Network Benefits

HealthSelect of Texas^® plan that requires a participant to choose and use a primary care physician (PCP) from the HealthSelect of Texas network of providers. A participant who seeks care from an in-network provider usually has lower out-of-pocket costs than if they seek care from a out-of-network provider.

In-area coverage

HealthSelect of Texas plan for a participant who lives or works in Texas and isn’t eligible for Medicare. In-area participants may seek care from network or out-of-network providers.

• Network benefits have lower out-of-pocket costs. You must select and use a PCP from the HealthSelect of Texas network of providers to coordinate your health care.
• Out-of-network benefits have higher out-of-pocket costs. You may use out-of-network providers; however, your out-of-pocket costs may be higher.

Out-of-state coverage

HealthSelect of Texas plan that does not require a participant to use a PCP. This plan applies to participants and their eligible dependents living outside of Texas, and retirees age 65 and over who have not returned to state employment.

• Although participants are not required to select a PCP in this plan, having a PCP to help coordinate their health care needs is encouraged.

Note: Once you turn age 65 and are Medicare-eligible your coverage changes to HealthSelect out-of-area coverage, regardless of where you live.