HealthSelect Plans
Decide which plan is best for you
Use the Plan Decision Tool or view the
Plan Comparison Chart
The following plans are available to you as a State of Texas agency or institution employee or non-Medicare-eligible retiree. Throughout this exercise, we will ask you simple questions to help guide you to make the best decision for your health care benefits. Please note: On all plans, in-network preventive services are covered at 100%. All plans also have an annual in-network out-of-pocket maximum to protect you from catastrophic health costs.
For more information on key features of ERS health plans, go to https://ers.texas.gov/Benefits-at-a-Glance/.
For detailed information on covered services, see ERS' Health Plans Comparison Chart at https://ers.texas.gov/Active-Employees/Health-Benefits.
HealthSelect of Texas®
- Point-of-service health plan with lower out-of-pocket costs at time of service (copays and coinsurance)
- No medical deductible for in-network services
- Higher monthly dependent premium
- Requires primary care provider (PCP) selection and referrals to see specialists
- Pay less by staying in the large, statewide network
Consumer Directed HealthSelectSM
- High-deductible health plan with access to a portable, tax-free health savings account (HSA)
- Plan pays for nothing except preventive services (such as annual checkups and recommended vaccinations) until you have paid the combined annual medical/prescription deductible amount: $2,100/person, $4,200/family in-network; $4,200/person, $8,400/family out-of-network
- Once you've met the annual deductible, you pay a percentage of the costs (coinsurance, not set copays) for prescriptions and non-preventive services
- To help pay for health care expenses, the State of Texas makes monthly contributions to your HSA: $45/person ($540 annually), $90/family ($1,080)
- Save money on taxes by making your own HSA contributions
- Slightly lower monthly dependent premiums
- Does not require a PCP selection, no referrals needed to see specialists
- Pay less by staying in the large, statewide network
Please note that HealthSelect Out-of-State coverage is available to active employees, non-Medicare-eligible retirees and their eligible dependents living or working outside Texas. Unless noted, the information in this exercise does not apply to people enrolled in Medicare Parts A and B, who can participate in Medicare Advantage plans (not covered in this exercise), or HealthSelect Secondary. We will provide additional information regarding all plans once you complete the plan selection exercise.
Are you retired and do you qualify for Medicare?
As a State of Texas employee who is either an active employee or retired but not eligible for Medicare you may qualify to enroll in a health plan. Complete eligibility requirements for each plan can be found in the Master Benefit Plan Documents found on the Publications, Forms and Presentations page.
HMOs have lower dependent premiums and low out-of-pocket costs. They also offer access to a dedicated network that coordinates care. The networks are smaller than the statewide HealthSelect network and limited to certain regions. There is no coverage for out-of-network services, except for emergency care. PCP referrals may also be necessary in an HMO. For more information on HMOs, please visit: https://ers.texas.gov/Active-Employees/Health-Benefits/HMOs.
Do you live in Texas?
Will you be covering any dependents on the plan?
If you are covering dependents on your plan, HealthSelect of Texas will have higher premiums than Consumer Directed HealthSelect. But there are other important factors to help decide which plan is best for your finances and health needs. Please continue to learn more about the plans and which might best meet your and your family's needs.
Select the statement that best describes you. Keep in mind that the deductible is the amount you have to pay out of pocket before the plan pays for anything except preventive care.
My/our use of health care and prescriptions can be described as
Heavy
The combined value of what I/we pay and what the plan pays for in-network health care and prescriptions is high. I am likely to reach the annual in-network out-of-pocket maximum of $7,500 per person/$15,000 per family for the 2024 calendar year. (Note: Out-of-pocket maximums include deductible, copays and coinsurance. They do not include monthly premiums.)
Moderate
My/our use of health care and prescriptions is between light and heavy. I/we do not have complex illnesses or conditions that require regular doctor visits. We also don’t expect any major procedures in the upcoming plan year (September 1 – August 31). We usually visit a doctor four to six times a year for basic continuing care for example, colds or infections, minor allergic reactions and minor injuries, in addition to preventive services.
Light
My/our use of health care and prescriptions is light and mostly limited to preventive care. I/we do not anticipate procedures in the upcoming plan year (September 1 - August 31). I/we rarely visit the doctor.
