What ERS gives Medicare retirees
The Employees Retirement System of Texas (ERS) offers Medicare-eligible state retirees, survivors and dependents in the Texas Employees Group Benefits Program (GBP) two main choices:
- HealthSelect Medicare Advantage (MA PPO), a Medicare Part C plan offered by ERS, with prescriptions through HealthSelect Medicare Rx. You need Part A and Part B.
- HealthSelect Secondary, for retirees who opt out. Medicare pays first and HealthSelect Secondary pays second. ERS says it generally costs more.
You can move between the two at any time by updating your Medicare plan options in ERS OnLine or calling ERS.
What happens if I join an outside Medicare Advantage plan?
Medicare allows only one Medicare Advantage plan at a time. ERS explains what follows:
- Medicare removes you from the HealthSelect MA PPO and HealthSelect Medicare Rx.
- You keep GBP coverage in HealthSelect Secondary, and higher premiums may apply.
- You have no GBP prescription coverage until you cancel the outside plan, call ERS to re-enroll in Medicare Rx, and the change is complete.
What about an outside Part D plan?
ERS warns that signing up for another Part D plan can cost you your HealthSelect Medicare Rx and your GBP Medicare Advantage plan. If you decline HealthSelect Medicare Rx, you have no GBP drug coverage; ERS recommends joining a Part D plan within 63 days to avoid a Medicare late enrollment penalty.
Before you change anything, call ERS at (877) 275-4377. Ask how the change would affect your premiums, your drug coverage and any covered dependents.
What should I compare before deciding?
If you're thinking about an individual plan, compare total yearly costs, including the HealthSelect Secondary premium you'd pay, your drugs and pharmacies, and whether your doctors are covered. If you have both Medicare and Medicaid, special needs plans may also be open to you.
Get help
A licensed insurance agent with Benefits Life can walk through how an individual Medicare plan would compare with your ERS coverage, from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. See TRS-Care, ERS and Medicare.
Related questions
Do TRS retirees need Medicare Part B?
TRS-Care rules for retired educators.
Can I switch Medicare Advantage plans after open enrollment?
Windows for changing plans.
Medicare phone numbers in Texas
ERS, TRS, Medicare and more.
Sources
- ERS — HealthSelect Medicare Advantage for retirees
- ERS — Medicare FAQs
- ERS — HealthSelect Secondary for retirees
- Medicare.gov — Which insurance pays first
Frequently asked questions
What do I need to be in HealthSelect Medicare Advantage?
ERS says you must be enrolled in Medicare Part A and Part B. Without Part B you can't enroll in the HealthSelect MA PPO, and you may have to pay the share Medicare would have paid.
What is HealthSelect Secondary?
It's the ERS plan for Medicare-eligible retirees who opt out of HealthSelect Medicare Advantage. It pays after Medicare, has a yearly deductible, and ERS says it generally costs more than the MA PPO.
Can I switch back to HealthSelect Medicare Advantage?
Yes. ERS says retirees and survivors can switch between HealthSelect Medicare Advantage and their previous non-Medicare Advantage plan at any time, without waiting for annual enrollment. If you joined an outside plan, cancel it first, then call ERS.
How do I reach ERS?
Call ERS at (877) 275-4377 (TTY 711), or use your ERS OnLine account and choose Medicare Plan Options.
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