Welcome to HealthSelect of Texas
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Health maintenance organization (HMO) plans will no longer be offered through the Texas Employees Group Benefits Program (GBP) after August 31, 2021.
All current HMO participants will be enrolled in HealthSelect of Texas®, administered by Blue Cross and Blue Shield of Texas (BCBSTX) effective September 1, unless they chose to enroll in Consumer Directed HealthSelectSM or HealthSelectSM Out-of-State, or decided to waive GBP health coverage during Summer Enrollment.
Your prescription benefits
HealthSelect of Texas and Consumer Directed HealthSelect both have prescription drug coverage through the HealthSelect Prescription Drug Plan.
Important Information About Primary Care Providers (PCPs)
HealthSelect of Texas requires all participants to have a PCP on file with BCBSTX and get referrals to see some specialists. Most HMO network providers — more than 90% — participate in the HealthSelect network, and most current HMO participants will find that their current PCP is already in the network.
You must choose a PCP in this plan. If you do not choose a PCP within 60 days of your September 1 effective date, you will pay for any services you get at the out-of-network level. Members pay more – sometimes a lot more – for out-of-network care.
If you enrolled in Consumer Direct HealthSelect, you don’t need to have a PCP on file with BCBSTX, but will benefit from seeing an in-network PCP. A PCP knows you and your medical history and often can help you make good health care choices. Learn more about choosing a PCP.
To find out if your current health care providers are in the HealthSelect network or to find a PCP near you, 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 your providers to the network.
Important Information About Specialist Visits
There will be a 90-day referral grace period for in-network specialist office visits for participants who are transitioning to HealthSelect of Texas from an HMO plan. This means transitioning participants will get in-network benefits if they see an in-network specialist between September 1 and November 30 without a referral on file with BCBSTX.
This does not apply to non-network specialist office visits.
After November 30, if you see a specialist without a referral on file, you will pay for your specialist visit at the out-of-network benefit level, even if your specialist is in-network.
You pay more if you visit an out-of-network provider
Unlike HMOs, HealthSelect plans cover medical and mental health services and prescription drugs from providers who are not in the network, but you will pay more if you choose out-of-network providers.
For more information about your transition to HealthSelect of Texas, visit the ERS website.
To get an overview of HealthSelect benefits, check out this benefits flier for those currently enrolled in an HMO.