I am willing to risk paying an annual deductible of $2,100 per person or $4,200 per family for in-network care if I or my dependents become ill or injured. Note: Even though your plan would start Sept 1, your deductibles are based on the calendar year and reset Jan 1 of each year. Deductibles are much higher for out-of-network care. For family coverage, there is an individual out-of-pocket maximum of $7,500 and a family maximum of $15,000 for the 2024 calendar year. No one within the family will have to pay more than $7,500 in out-of-pocket expenses for the 2024 calendar year.
Here are some things to know about Consumer Directed HealthSelect:
- You have access to the large, statewide HealthSelect provider network.
- You do not need to select a primary care provider (PCP).
- You do not need a referral to see specialists.
- If you cover dependents, your premiums will be lower than HealthSelect of Texas premiums.
- Your out-of-pocket costs at the time of service could be much higher than in other plans.
- To help you pay for higher out-of-pocket costs, the plan allows you to participate in a tax-free health savings account (HSA) and receive monthly HSA contributions from the State of Texas. You can also contribute additional money to your HSA, tax-free.
- Preventive services provided by an in-network doctor – like annual check-ups and vaccinations – are covered at 100%, even if you haven't met the deductible.
Based on your selections, you might prefer the following plan:
HealthSelectSM of Texas
The HealthSelect of Texas point-of-service plan usually has lower upfront out-of-pocket costs. You must choose an in-network primary care provider (PCP) to coordinate your care, including getting referrals to specialists. HealthSelect of Texas has slightly higher dependent premiums, but does not have a deductible if you stay in the network and get necessary referrals. You will pay more if you use providers that are not in the HealthSelect network, or if you see a specialist without a referral from your PCP – even if the specialist is in the network.
Highlights for HealthSelect of Texas include:
- No deductible for in-network care
- Annual deductible for out-of-network care: $500 per person / $1,500 per family
- In-network preventive care covered at 100%
- In-network PCP required
- Referrals to most specialists required
- In-network PCP office visit: $25 copay
- In-network specialist office visit: $40 copay (with active PCP referral)
- Copay and/or coinsurance for most other covered services, including urgent care, outpatient surgery, and hospital stay
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
Based on your selections, you might prefer the following plan:
Consumer Directed HealthSelectSM
Consumer Directed HealthSelect is a high-deductible health plan paired with a tax-free, portable health savings account (HSA). It has a slightly lower monthly dependent premium. The annual in-network deductible for an individual is $2,100; the annual deductible for a family (member plus at least one family member) is $4,200. The higher deductible means you could pay more in out-of-pocket costs for health care services and prescriptions. For eligible participants, the State of Texas contributes to your HSA each month: $45 ($540 per year) for an individual, $90 ($1,080 per year) for a family. You can also contribute your own money to your HSA, tax-free. You can use the money in your HSA to pay for eligible health expenses (defined by the IRS), such as your deductible and coinsurance costs. Or you can save the money as long as you want. Your HSA can even be used as an investment account once your balance reaches a certain amount.
With Consumer Directed HealthSelect, you have access to the same large provider network as in the HealthSelect of Texas plan, including tens of thousands of doctors, hospitals and other providers across Texas. You don’t have to choose a primary care provider (PCP) or get referrals to specialists. But you will save money if you use providers in the HealthSelect network.
Highlights for Consumer Directed HealthSelect include:
- Lower dependent premiums
- In-network annual deductible:
$2,100 per person / $4,200 per family - Out-of-network deductible:
$4,200 per person / $8,400 per family - No PCP required
- No referrals to specialists required
- In-network preventive care covered at 100%
- Monthly employer contributions to a portable health savings account (HSA): $45 for member / $90 for family
- Ability to save money on federal income taxes and build savings by contributing to your HSA
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
Based on your selections, you might prefer the following plan:
HealthSelectSM Out-of-State
HealthSelect Out-of-State benefits are available to active employees, non-Medicare-eligible retirees and their eligible dependents living or working outside of Texas.
These benefits are similar to HealthSelect of Texas, but you do not need to choose a primary care provider (PCP) or get referrals to see specialists. You will pay more if you use providers that are not in the network. HealthSelect Out-of-State benefits also have lower upfront out-of-pocket costs, copays for doctor's office visits, urgent care, and outpatient surgery, and there is no deductible as long as you stay in the network.
