacy chains and most smaller local pharmacies.
Once you are enrolled in the plan, create a member account at:Â https://drexi.com
| Plan Features | $4,000 HSA Base Plan | $2,000 HSA Buy-up Plan | PPO Plan |
|---|---|---|---|
| In-Network* | In-Network* | In-Network* | |
| Prescription Drug – Retail (Up to 30-day supply) | |||
| Preventive OTC Medications &Â Contraceptive | Covered in full | Covered in full | Covered in full |
| Preventive Prescriptions | 20%, deductible wavied | 20%, deductible wavied | Applicable copay applies |
| Tier 1 & 2 (Generic) | 20% after medical deductible | 20% after medical deductible | $15 copay |
| Tier 3 (Brand) | 20% after medical deductible | 20% after medical deductible | $45 copay |
| Tier 4 (Non-Preferred Brand) | 20% after medical deductible | 20% after medical deductible | $100 copay |
| Tier 5 (Specialty) | 20% after medical deductible | 20% after medical deductible | 25% (minimum $50 / maximum $200) per script |
| Prescription Drug – Mail Order (Up to 90-day supply) | |||
| Preventive OTC Medications &Â Contraceptive | Covered in full | Covered in full | Covered in full |
| Preventive Prescriptions | 20%, deductible wavied | 20%, deductible wavied | Applicable copay applies |
| Tier 1 & 2 (Generic) | 20% after medical deductible | 20% after medical deductible | $45 copay |
| Tier 3 (Brand) | 20% after medical deductible | 20% after medical deductible | $135 copay |
| Tier 4 (Non-Preferred Brand) | 20% after medical deductible | 20% after medical deductible | $300 copay |
*Out-of-network coverage is also available. Review your benefits summary for complete details.
Best Ways to Save on Rx
- Go Generic. Ask your doctor for generic drugs to keep your costs as low as possible. If you choose a brand name drug when a generic drug is available, you will pay the difference in cost in addition to the copay.
- Use Mail Order. Use the Mail Order program for the daily maintenance medications you take for chronic conditions.
2024 Medical Premiums
Your payroll deduction for medical are shown here.
BCBSNC Blue Options HDHP
| Employee Cost | Monthly | Per Pay Period |
|---|---|---|
| Employee Only | $50 | $25 |
| Employee + Spouse | $290 | $145 |
| Employee + Child(ren) | $254 | $127 |
| Employee + Family | $379 | $189 |
BCBSNC Blue Options HDHP
| Employee Cost | Monthly | Per Pay Period |
|---|---|---|
| Employee Only | $139 | $70 |
| Employee + Spouse | $369 | $185 |
| Employee + Child(ren) | $321 | $160 |
| Employee + Family | $531 | $266 |
BCBSNC Blue Options PPO Copay Plan
| Employee Cost | Monthly | Per Pay Period |
|---|---|---|
| Employee Only | $222 | $111 |
| Employee + Spouse | $509 | $255 |
| Employee + Child(ren) | $441 | $221 |
| Employee + Family | $738 | $369 |
When searching for participating providers or pharmacy inquires, please select the below networks during your search. This information is also located on your BCBNC ID Card.
Medical Provider Network:
Blue Options PPO
Pharmacy Network: Drexi
Medical Group ID #: 14167375
(applies to all isolved plans)
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