Rowan County provides a self-insured health plan for active employees which is administered through Blue Cross Blue Shield of North Carolina (BCBSNC). Employee coverage is provided by the County and dependents’ coverage is available through payroll deduction. The plan is designed to protect employees and their families against catastrophic health expenses beyond the deductible and provide basic health services through their primary care physician. A primary care physician is a general internist, pediatrician, family physician, or gynecologist. Benefits are payable at 100% after a $30 co-payment.
Learn about eligibility for dependent coverage (PDF) on the Rowan County Health Plan and follow the instructions provided in the packet.
Major Medical Services, Specialist services, Emergency Room Visits, Urgent Care visits, Inpatient/Outpatient Hospital stays are those services that fall outside of primary care services and are subject to a deductible and co-insurance.
Submit claims to:
P.O. Box 35
Durham, NC 27702-0035
The Prescription Drug benefit utilizes your health insurance identification card and a network of participating pharmacies provided by Prime Therapeutics. Participating pharmacies will accept the required co-pay and file your claim directly. One co-pay applies to a maximum 30 day supply. Prescription drug co-pays are as follows:
- Brand Name (Tier III): $70 co-pay
- Formulary (Tier II): $55 co-pay
- Generic (Tier I): $10 co-pay
In order to find out your co-pay amount for your prescription medication, visit the BCBS website and choose "Find a Drug" on the home page. Then choose "Prescription Drug Search." At the top of the page you will see several options - "Printable Formulary Guide" will give you an updated list of prescription medications and their Tier Level (cost); "Prior Approval and Limitations" will provide you with a listing of medications that require prior authorization or certification from your health care provider prior to dispensing of the medication. The listing will tell you what steps you should take to have the medication pre-approved (if necessary). You should check both of these pages often, as changes in pharmaceuticals occur throughout the year and may require changes in prescription status.
Prime Therapeutics has a mail service pharmacy program (PrimeMail) that offers many unique features, including exceptional customer service and innovative clinical features. With PrimeMail, you receive fast, convenient delivery of maintenance medication delivered directly to your home. PrimeMail manages your care by managing costs. When you fill or refill your prescription by mail, you pay only two co-pays for a three-months supply. Forms are available on the PrimeMail website.
Health Insurance Employee Cost
- Employee: $75.00 monthly (for new full-time employees effective January 22, 2012)
- Additional for Child(ren): $280 monthly
- Additional for Spouse: $400 monthly
- Additional for Family: $470 monthly