HealthSelect Medicare Rx - prescription drugs program

HealthSelect Medicare Rx - prescription drugs program

UnitedHealthcare currently administers the HealthSelectSM Medicare Rx prescription drug plan.

Contact HealthSelect Medicare Rx Customer Service toll-free at (866) 868-0609 (TTY: 711), 7 a.m. – 7 p.m. CT, Monday – Friday, 7 a.m. – 3 p.m. CT on Saturday. 

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 comparable to the HealthSelectSM of Texas Prescription Drug Program for employees and non-Medicare-eligible retirees. 

HealthSlect Medicare Rx   qualifies ERS for subsidies and manufacturer discounts from the Centers for Medicare & Medicaid Services (CMS). These subsidies and discounts provide savings that help offset the need to reduce benefits.
 
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.

Participants in Scott and White Care Plans or Community First Health Plans have prescription drug coverage through those plans and are not enrolled in HealthSelect Medicare Rx.
 
Most retirees and dependents enrolled in the HealthSelect Medicare Rx plan do not pay an additional Medicare Part D premium. However, if your income is higher than the threshold set by Medicare ($85,000 or above for individuals and married individuals filing separately; $170,000 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, HealthSelect 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 network pharmacies. Find in-network pharmacies using the Pharmacy Locator tool on the HealthSelectSM Medicare Rx website. Enter a ZIP code and radius of miles to refine your search.

Yes. OptumRx® is the plan’s mail service pharmacy. While filling prescriptions by mail can be a convenient option, you are not required to use the service for your maintenance medications.

To get started, your provider must send your prescription directly to OptumRx. This includes new prescriptions and prescription refills. OptumRx will contact you by phone to get your approval. At that time you may approve OptumRx to automatically fill future prescriptions from your provider(s) for up to one year.

Contact UnitedHealthcare Customer Care 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. Pharmacies on the EDS list include HEB, Kroger, Good Neighbor and many others. 

View the EDS list of participating pharmacies or visit the HealthSelectSM Medicare Rx website. 
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 disenrolled 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 29-60 days.