The high-deductible health plan (HDHP) part of Consumer Directed HealthSelectSM is different from the other Texas Employees Group Benefits Program (GBP) health plans in that it has high annual deductibles for both in-network and out-of-network coverage. The deductible is the amount you owe for covered health services or prescriptions before the plan begins to pay for anything except for preventive services.
- Preventive services – like annual check-ups and vaccinations – are covered at 100%, even if you haven’t met the deductible.
- Out-of-pocket costs could be much higher than in HealthSelect of Texas and the HMOs. To help you pay for higher out-of-pocket costs, the plan allows you to participate in a tax-free health savings account (HSA).
- No primary care physician (PCP) is required.
- You don't need a PCP referral to see a specialist.
- The HDHP is administered by Blue Cross and Blue Shield of Texas and has the same large, nationwide provider network as HealthSelect of Texas. You can go to out-of-network providers, but you will pay more.
- People enrolled in Medicare cannot participate in Consumer Directed HealthSelect.
Calendar Year Deductibles and Total Out-of-Pocket Maximums for 2019 (January 1 – December 31, 2020)
|Annual in-network deductible for 2019 and 2020
|Annual out-of-network deductible for 2019 and 2020
|Annual in-network, total out-of-pocket maximum for 2019*
|Annual in-network, total out-of-pocket maximum for 2020
*Out-of-pocket maximums are based on federal regulations and might change from year to year.
Once you meet the deductible, the plan pays a percentage of health expenses:
- 80% for in-network health and prescription services (you pay 20%) and
- 60% for allowable out-of-network health and prescription services (you pay 40%).
Visit the Consumer Directed HealthSelect website