Publications, Forms and Presentations

Medical Plan Overview

• 2023 Guide to Medical Benefits Brochure PDF
• 2023 Guide to Medical Benefits Flipbook 
• Adult Wellness Guidelines Flier  
• Childhood Immunization Schedule Flier  
• Diabetes Member Journey Flier 
• Maternity Wellness Guidelines Flier
• Preventive Services Flier  
• Virtual Visits Flier
• Mental Health Resources Flier  
• HealthSelectShoppERS FAQ 
• HealthSelectShoppERS Flier
• Mental Health Virtual Visits Participant Journey Flier 
• PCP Selection Participant Journey Flier
• Model Disclosure - Your Rights and Protections Against Surprise Medical Bills
• Machine Readable Files - Transparency in Coverage Rule

Master Benefit Plan Documents

• Plan Year 2023 HealthSelect of Texas In-Area MBPD
• Plan Year 2023 HealthSelect of Texas Out-of-State MBPD
• Plan Year 2023 Consumer Directed HealthSelect MBPD
• Plan Year 2023 HealthSelect Secondary MBPD
• Plan Year 2022 HealthSelect of Texas In-Area MBPD
• Plan Year 2022 HealthSelect of Texas Out-of-State MBPD
• Plan Year 2022 Consumer Directed HealthSelect MBPD
• Plan Year 2022 HealthSelect Secondary MBPD
• Archive

Summary of Benefits and Coverage Documents

• Plan Year 2023 HealthSelect SBC I (Spanish version)
• Plan Year 2023 HealthSelect Out-of-State SBC  I  (Spanish version)
• Plan Year 2023 Consumer Directed HealthSelect SBC  I  (Spanish version)
• Plan Year 2023 HealthSelect Secondary SBC  I   (Spanish version)
• Plan Year 2022 HealthSelect SBC
• Plan Year 2022 HealthSelect Out-of-State SBC
• Plan Year 2022 Consumer Directed HealthSelect SBC
• Plan Year 2022 HealthSelect Secondary SBC
• SBC Glossary of Health Coverage and Medical Terms  
• Archive

• Your Health, Your Way Summer Enrollment Brochure
• HealthSelect of Texas Summer Enrollment Presentation
• Consumer Directed HealthSelect Summer Enrollment Presentation

• 24/7 Nurseline Flier
• Adult Wellness Guidelines Flier  
• Childhood Immunization Schedule Flier  
• Fitness Program Flier
• Maternity Wellness Guidelines Flier
• On the Road to Wellness  |  Print-ready version  
• Preventive Services Flier  
• Self-Management Programs Flier 
• Blue Points Member Journey Flier 

• Participant Medical and Mental Health Claim Form   | (Mental health services for HealthSelect of Texas and Consumer Directed HealthSelect: Use this form only for services after September 1, 2020) Submitting a Claim
• Continuity of Care Request Form (Request for Continued Access for Providers) 
• International Claim Form  
• Standard Authorization Form with Instructions  
• Nominate a Provider
• Benefit/Wellness Fair Presentation Request Form