Highlights for HealthSelect Out-of-State include:
- In-Network $0 deductible
- Out-of-Network deductible
$500 per person /
$1,500 per family - Preventive care covered at 100%
- $25 PCP office visit copay (In-Network)
- $40 Specialist office visit copay (In-Network)
- Combination of either copay or coinsurance for most other covered services including urgent care, outpatient surgeries, etc
- In-Network out-of-pocket maximums
$7,500 per person /
$15,000 per family - No Out-of-Network out-of-pocket maximum
Secondary Plan Options
If you are retired and eligible for Medicare, you might be eligible for one of the following coverage options:
- HealthSelect Medicare Advantage
- HealthSelect Secondary
- Regional HMOs, if you live in certain Texas counties
Once you enroll in Medicare, contact ERS with your Medicare ID and the dates that your Medicare A & B take effect. ERS will need this information to verify your eligibility for the HealthSelect Medicare Advantage plan, administered by Humana. ERS will not be able to enroll you into this plan without first confirming that you are enrolled in both Medicare A & B.
In most cases, you can choose to stay in the plan you were in before you enrolled in Medicare. If you live in an eligible county, you can enroll in an HMO. If you stay in HealthSelect of Texas, your coverage will change to HealthSelect Secondary.
For most people, HealthSelect Medicare Advantage offers lower out-of-pocket costs, lower dependent premiums (if applicable) and more value-added services.
Please visit the Medicare section of the Retirees Health Benefits page for more information regarding your health coverage options.
Will you be covering any dependents on the plan?
If you are covering dependents on your plan, HealthSelect of Texas will have higher premiums than Consumer Directed HealthSelect. But there are other important factors to help decide which plan is best for your finances and health needs. Please continue to learn more about the plans and which might best meet your and your family's needs.
Select the statement that best describes you. Keep in mind that the deductible is the amount you have to pay out of pocket before the plan pays for anything except preventive care.
My/our use of health care and prescriptions can be described as
Heavy
The combined value of what I/we pay and what the plan pays for in-network health care and prescriptions is high. I am likely to reach the annual in-network out-of-pocket maximum of $7,500 per person/$15,000 per family for the 2024 calendar year. (Note: Out-of-pocket maximums include deductible, copays and coinsurance. They do not include monthly premiums.)
Moderate
My/our use of health care and prescriptions is between light and heavy. I/we do not have complex illnesses or conditions that require regular doctor visits. We also don’t expect any major procedures in the upcoming plan year (September 1 – August 31). We usually visit a doctor four to six times a year for basic continuing care for example, colds or infections, minor allergic reactions and minor injuries, in addition to preventive services.
Light
My/our use of health care and prescriptions is light and mostly limited to preventive care. I/we do not anticipate procedures in the upcoming plan year (September 1 - August 31). I/we rarely visit the doctor.
I am willing to risk paying an annual deductible of $2,100 per person or $4,200 per family for in-network care if I or my dependents become ill or injured. Note: Even though your plan would start Sept 1, your deductibles are based on the calendar year and reset Jan 1 of each year. Deductibles are much higher for out-of-network care. For family coverage, there is an individual out-of-pocket maximum of $7,500 and a family maximum of $15,000 for the 2024 calendar year. No one within the family will have to pay more than $7,500 in out-of-pocket expenses for the 2024 calendar year.
Here are some things to know about Consumer Directed HealthSelect:
- You have access to the large, statewide HealthSelect provider network.
- You do not need to select a primary care provider (PCP).
- You do not need a referral to see specialists.
- If you cover dependents, your premiums will be lower than HealthSelect of Texas premiums.
- Your out-of-pocket costs at the time of service could be much higher than in other plans.
- To help you pay for higher out-of-pocket costs, the plan allows you to participate in a tax-free health savings account (HSA) and receive monthly HSA contributions from the State of Texas. You can also contribute additional money to your HSA, tax-free.
- Preventive services provided by an in-network doctor – like annual check-ups and vaccinations – are covered at 100%, even if you haven't met the deductible.
