Medical / Rx
Medical Plan Options
Beginning January 1st, 2025, the isolved medical plans are administered by Brighton Health Plan Solutions. The team at Brighton Health Plan Solutions has been providing comprehensive third party administrator services for more than 30 years, specializing in self-funded clients, providing medical claims administration, medical management and superior customer support.
Brighton’s concierge customer service team will help you understand your BCBSNC medical plan, navigate to the right care, resolve billing matters, and more. You can reach out for assistance with finding providers, scheduling and coordinating doctor appointments, navigating benefits and bills, and more.
Brighton also provides access to their online portal, MyCreate Health, where you can obtain all your health plan information online or from your phone to get the answers you need:
- Check what’s covered
- Order or download your ID card
- View your Claims
- Find a doctor
- Track you medical costs and balances
The isolved medical plans through Brighton offer access to the Blue Cross Blue Shield of North Carolina (BCBSNC) network of providers and facilities. While you can visit any doctor, you’ll save the most money by using in-network physicians and facilities.
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: 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 & 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 & 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.
2025 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 | $153 | $77 |
| Employee + Spouse | $406 | $203 |
| Employee + Child(ren) | $353 | $177 |
| Employee + Family | $584 | $292 |
BCBSNC Blue Options PPO Copay Plan
| Employee Cost | Monthly | Per Pay Period |
|---|---|---|
| Employee Only | $266 | $133 |
| Employee + Spouse | $611 | $306 |
| Employee + Child(ren) | $529 | $265 |
| Employee + Family | $886 | $443 |
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
(applies to all isolved plans)
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