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HealthSelectSM of Texas Benefits

HealthSelect of Texas is administered by Blue Cross and Blue Shield of Texas and offers three levels of coverage, depending on if the participant lives in Texas and/or is enrolled in Medicare.

In-state coverage

BeFor HealthSelect of Texas participants who live and work in Texas and aren't enrolled in Medicare, HealthSelect of Texas offers in-network and out-of-network benefits.

  • In-network benefits have lower out-of-pocket costs. You must choose a primary care physician (PCP) from the HealthSelect network and get referrals from that PCP to in-network specialists and facilities.
  • Out-of-network care and services are still covered, allowing you to see any doctor or go to any facility without a PCP referral. They are covered at a lower rate, however, and you will have higher – sometimes much higher – out-of-pocket costs.
  • Prescription drug coverage is administered by OptumRx.

HealthSelect Secondary

HealthSelect Secondary (formerly referred to as “out-of-area” coverage) is available to Medicare-eligible retirees who opt out of HealthSelect Medicare Advantage (administered by Humana). The cost for participants is higher than in HealthSelect Medicare Advantage: The monthly premiums are higher for retirees whose premiums aren’t paid 100% by the state, dependents and survivors. In addition, there are more out-of-pocket costs.

  • You can see any provider that accepts Medicare. You don’t need a primary care physician (PCP) or referrals to see specialists.
  • There is an annual deductible for medical care, in addition to the annual prescription drug deductible.
  • You might also be responsible for out-of-pocket costs like coinsurance or copays.
  • Prescription drug coverage is administered by UnitedHealthcare.

HealthSelect Out-of-State

This benefit level (formerly called “out-of-area” coverage) is available only to participants who live or work outside Texas. (The address you have on file with ERS must be outside Texas.) It offers in-network and out-of-network benefits.

  • In-network benefits have lower out-of-pocket costs. You do not have to choose a primary care physician or get referrals to specialists or facilities. But you should see in-network providers to save money.
  • There is no longer a deductible for in-network care and services.
  • Out-of-network care and services are still covered, allowing you to see any doctor or go to any facility. They are covered at a lower rate, however, and you will have higher – sometimes much higher – out-of-pocket costs if you see out-of-network providers.
  • Prescription drug coverage is administered by OptumRx.