Medical and pharmacy
The ECU Health Medical Plan is administered by Allegiance.
If you need to request an ID card, print or view an explanation of benefits (EOB) or find a provider, visit askallegiance.com/ECUHealth. The ECU Health group number for Allegiance is 2005028.
Save more by choosing Tier 1 providers and facilities
Choosing Tier 1 providers whenever possible can help reduce your out-of-pocket expenses and manage overall plan costs.
Visit the Find a Provider page of askallegiance.com/ecuhealth to access in-network provider directories.
ECU HealthNow
You can use ECU HealthNow to connect with a provider 24/7 by phone or online.
Visit ECU HealthNow. From minor illnesses to routine care needs, ECU HealthNow is free for those covered by an ECU Health medical plan.
ECU Health medical plan options
| Tier 1 ECU Health Alliance/In-network |
Tier 2 Allegiance/In-network |
Tier 3 Out-of-network |
|
|---|---|---|---|
| Preventive care | Covered at 100% | Covered at 100% | Ded., then 50% coins. |
| Plan coinsurance | Ded., Plan pays 85%, you pay 15% | Ded., Plan pays 75%, you pay 25% | Plan pays 50%, you pay 50% |
| Primary care provider (PCP) visit | Ded., then 5% coins. | Ded., then 5% coins. | Ded., then 50% coins. |
| Specialty visit | Ded., then 10% coins. | Ded., then 25% coins. | Ded., then 50% coins. |
| Behavioral Health office visit | Ded., then 5% coins. | Ded., then 5% coins. | Ded., then 50% coins. |
| ECU HealthNow | Covered at 100% | Covered at 100% | Covered at 100% |
| Med deductible (Single/Family) | $2,000/$4,000 | $2,500/$5,000 | $6,000/$12,000 |
| Med max out-of-pocket (OOP) (Single/Family) | $6,000/$12,000 | $6,750/$13,500 | $12,500/$25,000 |
| Prescription max OOP (Single/Family) | Included in OOP max | Included in OOP max | Included in OOP max |
| Combined OOP max (Med + Rx) | $6,000/$12,000 | $6,750/$13,500 | $12,500/$25,000 |
| Emergency room | Ded., then 15% coins. | Tier 1 ded., then 15% coins. | Tier 1 ded., then 15% coins. |
| Urgent care | Ded., then 15% coins. | Ded., then 25% coins. | Ded., then 50% coins. |
| Inpatient/Outpatient hospital | Ded., then 15% coins. | Ded., then 25% coins. | Ded., then 50% coins. |
| Tier 1 ECU Health Alliance/In-network |
Tier 2 Allegiance/In-network |
Tier 3 Out-of-network |
|
|---|---|---|---|
| Preventive care | Covered at 100% | Covered at 100% | Ded., then 50% coins. |
| Plan coinsurance | Plan pays 80%, you pay 20% | Plan pays 70%, you pay 30% | Plan pays 50%, you pay 50% |
| Primary care provider (PCP) visit | $15 copay | $25 copay | Ded., then 50% coins. |
| Specialty visit | $30 copay | $75 copay | Ded., then 50% coins. |
| Behavioral Health office visit | $15 copay | $25 copay | Ded., then 50% coins. |
| ECU HealthNow | Covered at 100% | Covered at 100% | Covered at 100% |
| Med deductible (Single/Family) | $1,000/$2,000 | $2,000/$4,000 | $4,500/$9,000 |
| Med max out-of-pocket (OOP (Single/Family) | $4,000/$8,000 | $10,000/$20,000 | $10,600/$21,200 |
| Prescription max OOP (Single/Family) | $2,500/$5,000 | $2,500/$5,000 | $2,500/$5,000 |
| Combined OOP max (Med + Rx) | $6,500/$13,000 | $12,500/$25,000 | $13,100/$26,200 |
| Emergency room | $250 copay | $250 copay | $250 copay |
| Urgent care | $50 copay | $60 copay | Ded., then 50% coins. |
| Inpatient/Outpatient hospital | Ded., then 20% coins. | Ded., then 30% coins. | Ded., then 50% coins. |
| Tier 1 ECU Health Alliance/In-network |
Tier 2 Allegiance/In-network |
Tier 3 Out-of-network |
|
|---|---|---|---|
| Preventive care | Covered at 100% | Covered at 100% | Ded., then 50% coins. |
| Plan coinsurance | Plan pays 90%, you pay 10% | Plan pays 70%, you pay 30% | Plan pays 50%, you pay 50% |
| Primary care provider (PCP) visit | $10 copay | $20 copay | Ded., then 50% coins. |
| Specialty visit | $15 copay | $60 copay | Ded., then 50% coins. |
| Behavioral Health office visit | $10 copay | $20 copay | Ded., then 50% coins. |
| ECU HealthNow | Covered at 100% | Covered at 100% | Covered at 100% |
| Med deductible (Single/Family) | $800/$1,600 | $1,400/$2,800 | $3,500/$7,000 |
| Med max out-of-pocket (OOP) (Single/Family) | $3,300/$6,600 | $9,000/$18,000 | $10,600/$21,200 |
| Prescription max OOP (Single/Family) | $2,500/$5,000 | $2,500/$5,000 | $2,500/$5,000 |
| Combined OOP max (Med + Rx) | $5,800/$11,600 | $11,500/$23,000 | $13,100/$26,200 |
| Emergency room | $200 copay | $200 copay | $200 copay |
| Urgent care | $40 copay | $50 copay | Ded., then 50% coins. |
| Inpatient/Outpatient hospital | Ded., then 10% coins. | Ded., then 30% coins. | Ded., then 50% coins. |
| Resident Plan (PPO) | |||
|---|---|---|---|
| Tier 1 ECU Health In-network |
Tier 2 Allegiance In-network |
Tier 3 Out-of-network |
|
| Preventative care | Covered at 100% | Covered at 100% | Ded., then 50% coins. |
| Plan coinsurance | Ded., then 10% coins. | Ded., then 30% coins. | Plan pays 50%, you pay 50% |
