HealthSelect Prescription Drugs

  • HealthSelect of TexasSM coverage includes a comprehensive Prescription Drug Program. Beginning January 1, 2017, OptumRx, an affiliate of UnitedHealthcare, is the new administrator of the plan. Visit OptumRx at www.HealthSelectRx.com. Contact Caremark for information on claims processed through December 31, 2016. 

    For network providers and drugs lists for the HMO plans, visit the Community First Health Plans, KelseyCare powered by Community Health Choice or the Scott & White Health Plan websites.

    > Watch the recording of Introduction to OptumRx webinar

    Annual Deductible

    Each participant must pay a $50 annual deductible (per plan calendar year) before the copay is applied. The $50 drug deductible is based on a calendar year, which is from January 1 to December 31.

    Short-Term Prescriptions

    Retail Pharmacy Prescription Drug Costs

    Fill short-term medications, such as antibiotics, at a local retail pharmacy. Costs shown below are for network pharmacies. Your costs at non-participating pharmacies will be higher.

    Tier 1 

    Tier 2* 

    Tier 3* 

    Non-maintenance medication 
    $10
    1-30 day supply
    $35
    1-30 day supply
    $60
    1-30 day supply
    Maintenance medication
    $10
    1-30 day supply
    $45
    1-30 day supply
    $75
    1-30 day supply

    Long-Term Prescriptions

    All Carrier Mail Order/HealthSelect Prescription Drug Program EDS* Costs

    You may fill long-term medications (also known as maintenance medications), such as those taken for high blood pressure, through an Extended Days Supply (EDS) retail pharmacy or through the OptumRx Home Delivery Pharmacy. 

    Tier 1

    Tier 2*

    Tier 3*

    $20
    31-60 day supply

    $30
    61-90 day supply

    $70
    31-60 day supply 

    $105
    61-90 day supply 

    $120
    31-60 day supply 

    $180
    61-90 day supply 

    *If a generic is available and you choose to buy the brand-name drug, you will pay the generic copay plus the cost difference between the brand-name and the generic drug.