HealthSelect of Texas medical plan: the basics

3-minute read

HealthSelect of Texas is a network-based medical plan administered by Blue Cross and Blue Shield of Texas (BCBSTX). The plan requires that you choose a primary care provider (PCP) to coordinate your care and manage any referrals you may need to see specialists.

You can help keep costs down—for yourself and the plan—by seeing providers in the HealthSelect network. There is no annual deductible if you stay in the network. You are responsible for copays and/or coinsurance for some doctor and hospital visits and other medical services.

Get the most from your HealthSelect of Texas benefits:

• Stay in the HealthSelect network. To find in-network health care providers or check network status, go to the Find a Doctor/Hospital page.
• Choose a PCP. HealthSelect of Texas participants and their covered dependents must have a PCP on file with BCBSTX to get in-network benefits. If you haven’t chosen a PCP, out-of-network benefits will apply to all covered health services, including preventive care.
• Your plan covers the cost of most preventive screenings and services when you visit an in-network provider and your provider bills those screenings and services as preventive care.
• You need a referral from your PCP to see most specialists to get in-network benefits. To check if you have a valid referral on file, log in to Blue Access for Members^SM or call a BCBSTX Personal Health Assistant.
• BCBSTX must approve certain covered health services before you get them. This is called a prior authorization. In general, in-network PCPs and other in-network providers are responsible for obtaining prior authorizations before they provide these services to you.
• Earn rewards with HealthSelectShoppERS^SM to save money when shopping for certain medical services and procedures. Rewards are deposited into a TexFlex^SM health care flexible spending account (FSA). If you are not already enrolled in a limited-purpose FSA, ERS will set one up for you.
• Use Virtual Visits to get care where and when you need it. Connect with a medical doctor online or by telephone 24 hours a day, seven days a week through Doctor On Demand^® and MDLIVE^®. Medical and mental health Virtual Visits are covered at 100% under the HealthSelect of Texas medical plan.
• Call a BCBSTX Personal Health Assistant when you have questions about your health plan benefits. They can answer questions, help you find in-network providers, assist with prior authorizations and referrals and more. Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711) Monday – Friday, 7 a.m. – 7 p.m. and Saturday, 7 a.m. – 3 p.m. CT.

Cost for Plan Year 2024

Please keep in mind that costs could change for Plan Year 2025 (starting Sept. 1, 2024). Plan Year 2025 rates will be available in late May, after the Employees Retirement System of Texas (ERS) Board of Trustees votes on them.

How to Enroll

You may enroll yourself and dependents:

• during Summer Enrollment,
• within 31 of a qualifying life event (QLE) such as marriage or a new child or
• within 31 days of starting work at an agency or higher education institution that participates in the Group Benefits Program (GBP) or 60 days if you have a health coverage waiting period as a new employee.

During your Summer Enrollment phase or after a QLE, you can enroll through your ERS OnLine account, by filling out a Summer Enrollment form and returning it to you HR department, or by calling ERS.

Learn more

Visit the HealthSelect of Texas website to find the most up-to-date information about your medical plan benefits, value-added programs, resources and tools.