HealthSelectSM of Texas Prescription Drug Program
HealthSelect of Texas®, HealthSelectSM Out-of-State and Consumer Directed HealthSelectSM plans include a comprehensive prescription drug plan called the HealthSelectSM 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.