| Primary care provider (PCP) visit | $10 copay | $20 copay | Ded., then 50% coins. |
| Specialty visit | $15 copay | $60 copay | Ded., then 50% coins. |
| Behavioral Health office visit | $10 copay | $20 copay | Ded., then 50% coins. |
| ECU HealthNow | Covered at 100% | Covered at 100% | Covered at 100% |
| Med deductible (Single/Family) | $500/$1,600 | $1,400/$2,800 | $3,500/$7,000 |
| Med max out-of-pocket (OOP) (Single/Family) | $2,000/$6,600 | $9,000/$18,000 | $10,600/$21,200 |
| Prescription max OOP (Single/Family) | Included in OOP max | Included in OOP max | Included in OOP max |
| Combined OOP max (Med + Rx) | $4,500/$11,600 | $11,500/$23,000 | $13,100/$26,200 |
| Emergency room | $200 copay | $200 copay | $200 copay |
| Urgent care | $40 | $50 | Ded/50% coins. |
| Inpatient/Outpatient hospital | Ded., then 10% coins. | Ded., then 30% coins. | Ded., then 50% coins. |
Pharmacy
Your ECU Health medical plan includes prescription drug coverage. Judi Rx administers the prescription drug benefit for all ECU Health medical plan participants. Get exclusive savings by using the ECU Health Employee Pharmacy. You may also use the network of retail pharmacies to fill prescriptions.
When you or a covered family member need a prescription filled, you pay a share of the cost of your prescription in the form of a copay or coinsurance. The amount you pay depends on whether you receive a generic, preferred brand or non-preferred brand name drug and which pharmacy you choose.
Review the packet to learn more about your Judi Rx Pharmacy Benefits. Questions about ECU Health prescription drug benefits? Contact Judi Rx at 833-554-4733 or visit Judi Rx.
Maintenance medications
If you take chronic/maintenance medications, you can get a 90-day prescription at the Employee Pharmacy for the equivalent cost of 2.5 rather than 3 full copays.
ECU Health provides a fertility benefit for medications, with a maximum lifetime limit of $10,000.
ECU Health pharmacy plan
| Pharmacy | Medical Savings Plan | Basic, Choice and Resident Plan | ||
|---|---|---|---|---|
| ECU Health Pharmacy | Retail Pharmacy | ECU Health Pharmacy | Retail Pharmacy | |
| Rx deductible | Included w/medical | Included w/medical | None | None |
| Rx max out-of-pocket (OOP) (Single/Family) | Included w/medical | Included w/medical | $2,500/$5,000 | $2,500/$5,000 |
| Generic (30 days) | Ded., then 10% coins. | Ded., then 20% coins. | $10 copay | $25 copay |
| Preferred brand (30 days) | Ded., then 20% coins. | Ded., then 30% coins. | $25 copay | $50 copay |
| Non-preferred brand (30 days) | Ded., then 30% coins. | Ded., then 40% coins. | $50 copay | $100 copay |
| Generic (90 days) | Ded., then 10% coins. | Ded., then 20% coins. | $25 copay | $75 copay |
| Preferred brand (90 days) | Ded., then 20% coins. | Ded., then 30% coins. | $62.50 copay | $150 copay |
| Non-preferred brand (90 days) | Ded., then 30% coins. | Ded., then 40% coins. | $125 copay | $300 copay |
| Preferred brand specialty* | Ded., then 20% coins. | No coverage | $100 copay | No coverage |
| Non-preferred specialty* | Ded., then 30% coins. | No coverage | $300 copay | No coverage |
| If cost exceeds $300 for all tiers and number of day supply | N/A | N/A | 15% coins. | 25% coins. |
Once a covered family member meets the individual out-of-pocket maximum (OOP max), the plan will pay the full cost of covered charges for that family member. Charges for all covered family members will continue to count toward the family OOP max. The annual OOP max includes amounts paid toward your deductible.
* Certain specialty medications must be filled at the ECU Health Specialty Pharmacy.
Coverage of GLP-1 medication
ECU Health is proud to continue offering coverage for eligible GLP-1 medications at a time when many organizations are scaling back or discontinuing this benefit. To help keep the benefit sustainable, new program requirements are being developed for 2027. Additional information will be shared as soon as the requirements are finalized.
2027 premiums
Full-time team members — 24 biweekly deductions
| Coverage | Medical Savings Plan | Basic Medical | Choice Medical |
|---|---|---|---|
| Single | $41.83 | $47.81 | $63.35 |
| + Children* | $155.37 | $181.67 | $210.35 |
| + Spouse* | $243.81 | $284.45 | $319.11 |
| + Family* | $267.72 | $311.94 | $348.99 |
* Includes domestic partner/domestic partner’s children. Family must include you, your spouse/domestic partner and at least one child.
Part-time team members — 24 biweekly deductions
| Coverage | Medical Savings Plan | Basic Medical | Choice Medical |
|---|---|---|---|
| Single | $117.13 | $135.06 | $149.40 |
| + Children* | $265.33 | $309.55 | $337.04 |
| + Spouse* | $335.84 | $393.21 | $429.07 |
| + Family* | $396.80 | $462.53 | $498.39 |
* Includes domestic partner/domestic partner’s children. Family must include you, your spouse/domestic partner and at least one child.