Based on your selections, you might prefer the following plan:
HealthSelect of Texas®
The HealthSelect of Texas point-of-service plan usually has lower upfront out-of-pocket costs. You must choose an in-network primary care provider (PCP) to coordinate your care, including getting referrals to specialists. HealthSelect of Texas has slightly higher dependent premiums, but does not have a deductible if you stay in-network and get necessary referrals. You will pay more if you use providers that are not in the HealthSelect network, or if you see a specialist without a referral from your PCP – even if the specialist is in the network.
Highlights for HealthSelect of Texas include:
- No deductible for in-network care
- Annual deductible for out-of-network care: $500 per person / $1,500 per family
- In-network preventive care covered at 100%
- In-network PCP required
- Referrals to most specialists required
- In-network PCP office visit: $25 copay
- In-network specialist office visit: $40 copay (with active PCP referral)
- Copay and/or coinsurance for most other covered services, including urgent care, outpatient surgery, and hospital stay
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
Based on your selections, you might prefer the following plan:
Consumer Directed HealthSelectSM
Consumer Directed HealthSelect is a high-deductible health plan paired with a tax-free, portable health savings account (HSA). It has a slightly lower monthly dependent premium. The annual in-network deductible for an individual is $2,100; the annual deductible for a family (member plus at least one family member) is $4,200. The higher deductible means you could pay more in out-of-pocket costs for health care services and prescriptions. For eligible participants, the State of Texas contributes to your HSA each month: $45 ($540 per year) for an individual, $90 ($1,080 per year) for a family. You can also contribute your own money to your HSA, tax-free. You can use the money in your HSA to pay for eligible health expenses (defined by the IRS), such as your deductible and coinsurance costs. Or you can save the money as long as you want. Your HSA can even be used as an investment account once your balance reaches a certain amount.
With Consumer Directed HealthSelect, you have access to the same large provider network as in the HealthSelect of Texas plan, including tens of thousands of doctors, hospitals and other providers across Texas. You don’t have to choose a primary care provider (PCP) or get referrals to specialists. But you will save money if you use providers in the HealthSelect network.
Highlights for Consumer Directed HealthSelect include:
- Lower dependent premiums
- In-network annual deductible:
$2,100 per person / $4,200 per family - Out-of-network deductible:
$4,200 per person / $8,400 per family - No PCP required
- No referrals to specialists required
- in-network preventive care covered at 100%
- Monthly employer contributions to a portable health savings account (HSA): $45 for member / $90 for family
- Ability to save money on federal income taxes and build savings by contributing to your HSA
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
Will you be covering any dependents on the plan?
If you are covering dependents on your plan, Consumer Directed HealthSelect has lower premiums than HealthSelect Out-of-State. But there are other important factors to help you decide which plan is best for your finances and health needs. Please continue to learn more about the plans and which might best meet your and your family's needs.
Select the statement that best describes you. Keep in mind that the deductible is the amount you have to pay out of pocket before the plan pays for anything except preventive care.
My/our use of health care and prescriptions can be described as
Heavy
The combined value of what I/we pay and what the plan pays for in-network health care and prescriptions is high. I am likely to reach the annual in-network out-of-pocket maximum of $7,500 per person/$15,000 per family for the 2024 calendar year. (Note: Out-of-pocket maximums include deductible, copays and coinsurance. They do not include monthly premiums.)Moderate
My/our use of health care and prescriptions is between light and heavy. I/we do not have complex illnesses or conditions that require regular doctor visits. We also don’t expect any major procedures in the upcoming plan year (September 1 – August 31). We usually visit a doctor four to six times a year for basic continuing care for example, colds or infections, minor allergic reactions and minor injuries, in addition to preventive services.
Light
My/our use of health care and prescriptions is light and mostly limited to preventive care. I/we do not anticipate procedures in the upcoming plan year (September 1 - August 31). I/we rarely visit the doctor.
I am willing to risk paying an annual deductible of $2,100 per person or $4,200 per family for in-network care if I or my dependents become ill or injured. Note: Even though your plan would start Sept 1, your deductibles are based on the calendar year and reset Jan 1 of each year. Deductibles are much higher for out-of-network care. For family coverage, there is an individual out-of-pocket maximum of $7,500 and a family maximum of $15,000 for the 2024 calendar year. No one within the family will have to pay more than $7,500 in out-of-pocket expenses for the 2024 calendar year.
