Deductibles, out-of-pocket maximums reset Jan. 1
Medical deductibles, coinsurance reset
January 1 marks a new year and fresh start. The same is true for your prescription drug deductibles and any medical deductibles for your Texas Employees Group Benefits Program (GBP) health plans. You’ll have to reach the deductible amount before the plan pays its share. Coinsurance and total out-of-pocket maximums also start over.
How do you know what your deductible is?
See deductibles and coinsurance amounts for each GBP plan on the Health Plan Comparison chart that came in your annual benefits enrollment packet earlier this year. You can also view the chart on the ERS website.
Except for Consumer Directed HealthSelectSM (which has one deductible covering medical services and prescription drugs), each GBP prescription drug plan has a $50 annual deductible. See medical plan deductibles below.
|
Medicare-eligible plans |
In-network deductible |
Out-of-network deductible |
|---|---|---|
| HealthSelectSM Medicare Advantage Plan, insured by UnitedHealthcare | None | None |
| HealthSelectSM Secondary, administered by Blue Cross and Blue Shield of Texas | $200 per individual $600 per family |
$200 per individual $600 per family |
|
Non-Medicare plans |
In-network deductible |
Out-of-network deductible |
| HealthSelect of Texas® and HealthSelectSM Out-of-State | None | $500 per individual $1,500 per family |
| Consumer Directed HealthSelect high-deductible plan | $2,100 per individual $4,200 per family |
$4,200 per individual $8,400 per family |