Your deductibles may have restarted on January 1

Your deductibles may have restarted on January 1

January 8, 2020
January 2020 calendarMost medical and prescription drug deductibles in ERS health insurance plans restarted on January 1. What does that mean for you? If your prescription drug deductible restarted, for example, that means until you reach the $50 prescription drug deductible, you might pay more for a prescription now than the last time you filled it in 2019.

Coinsurance and out-of-pocket maximums for most plans also restarted in the new year.

Use the table below to find out the restart dates for your ERS health plan’s prescription drug and medical deductibles.
 
If participant is enrolled in: When does the deductible restart?
HealthSelect of Texas® (your eligibility county on file with ERS is in Texas and you're not eligible for Medicare)
                                        -or-
HealthSelectSM Out-of-State (your eligibility county on file with ERS is outside Texas and you're not eligible for Medicare)
In-network: There is no medical deductible to see in-network providers.

Out-of-network: The out-of-network medical deductible restarts on January 1.

The prescription drug deductible restarts on January 1.
Consumer Directed HealthSelectSM In-network: The in-network combined medical and pharmacy deductible restarts on January 1.

Out-of-network: The out-of-network combined  medical and pharmacy deductible restarts on January 1.

NOTE: Consumer Directed HealthSelect has a combined medical and pharmacy deductible, which means that both medical and prescription drug expenses go toward meeting the deductible.
HMOs
Community First Health Plans
                         -or-
Scott and White Health Plan
There is no medical deductible.

The prescription drug deductible restarts on September 1.
HealthSelectSM Secondary (retirees eligible for Medicare, or a Medicare-enrolled return-to-work retiree with retiree benefits) The medical deductible restarts on January 1.

The prescription drug deductible restarts on January 1.
HealthSelectSM Medicare Advantage, a preferred provider organization (MA PPO), administered by Humana or KelseyCare Advantage (retirees enrolled in Medicare) There is no medical deductible.

The prescription drug deductible restarts on January 1.