2024 Fall Enrollment
Healthy You Healthy Texas
Know your options for medical coverage
The Fall Enrollment period for Medicare-eligible retirees in the Group Benefits Program is Oct. 28 through Nov. 15. Fall Enrollment is the one time of the year when you can enroll in new coverage for yourself and/or your eligible dependents without experiencing a qualifying life event.
During Fall Enrollment, if you:
- are retired with Medicare,
- are a Medicare-eligible return-to-work retiree who chooses retiree benefits or
- have an address outside of the United States on file with the Employees Retirement System of Texas (ERS),
you have an opportunity to enroll in a new health plan. If you don’t want to make changes to your health plan, you do not need to do anything. Your current HealthSelectSM Secondary plan coverage will continue.
The 2025 plan year begins Jan. 1, 2025, and runs through Dec. 31, 2025.
Upcoming and recent benefits updates
Condition management programs
Several new condition management programs are available to HealthSelect Secondary participants. Learn about:
Hello Heart
Hinge Health
Learn to Live
New Wellness Tools
Effective Oct. 1, 2024, HealthSelectSM medical plan participants have access to Buena Vida, a new well-being program. Buena Vida can help you take control of your well-being and achieve what matters most to you.
Recommended Clinical Review
Your provider may submit a recommended clinical review (RCR) request to BCBSTX to confirm your plan coverage, benefit limitations and medical necessity prior to providing certain covered health services when Medicare is not your Primary Plan. For more information, call a BCBSTX Personal Health Assistant at (800) 252-8039 (TTY: 711).
Annual out-of-pocket maximum
Effective Jan. 1, 2025, the out-of-pocket maximum will increase to $8,050 for individual coverage and $16,100 for family coverage. The out-of-pocket maximum includes expenses you pay toward medical and prescription drug copays, coinsurance and deductibles, if your plan has one.
Enrollment Materials
Healthy You Healthy Texas Fall Enrollment Brochure - You will learn about the HealthSelect Secondary medical plan, including information about changes to your medical benefits and how to access important resources for Plan Year 2025.
HealthSelect Secondary Presentation - An overview of the HealthSelect Secondary plan.
Fall Enrollment Webinars and Fairs - You can register to attend live webinars on the Employees Retirement System of Texas (ERS) Events Calendar. You will have the opportunity to ask questions directly to the ERS and Blue Cross and Blue Shield of Texas representatives. ERS will also host in-person Fall Enrollment fairs this year. Be sure to check the ERS events calendar often for updates.
Condition Management Programs
Hello Heart
The Hello Heart program focuses exclusively on cardiovascular health, aiming to prevent or decrease the development or advancement of heart disease and other cardiovascular conditions.
Hello Heart is available at no additional cost to eligible participants and includes a free Hello Heart blood pressure monitor that pairs directly with a smartphone. By building a habit of monitoring blood pressure and other aspects of heart health, participants can create sustained lifestyle changes.
Hello Heart’s health technology uses artificial intelligence (AI), behavioral science and personalized digital coaching to drive lifestyle changes through the program’s mobile app. Through this technology, participants can:
- understand and manage their blood pressure,
- get help with cholesterol and blood pressure medication adherence,
- detect irregular heartbeat and
- bring awareness to serious heart issues.
HealthSelect of Texas® medical plan participants who are age 18 and older and living in the U.S., including those enrolled in Consumer Directed HealthSelectSM or HealthSelect Secondary, administered by BCBSTX, are eligible to enroll in the Hello Heart program. Participants must also have one or more of the following clinical conditions to be eligible to participate in the program:
- blood pressure readings of 130/80 mmHg or higher,
- currently taking medication for treatment of cardiovascular disease, including but not limited to blood pressure and/or cholesterol medication,
- increased risk for cardiovascular disease (CVD) such as family history and/or
- a woman aged 52 or older who is going through or has gone through menopause.
Resources:
Hello Heart FAQ
Hello Heart Flier
Hinge Health for MSK
Hinge Health is a digital, physical therapist (PT)-led musculoskeletal (MSK) care program. Hinge Health is available no additional cost to eligible participants and includes access to the Hinge Health mobile app and a care team including a board-certified health coach and physical therapist.
This digital program is focused on exercise therapy designed to address a wide range of MSK conditions. It can be done anywhere, at any time. The program includes:
- personalized exercise therapy to improve strength and mobility in short, 15-minute sessions,
- one-on-one health coaching to provide motivation and support via text, email or phone and
- interactive education to teach you how to manage your specific condition, treatment options and more.
HealthSelect of Texas medical plan participants who are age 18 and older, and living in the U.S., including those enrolled in Consumer Directed HealthSelect or HealthSelect Secondary, administered by BCBSTX, are eligible to enroll in the Hinge Health program. Participants with musculoskeletal pain may benefit from participating in the Hinge Health program.
Resources:
Hinge Health FAQ
Hinge Health Flier
Learn to Live
Learn to Live is an online, on-demand, self-paced mental health service grounded in cognitive behavioral therapy (CBT). This style of therapy focuses on thoughts and actions and how adjusting those can positively impact an individual’s state of mind.
Learn to Live provides online, coach-supported programs to help participants overcome depression, insomnia, panic, stress, anxiety and worry, social anxiety and substance use. Participants can also work with a Learn to Live Coach via their preferred communication method after completing an initial assessment.
All Learn to Live programs are accessed online and use videos and interactive features to engage a participant. An internet connection, smartphone, tablet or computer and a quiet place or headphones are needed to utilize Learn to Live programs and services. It works on any device – Android, iOS, PC, MAC, laptop or tablet.
HealthSelect of Texas medical plan participants who are age 13 and older and living in the U.S., including those enrolled in Consumer Directed HealthSelect or HealthSelect Secondary, administered by BCBSTX, are eligible to participate.
Resources:
Learn to Live FAQ
Learn to Live Flier
BCBSTX Personal Health Assistants are available
by phone
Call a BCBSTX Personal Health
Assistant toll-free
(800) 252-8039 (TTY:711)
Monday-Friday, 7 a.m.-7 p.m. and
Saturday, 7 a.m.-3 p.m. CT.
You can also communicate via secure chat and secure messaging
Monday-Friday, 8 a.m.-5 p.m.,
after logging into Blue Access for MembersSM