ERS Tools

We are proud to insure the Employees Retirement System of Texas (ERS) account as of Sept. 1, 2017. ERS participants covered under HealthSelect of Texas® and Consumer Directed HealthSelectSM (HealthSelect) benefit plans access care through a custom point of service network using Blue EssentialsSM providers in all 254 counties in Texas.

 

ERS Participant Plans

HealthSelect of Texas (In Texas)

  • Participants must select a primary care provider (PCP) participating in the Blue Essentials provider network.
  • Referrals are required to see Blue Essential providers for in-network benefits.

Important: Participants are required to obtain a referral from their PCP prior to seeing a specialist for most services.  Even if a prior authorization is obtained, non-network benefits may apply for services when the participant did not receive a referral.

  • Referrals are not required for the following:

    • Covered vision care, including routine and diagnostic eye exams
    • OB/GYN visits
    • Mental health counseling
    • Chiropractic visits
    • Occupational therapy and physical therapy
    • Virtual visits through MDLIVE and Doctor on Demand, urgent care centers and convenience care clinics.

Consumer Directed HealthSelect (In Texas)

  • Participants have open access to providers in the Blue Essentials provider network for in-network benefits.
  • PCP selection or referrals are not required when accessing Blue Essentials providers for in-network benefits.

HealthSelect of Texas and Consumer Directed HealthSelect Out-of-State

  • ERS participants living outside of Texas have access to a PPO network under Blue Card.
  • This plan does not require PCP selection and does not require referrals.

For the above plans, refer to the Prior Authorization Lists for Designated Groups page under Utilization Management  Prior Authorizations and Predeterminations for lists of services that require prior authorization or referrals (if needed).

HealthSelect Secondary 65+

  • ERS Retirees and Participants are eligible for Medicare.

How to Identify ERS Participants

  • The plan names HealthSelect of Texas and Consumer Directed HealthSelect will be printed directly on the ID card.
  • Some ERS participants in Texas will have a unique network ID labeled HME.

How to be an In-Network Provider for ERS Participants

  • Must have privileges at one of the Blue Essentials/HealthSelect participating hospitals (unless inpatient admissions are uncommon or not required for the provider's specialty or provider has someone who will admit on their behalf)
  • Must have a valid National Provider Identifier (NPI) number
  • Must sign a Blue Essentials agreement

If you are interested in participating, please visit the Network Participation – How to Join page and follow the steps.

Mental Health Services

 BCBSTX manages mental health benefits and services for HealthSelect plans, including network management

Telemedicine and Virtual Visits

HealthSelect participants have benefits for telemedicine/telehealth and virtual visits.

  • Virtual Visits

Medical and mental health virtual visits are available through Doctor on Demand and MDLIVE. Use the Availity® Essentials or your preferred vendor to check eligibility and benefits.

  • Telemedicine/Telehealth

Use the Availity Essentials  or your preferred vendor to check eligibility and benefits. You can also refer to Section 5, Schedule of Benefits and Coverage, in the plan’s Master Plan Benefits Documents for more information.

  • Submitting Telemedicine/Telehealth and Virtual Visit Claims

For details on submitting telemedicine/telehealth claims, refer to our Telemedicine and Telehealth Services page.

Outpatient Clinical Laboratory Information

Effective 01/01/2022, all Plan providers should refer members to in-network lab providers for outpatient lab services. To locate participating labs in the Plan network, visit Provider Finder® on the BCBSTX website.

Statewide In-Network Clinical Labs for HealthSelect Participants include:.

Effective through 12/31/2021, providers located in the Reimbursable Lab County List can perform labs on the Reimbursable Lab List in the provider's office for HealthSelect of Texas and Consumer Directed HealthSelect of Texas participants. All other lab services must be sent to a participating lab.

Refer to Provider Finder for additional participating clinical laboratory providers.

Helpful Information