Here are some things to know about Consumer Directed HealthSelect:
- You do not need to select a primary care provider
- You do not need a referral to see specialists
- Your out-of-pocket costs could be much higher than in other plans
- To help you pay for higher out-of-pocket costs, the plan allows you to participate in a tax-free health savings account (HSA) and receive monthly HSA contributions from the State of Texas
- Preventive services provided by an in-network doctor – like annual check-ups and vaccinations – are covered at 100%, even if you haven't met the deductible
After careful review, I've decided that Consumer Directed HealthSelect...
Based on your selections, you might prefer the following plan:
HealthSelectSM Out-of-State
HealthSelect Out-of-State benefits are available to active employees, non-Medicare-eligible retirees and their eligible dependents living or working outside of Texas.
These benefits are similar to HealthSelect of Texas, but you do not need to choose a primary care provider (PCP) or get referrals to see specialists. HealthSelect Out-of-State benefits also have lower upfront out-of-pocket costs than Consumer Directed HealthSelect (including copays and/or coinsurance for doctor's office visits, urgent care and outpatient surgery), and there is no deductible as long as you stay in the network.
Highlights for HealthSelect Out-of-State include:
- No deductible for in-network care
- Annual deductible for out-of-network care: $500 per person/$1,500 per family
- in-network preventive care covered at 100%
- In-network PCP office visit: $25 copay
- In-network specialist office visit: $40 copay
- Copay and/or coinsurance for most other covered services, including urgent care, outpatient surgery, hospital stay, etc.
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
Based on your selections, you might prefer the following plan:
Consumer Directed HealthSelectSM
Consumer Directed HealthSelect is a high-deductible health plan paired with a tax-free, portable health savings account (HSA). It has a slightly lower monthly dependent premium. The annual in-network deductible for an individual is $2,100; the annual deductible for a family (member plus at least one family member) is $4,200. The higher deductible means you could pay more in out-of-pocket costs for health care services and prescriptions. For eligible participants, the State of Texas contributes to your HSA each month: $45 ($540 per year) for an individual, $90 ($1,080 per year) for a family. You can also contribute your own money to your HSA, tax-free. You can use the money in your HSA to pay for eligible health expenses (defined by the IRS), such as your deductible and coinsurance costs. Or you can save the money as long as you want. Your HSA can even be used as an investment account once your balance reaches a certain amount.
With Consumer Directed HealthSelect, you have access to the same large provider network as in the HealthSelect of Texas plan, including tens of thousands of doctors, hospitals and other providers across Texas. You don’t have to choose a primary care provider (PCP) or get referrals to specialists. But you will save money if you use providers in the HealthSelect network.
Highlights for Consumer Directed HealthSelect include:
- Lower dependent premiums
- In-network annual deductible:
$2,100 per person / $4,200 per family - Out-of-network deductible:
$4,200 per person / $8,400 per family - No PCP required
- No referrals to specialists required
- In-network preventive care covered at 100%
- Monthly employer contributions to a portable health savings account (HSA): $45 for member / $90 for family
- Ability to save money on federal income taxes and build savings by contributing to your HSA
- Annual in-network out-of-pocket maximum to protect you from catastrophic health costs: $7,500 per person/$15,000 per family. (There is not an annual out-of-pocket maximum for out-of-network care.)
HealthSelect of Texas®
HealthSelect of Texas is available to members of the Texas Employees Group Benefits Program, retirees under 65, and their eligible dependents.
Consumer Directed HealthSelectSM
Consumer Directed HealthSelect is a high-deductible health plan paired with a health savings account (HSA). If you are enrolled in Medicare, you are not eligible for this plan.
HealthSelectSM Out-of-State
HealthSelect Out-of-State is available only to active employees, retirees not enrolled in Medicare, and their eligible dependents living or working outside the state of Texas.
HealthSelectSM
Secondary
HealthSelect Secondary is available to retirees and their eligible spouses and dependents enrolled in Medicare. The benefits are coordinated with Medicare primary. HealthSelect participants who live outside the United States will be enrolled in HealthSelect Secondary.