Reminder: restart date for your prescription drug deductible in HMOs

Reminder: restart date for your prescription drug deductible in HMOs

August 5, 2020
open prescription drug bottleYour prescription drug deductible in ERS health insurance plans is the amount you must pay for prescription medications before your health plan pays anything. HealthSelectSM plans have a different restart date for prescription drug deductibles than the health maintenance organizations (HMOs):
 
  • HMOs (Community First Health Plans or Scott and White Health Plan):
    Your prescription drug deductible restarts on September 1.
  • HealthSelectSM Prescription Drug Program (administered by OptumRx®):
    Your prescription drug plan deductible restarts on January 1. 

The table below lists each ERS health plan’s prescription drug deductible restart dates.
 
If participant is enrolled in: When does the deductible restart?
HealthSelect of Texas® (your eligibility county on file with ERS is in Texas and you're not eligible for Medicare)
                                        -or-
HealthSelectSM Out-of-State (your eligibility county on file with ERS is outside Texas and you're not eligible for Medicare)
The prescription drug deductible restarts on January 1.
Consumer Directed HealthSelectSM The combined medical and pharmacy deductible restarts on January 1.

NOTE: Consumer Directed HealthSelect has a combined medical and pharmacy deductible, which means that both medical and prescription drug expenses go toward meeting the deductible.
HMOs
Community First Health Plans
                         -or-
Scott and White Health Plan
The prescription drug deductible restarts on September 1.
HealthSelectSM Secondary (retirees eligible for Medicare, or a Medicare-enrolled return-to-work retiree with retiree benefits) The prescription drug deductible restarts on January 1.
HealthSelectSM Medicare Advantage, a preferred provider organization (MA PPO), administered by Humana or KelseyCare Advantage (retirees enrolled in Medicare) The prescription drug deductible restarts on January 1.