COVID-19 and Your Health Plan
The Employees Retirement System of Texas is working with its health plan administrators, state leadership and other state agencies to closely monitor the impact of COVID-19 (coronavirus). Together, we can assist State of Texas employees and retirees and their families who may be affected by the virus. All Texas Employees Group Benefits Program (GBP) health plans are equipped to help participants understand, prevent and, if needed, treat the virus.
Please note: The benefits outlined below for COVID-19 testing and visits apply throughout the declaration of public health emergency by the U.S. Department of Health and Human Services. Special coverage during the pandemic is subject to change. ERS updates this page regularly, but cannot always make updates immediately. This page does not include all details of pandemic-related coverage. For the latest information on your coverage, please contact your plan administrator as noted below under “Medical Plans” and “Prescription Drug Plans.”
At this time, all GBP medical plans have no out-of-pocket costs for:
- in-network visits related to COVID-19 – whether in-office, virtual or telemedicine – and
- physician-ordered COVID-19 testing at in-network and out-of-network labs, for those who meet federal Centers for Disease Control and Prevention (CDC) guidelines.
Your health plan also has trained staff who can answer questions about the virus and COVID-19.
To help avoid contracting the virus and prevent its spread in your community, we encourage you to know and follow recommendations by the Texas Department of State Health Services and the CDC. Take common-sense measures like wearing a mask, washing your hands regularly and socially distancing from others.
Virtual Visits and Telemedicine
If you think you have been exposed to coronavirus or have symptoms – fever, cough and shortness of breath – please talk with your health care provider about recommended testing and treatment.
Virtual visits allow you to see a licensed doctor through your smartphone or computer, with providers such as Doctor on Demand and MDLIVE. Many GBP health plans offer virtual visits at no cost to participants or at a lower cost than a typical office visit.
Many health providers now offer telemedicine visits as an alternative to going to the doctor’s office. A telemedicine visit is covered by your GBP health plan, and may be referred to as an e-visit, video visit or another name established by your health provider. Your health provider will initiate a telemedicine visit.
Please note: ERS will continue to evaluate the member’s cost for virtual and telemedicine visits, based on factors including official social distancing guidelines. Please check back for updates and read any information you get from ERS by mail or email.
Find more information about virtual or telemedicine visits in your health plan below.
- HealthSelect of Texas®, HealthSelectSM Secondary, HealthSelectSM Out-of-State and Consumer Directed HealthSelectSM (administered by Blue Cross and Blue Shield of Texas)
- Virtual visits –All in-network virtual visits NOT related to COVID-19 are covered at no cost to the participant through December 31, 2020.
- After December 31, Consumer Directed HealthSelect participants must meet their annual deductible and then pay coinsurance for virtual visits not related to COVID-19.
- HealthSelect of Texas, HealthSelect Out-of-State and HealthSelect Secondary participants will continue to have $0 copay for in-network medical virtual visits.
- After December 31, the usual plan benefits and cost-sharing will apply to mental health virtual visits in all HealthSelect plans. For more information on mental health benefits, please see below (under “Emotional Support”).
- In-network medical virtual visits related to COVID-19 will continue to be covered at no cost to participants in all HealthSelect plans until the end of the declaration of public health emergency by the U.S. Department of Health and Human Services.
- Telemedicine visits initiated by your health care provider – In-network telemedicine visits with primary care providers and specialists NOT related to COVID-19 are covered at no cost to the participant through December 31, 2020. (Out-of-network telemedicine visits are always subject to the usual participant costs.)
- After December 31, the usual participant costs will apply to in-network telemedicine visits not related to COVID-19.
- In-network telemedicine visits related to COVID-19 will continue to be covered at no cost to participants in all plans until the end of the declaration of public health emergency by the U.S. Department of Health and Human Services
See more information on HealthSelect medical plan benefits during the COVID-19 pandemic.
The situation has many people feeling anxious and scared. As a GBP participant, you have the following emotional support and mental health benefits at this time.
- Optum has opened its Emotional Support Help Line – staffed by mental health professionals – to anyone who may be experiencing fear or stress because of COVID-19. Call (866) 342-6892 (TTY: 711), free of charge, 24 hours a day, seven days a week. This help line is available to anyone, so you can share it with family and friends. Caring professionals may also connect callers to additional resources.
- HealthSelect of Texas, HealthSelect Secondary, HealthSelect Out-of-State and Consumer Directed HealthSelect (administered by Blue Cross and Blue Shield of Texas) provides you with options for mental health care. Call a Personal Health Assistant at (800) 252-8039 (TTY:711). Mental health virtual visits can also be scheduled with Doctor on Demand and MDLIVE at no cost to the participant.
- HealthSelect Medicare Advantage Plan preferred provider organization (administered by Humana) – Call (855) 377-0001 (TTY: 711) for more information on mental health benefits and providers. Prior authorizations may apply.
- KelseyCare Advantage Medicare health maintenance organization – Call (713) 442-2ERS (2377) or toll-free (877) 853-9075 (TTY: (866) 302-9336) for more information on mental health benefits and providers.
- Scott and White Health Plan – Call (800) 321-7947 (TTY: 711) for more information on mental health benefits and providers. Prior authorizations and copays apply.
- Community First Health Plans – Call (210) 358-6100 (TTY: 711), log into the member portal or review the plan website and FAQs for more information.
In addition to your health plan’s services, the Texas Health and Human Services Commission (HHSC) is offering a statewide mental health support line to help Texans experiencing anxiety, stress or other emotional challenges due to the COVID-19 pandemic. This resource offers support for all Texans and can be reached any time day or night at (833) 986-1919.
For information about your coverage and how to appropriately access covered health services, please contact your specific plan as shown below.
- HealthSelect of Texas, HealthSelect Secondary, HealthSelect Out-of-State and Consumer Directed Health Select (administered by Blue Cross and Blue Shield of Texas)
- HealthSelect Medicare Advantage Plan preferred provider organization (administered by Humana)
- Scott and White Health Plan
- KelseyCare Advantage Medicare health maintenance organization
- Community First Health Plans
Prescription Drug Plans
All GBP prescription drug programs have taken action to ensure you have the support and resources you need. Early-fill programs are in place to help you at this time. Please note that the early-fill programs could change, so please check with your prescription drug program to confirm.
- HealthSelectSM Prescription Drug Program (administered by OptumRx and serving HealthSelect of Texas, HealthSelect Out-of-State and Consumer Directed HealthSelect)
- (855) 828-9834 (TTY:711)
- You can request an early refill at the pharmacy (or through mail order) as long as you have refills available.
- HealthSelectSM Medicare Rx (administered by UnitedHealthcare and serving HealthSelect Medicare Advantage, HealthSelect Secondary and KelseyCare Advantage)
- (877) 275-4377 (TTY:711)
- An early refill of up to a 90-day supply of a prescription is available.
- Scott and White Health Plan and Community First Health Plans have early-refill provisions upon request. Call the number on the back of your ID card for more information about these plans.