Welcome to HealthSelect of Texas
Health maintenance organization (HMO) plans will no longer be offered through the Texas Employees Group Benefits Program (GBP) after September 1, 2021. For more information about why the Employees Retirement System of Texas (ERS) is making this change, please visit the ERS website.
If you are currently enrolled in an HMO and do not have Medicare as your primary insurer, here is what you need to know:
- Beginning September 1, 2021, you will be automatically enrolled in HealthSelect of Texas, administered by Blue Cross and Blue Shield of Texas (BCBSTX).
- You can also choose to enroll in Consumer Directed HealthSelectSM or waive GBP health coverage during your agency’s Summer Enrollment phase.
To get the most out of your HealthSelect of Texas benefits, you will have to contact BCBSTX to name an in-network PCP. If you haven’t named a PCP after your first 60 days in the plan, out-of-network costs apply to most services – even if they’re from an in-network provider – until you name a PCP. This includes preventive care and care from in-network providers and facilities.
The HealthSelect network has more than 113,000 medical and mental health providers. More than 90% of HMO network providers participate in the HealthSelect network, so you will likely find that your current PCP is already in the network. HealthSelect participants do get coverage when they see out-of-network providers, but will pay more – sometimes a lot more – if they do.
To find out if a health care provider is in the HealthSelect network, you can use Provider Finder® or call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711), Monday – Friday, 7 a.m. - 7 p.m. and Saturday, 7 a.m. - 3 p.m. CT. If your provider is not in the network, you can nominate them to the network.
Consumer Directed HealthSelect is a high deductible health plan paired with a health savings account. You must meet a deductible of $2,100 per individual or $4,200 per family before the plan pays for most care. If you enroll in Consumer Directed HealthSelect, you do not have to have a PCP, but you may benefit from having one. An in-network PCP can help you control costs.
Both plans cover preventive care at 100% and require prior authorization for certain services.
Prescription drug benefits
HealthSelect medical plans include coverage for prescription drugs. Learn more about HealthSelect Prescription Drug Programs.
The prescription drug ID card is separate from the medical ID card. You may need to present your prescription drug ID card when filling a prescription.
New ID cards
You and any covered dependent(s) will get a new HealthSelect of Texas medical ID card in August 2021. If you choose a PCP during the upcoming Summer Enrollment period, the name of that PCP will be on your medical ID card.
Other important information
Referrals are required under the HealthSelect of Texas plan. A referral is an order from your PCP that must be obtained and authorized through BCBSTX for you to see a specialist. For most services, you need to get a referral before you can get medical care from anyone except your PCP. If you don’t get a referral before you get services, your services will be considered out-of-network, and you will pay more, even if the provider is in your plan’s network.
You are required to get prior authorization from BCBSTX for certain services, including inpatient hospital stays, surgery and durable medical equipment. In general, in-network providers are responsible for getting prior authorization before they provide services.
HealthSelect plans offer a variety of benefits that weren’t available through HMO plans.
Support for you and your family
Care management programs give you access to a team of dedicated clinicians who are available by phone to provide extra support and guidance with many mental and medical health concerns.
For general care questions, or if you aren’t sure where to go for care, you can get answers day or night by calling the 24/7 Nurseline at (800) 581-0368.
If you or your covered dependents are in a crisis situation, mental health counselors are available 24/7 at the same number you call for BCBSTX Personal Health Assistants.
HealthSelect can help you save time and money
Virtual Visits allow you to connect with medical and mental health providers via online video or by telephone anywhere a connection is available, through Doctor on Demand® and MDLIVE®.
HealthSelectShoppERSSM is an incentive program that helps you save money and earn TexFlexSM flexible spending account (FSA) rewards when shopping for certain medical services and procedures.
With the Blue365 discount program, you can save money on health and wellness products and services from top retailers that are not covered by your health plan.
Journey to Wellness
The Well onTarget® wellness portal gives you access to self-management programs, trackers and personalized coaching.
The Blue PointsSM rewards allows you to earn points for regularly participating in many different healthy activities. You can redeem up to 17,325 points each year in an online shopping mall.
The Fitness Program gives you discounted memberships to more than 12,000 gyms and fitness facilities as well as a digital-only membership option.
WondrTM and Real Appeal® weight management programs can help you reach and maintain a healthy weight.
For more information
If you have any questions about HealthSelect, you can call a BCBSTX Personal Health Assistant.