Also known as HealthSelect Medical. HealthSelect Medical is a health insurance plan for you and your covered family members. The plan offers three benefit levels – in-area network, in-area non-network, and out-of-area. The benefit level depends on where you live or work, the doctors and providers you use, or your eligibility for Medicare. HealthSelect coverage includes a comprehensive Prescription Drug Program, provided by Caremark, and basic term life insurance.
If you live or work in the State of Texas and are not eligible for Medicare, you can have in-area network benefits, except for certain retirees under age 65. Individuals who have in-area benefits can save money on out of pocket costs by using network doctors and providers.
If you are a retiree under age 65 residing in Texas and eligible for Medicare due to a disabling condition, you have out-of-area benefits for yourself with Medicare paying primary and your covered dependents will retain in-area benefits.
UnitedHealthcare administers HealthSelect of Texas effective September 1, 2012.
Benefit level for a participant who lives or works in Texas.
$2,000 per person (per calendar year)
$25-40 per office visit
$150 for hospital or $50 for urgent care center
20% for x-rays, lab tests, mammography, and similar procedures
$150 per day + 20% per person
Charges vary between inpatient and outpatient surgery
You pay $40 and/or 20% + amount above $75 per visit (max. 30 visits per calendar year)
Includes durable medical equipment and hearing aids
20% without office visit for allergy, speech/hearing testing, and rehabilitative therapy
May be covered under preventative care.
$40 for first visit; support available through UnitedHealthcare
$40 for network doctor exam, discounts for frames and contacts
$5,000 deductible + 20% Coinsurance
Benefits you receive when you see a non-network provider.
$500 individual or $1,500 family
$7,000 per person (per calendar year)
40% when using non-network benefits
40% for hospital or urgent care center
40% for x-rays, lab tests, mammography, and similar procedures
$150 per day + 40%
40% (max. $75 per visit)
Allergy, Behavioral Health, Speech, Hearing, and Rehabilitive Therapy
$40 for first visit; support available through UnitedHeatlhcare.
40% for exam; discounts for frames and contacts
Applies to participants living outside of Texas, and retirees age 65
$200 individual/ $600 per family
$3,000 per person (per calendar year)
30% for hospital or urgent care center
30% for x-rays, lab tests, mammography, and similar procedures
$150 per day + 30% per person
30% (max. $75 per visit)
No charge for some services
May be covered by preventative care.
30% after deductible; support available through UnitedHealthcare.
30% for exam; discounts for frames and contacts
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