HealthSelectSM of Texas, HealthSelect Out-of-State and Consumer Directed HealthSelect plans include a comprehensive prescription drug plan called the HealthSelect Prescription Drug Program, which is administered by OptumRx.
- You can take your prescription to the pharmacy of your choice, but you will save money when you use an in-network pharmacy and the pharmacy will submit the claim for you.
- A participant enrolled in HealthSelect of Texas must pay a $50 annual deductible before benefits are paid. The $50 drug deductible is based on a calendar year, which is from January 1 to December 31.
- A participant enrolled in Consumer Directed HealthSelect must meet the combined medical/pharmacy deductible before benefits are paid. The deductible is based on a calendar year, which is from January 1 to December 31.
- If you are enrolled in HealthSelect of Texas, you pay copayments when you visit network pharmacies or use the mail order program.
- If you are enrolled in Consumer Directed HealthSelect, you pay 20% coinsurance after you have met your in-network deductible if you visit a network pharmacy or use the mail order program. If you visit an out-of-network pharmacy, you pay 40% coinsurance after you have met your out-of-network deductible. The deductibles reset every January 1.
- You can purchase your short-term medication at a local retail pharmacy.
- You can purchase your long-term medication at an Extended Days’ Supply (EDS) retail pharmacies or through the mail order program. You can register for an online account using your medical/prescription card. Registering allows you to take advantage of OptumRx’s many services including online prescription refills from the mail service pharmacy.
- You will receive separate medical and prescription drug benefit ID cards.
Eligibility and Enrollment
You and your and eligible dependents
are automatically enrolled in this plan, when you enroll in HealthSelect.