2008 Prescription Drug Benefits
We offer prescription drug coverage through many of our health plans. This coverage includes a large network of pharmacies across the country as well as an extensive list of covered drugs.
For the Greater Houston health plans that include drug benefits are as follows: TexanPlus®, TexanSelect™, TexanStar™ and TexanPremier™. For more information please click on the formulary link provided below:
For the Golden Triangle health plans that include drug benefits are as follows: TexanPlus®, TexanSelect™, and TexanStar™. For more information please click on the formulary link provided below.
As of January 1, 2006, new Medicare prescription drug coverage is available to everyone with Medicare. This drug coverage may help lower prescription drug costs and help protect against higher costs in the future.
Formulary
Our prescription formulary is a preferred list of drugs selected by SelectCare of Texas to meet enrollee needs at lower costs.
To find out whether your prescriptions are covered on our formulary, please use our Formulary Search.
If you would prefer to view and download either the abridged or comprehensive formulary, please use the links below.
Abridged Formulary
Comprehensive Formulary
March 08 Addendum
Pharmacies
We offer an extensive network of pharmacies within our service area and across the country. Please use our Pharmacy Search to find a network pharmacy near you.
Out-of-network Benefits
Out-of-network prescription benefits are available at higher out-of-pocket costs. Before using an out-of-network pharmacy, though, you are encouraged to call Member Services or use Pharmacy Search to determine if a participating pharmacy is nearby. Participating pharmacies are available nationwide.
If you must obtain a medication from an out-of-network pharmacy, you will be responsible for the full amount of the prescription at the time it is dispensed. You should call Member Services as soon as possible to obtain a claim form for out-of-network prescription coverage or complete and submit the Direct Member Reimbursement form.
Payment will be based on the normal, in-network cost for the medication, less the appropriate co-payment, assuming the medication dispensed is within quantity limits and no prior authorization is required.
Medication Therapy Management (MTM)
SelectCare of Texas Health Plans also offers participation in a MTM program for qualified members at no additional cost. Program participation is voluntary and is not considered an additional plan benefit. The program offers additional individualized education on your medications and the conditions they are treating (specifically asthma and diabetes) by a pharmacist. There are certain conditions which limit program eligibility. Call member services for additional information
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