Prescription Drug Programs

You are automatically enrolled in a comprehensive prescription drug program when you enroll in a GBP health plan. Every GBP health plan, except Consumer Directed HealthSelect, has a $50 annual prescription drug deductible that must be paid before the plan pays anything for prescriptions. Consumer Directed HealthSelect has an overall deductible that includes both medical care and prescription drugs. The deductibles are based on a calendar year, which is from January 1 to December 31.

The following copayments apply to all prescription drug programs, after the deductible is met.

Short-term prescriptions

 

Tier 1 

Tier 2* 

Tier 3* 

Non-maintenance medication  $10
1-30 day supply
$35
1-30 day supply
$60
1-30 day supply
Maintenance medication $10
1-30 day supply
$45
1-30 day supply
$75
1-30 day supply

Long-term prescriptions

  • In the HealthSelect Prescription Drug Program and HealthSelect Medicare Rx, you may fill long-term medications (also known as maintenance medications), such as those taken for high blood pressure, through an Extended Days' Supply (EDS) retail pharmacy or through the OptumRx Home Delivery Pharmacy.
  • For information on long-term prescriptions in the HMOs (except KelseyCare Advantage), please see your HMO’s website.

Tier 1

Tier 2*

Tier 3*

$20
31-60 day supply

$30
61-90 day supply

$70
31-60 day supply 

$105
61-90 day supply 

$120
31-60 day supply 

$180
61-90 day supply 

*If a generic is available and you choose to buy the brand-name drug, you will pay the generic copay plus the cost difference between the brand-name and the generic drug.

Visit your plan's website below to learn about prescription drug coverage specific to your plan.

HealthSelect of Texasâ„  Prescription Drug Program for people enrolled in:

  • HealthSelect of Texas (non-Medicare)
  • Consumer Directed HealthSelect
  • HealthSelect Out-of-State

HealthSelect Medicare Rx for people enrolled in:

  • HealthSelect Medicare Advantage
  • HealthSelect Secondary
  • KelseyCare Advantage

Health maintenance organizations (HMOs):