HealthSelectSM Medicare Advantage replaces both original Medicare and other Texas State Employee Group Benefits Plan (GBP) coverage as your primary and secondary coverage. When you become eligible for Medicare and enroll in Medicare Parts A and B, you will be automatically enrolled in HealthSelect Medicare Advantage, administered by Humana. The plan includes a comprehensive prescription drug program called HealthSelect Medicare Rx, which is administered by UnitedHealthcare.
Enrollment in this plan also includes $2,500 of Basic Term Life Insurance.
- You must continue to pay for Medicare Part B premiums; however, you pay less for dependent premiums and the plan has no yearly deductible.
- This plan covers your Medicare deductible.
- You can visit any provider that is willing to bill Medicare You may be responsible for coinsurance.
- HealthSelect Medicare Advantage also offers additional benefits, such as no cost gym memberships along with health and wellness services.
- All household members who are Medicare-eligible need to enroll in parts A and B of Medicare and must have the same GBP health plan.
- HealthSelect has a suite of wellness programs available to all participants.
- You will receive two ID cards: one for medical and one for prescription drug benefits.
Eligibility and Enrollment
Retirees, survivors, and their dependents are eligible for HealthSelect Medicare Advantage if they meet the following eligibility requirements:
- enrolled in Medicare Part A (hospital) and Part B (other medical) coverage;
- living in the United States; and
- not return to work (RTW) retirees (active or retiree benefit).
Most retirees, survivors, and their dependents enrolled in Medicare Part A and Part B will be automatically enrolled in the HealthSelect Medicare Advantage Plan. If your Medicare Claim Number on your card does not end in ‘A,’ you will need to call ERS toll-free at (877) 275-4377 to update your Medicare information.
You can switch between HealthSelect Medicare Advantage and your previous health plan at any time during the plan year. You don’t have to wait until annual enrollment. Evidence of Insurability is never required to enroll in this plan.
Active employees and dependents of active employees (even if enrolled in Medicare) are not eligible for this plan. If you return to work in a benefits-eligible position, you will no longer be eligible for HealthSelect Medicare Advantage and HealthSelect Medicare Rx. Your coverage will revert to your previous GBP coverage.
A household of at least two people, where at least one member is enrolled in Medicare and one member is not eligible for Medicare.
For example, Rita and Gus are married and both are currently enrolled in HealthSelect of Texas. Rita is a state retiree who is 65 years old and enrolled in Medicare. Gus is also retired and is enrolled as Rita’s dependent, but he is 64 years old and not yet eligible for Medicare. Rita can enroll in the HealthSelect Medicare Advantage Plan while Gus stays enrolled in HealthSelect.
If more than one person in a household is enrolled in Medicare, all Medicare-enrolled household members must be enrolled in the same GBP health coverage plan.
For example, Rosie and Mario are both 65, retired, enrolled in Medicare, and enrolled in HealthSelect. Mario is enrolled as Rosie’s dependent. Their daughter Gabriella lives with them, is disabled and enrolled in Medicare, and also enrolled in HealthSelect. Rosie, Mario, and Gabriella must all be enrolled in the same GBP health coverage plan. Rosie cannot enroll in HealthSelect Medicare Advantage while Mario and Gabriella stay with HealthSelect.