HealthSelect Medicare Rx Prescription Drug Plan
Express Scripts Medicare® (PDP) currently administers the HealthSelectSM Medicare Rx prescription drug plan.
Contact HealthSelect Medicare Rx Customer Service toll-free at (866) 264-4676 (TTY: 711), 24 hours a day, 7 days a week.
HealthSelect Medicare Rx is an EGWP+Wrap plan. EGWP+Wrap stands for Employer Group Waiver Plan with a commercial wrap. EGWP+Wrap plans are intended to help fill coverage gaps in Medicare Part D and provide retirees with prescription drug benefits that are comparable to the HealthSelectSM of Texas Prescription Drug Program for active employees and non-Medicare-eligible retirees.
HealthSelect Medicare Rx qualifies ERS for subsidies and manufacturer discounts from the Centers for Medicare & Medicaid Services (CMS). These subsidies and discounts help keep the cost of your coverage down.
Participants enrolled in HealthSelectSM Medicare Advantage Plan preferred provider organization (MA PPO) or HealthSelectSM Secondary who also are enrolled in Medicare Part A or Part B (or both) are eligible for HealthSelectSM Medicare Rx. You must live in the HealthSelect of Texas® service area.
Most retirees and dependents enrolled in the HealthSelectSM Medicare Rx plan do not pay an additional Medicare Part D premium. However, if your income is higher than the threshold set by Medicare ($103,000 or above for individuals and married individuals filing separately; $206,000 or above for married couples filing jointly), you will pay extra for Medicare Part D coverage. This is the income-related monthly adjustment amount, or IRMAA.
The IRS provides the Social Security Administration (SSA) with information to determine whether you are subject to IRMAA, and SSA will let you know if you must pay the IRMAA premium. ERS does not pay IRMAA premiums; you pay the premium directly to SSA.
Contact Medicare toll-free at 800-MEDICARE (800-633-4227) if you have questions about the IRMAA payment.
No. Prescription coverage is only available in the United States and its territories.
Yes. The two plans will coordinate benefits. Typically, HealthSelectSM Medicare Rx will pay primary and TRICARE secondary.
Yes. You can fill your prescription at any pharmacy, but you will save money when you purchase from one of the thousands of network pharmacies in the plan's network. Find in-network pharmacies using the Find a Pharmacy tool on the HealthSelectSM Medicare Rx website. Enter a ZIP code and adjust your search options.
Yes. Express Scripts Mail Order pharmacy through Express Scripts® Home Delivery. While filling prescriptions by mail can be a convenient option, you are not required to use the service for your maintenance medications. Find out how to get started with Home Delivery from Express Scripts Pharmacy.
Contact Express Scripts Customer Service if you have questions.
Yes. You can use a retail pharmacy from the EDS network to purchase a 31- to 90- day supply of long-term medication. Use the Find a Pharmacy tool to find an EDS pharmacy.
Yes, however, if you are eligible for the HealthSelectSM Medicare Rx plan and decline coverage, you and any covered Medicare-eligible dependent will not have any prescription drug coverage through the Texas Employees Group Benefits Program (GBP).
If you are enrolled in the HealthSelectSM Medicare Advantage Plan preferred provider organization (MA PPO), decline HealthSelect Medicare Rx coverage and enroll in a private Medicare Advantage plan or Part D plan, you will be dropped from HealthSelect MA PPO and/or HealthSelect Medicare Rx. However, if you enroll in a group Part D plan (perhaps through a spouse's employer coverage), you can remain enrolled in HealthSelect MA PPO, but you won't have prescription coverage through the GBP.
If you decline enrollment in HealthSelect Medicare Rx, you can enroll later by contacting ERS. If you decide to enroll later, your coverage will not become effective right away. You may be without prescription coverage for 29 to 60 days.