HealthSelect participants: Learn about your Plan Year 2022 medical benefits
The 2022 health plan year began September 1, 2021 and runs through August 31, 2022. Here’s what you can expect.
Welcome HMO participants to HealthSelect of Texas®
The Texas Employees Group Benefits Program (GBP) is no longer offering enrollment in a health maintenance organization (HMO) plan.
If you were enrolled in an HMO and didn’t change your enrollment selection or waive GBP health coverage during Summer Enrollment, you were automatically enrolled in HealthSelect of Texas beginning September 1, 2021.
Important: To get the most out of your HealthSelect of Texas benefits, you should choose an in-network primary care provider (PCP) as soon as possible. After your first 60 days in HealthSelect of Texas, if you haven't named a PCP, out-of-network costs will apply to most services—even if they’re from an in-network provider—until you name a PCP. This includes preventive care and care from in-network providers and facilities. Choose a PCP online now.
Change to total in-network out-of-pocket maximum
Effective January 1, 2022, the total in-network annual out-of-pocket maximums will increase for HealthSelect of Texas, HealthSelectSM Out-of-State, HealthSelectSM Secondary and Consumer Directed HealthSelectSM. The out-of-pocket maximum will increase to $7,000 for employee-only coverage and $14,000 for family coverage. The out-of-pocket maximum includes expenses you pay toward medical and prescription drug copays, coinsurance and deductibles (primarily for those enrolled in Consumer Directed HealthSelect).
$0 copay on mental health Virtual Visits
As of July 1, 2021, mental health Virtual Visits through Doctor on Demand® and MDLIVE® are covered at 100% if you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State or HealthSelect Secondary. This means you pay nothing for in-network medical and mental health Virtual Visits.
If you are enrolled in Consumer Directed HealthSelect, you must meet your annual deductible before mental health Virtual Visits are covered. After you meet your deductible, you will pay 20% coinsurance.
Medical Virtual Visits benefits remain the same. You have no cost if you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State or HealthSelect Secondary. If you are enrolled in Consumer Directed HealthSelect, you must meet your annual deductible before medical Virtual Visits are covered. After you meet your deductible, you will pay 20% coinsurance.
Hemoglobin A1C lab test for participants with diabetes
Effective September 1, 2021, in-network diagnostic A1C testing for participants with diabetes who are enrolled in Consumer Directed HealthSelect or HealthSelect Secondary is covered without having to first meet the annual in-network medical deductibles for those plans. Coinsurance will still apply.
Because there are no in-network medical deductibles for HealthSelect of Texas and HealthSelect Out-of-State, there is no change to these plans. In-network A1C testing will still be covered at its usual cost-share under those plans.