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ERS Benefits

Important Notice:

The KelseyCare Advantage Medicare health maintenance organization is no longer available through the Texas Employees Group Benefits Program (GBP), as of January 1, 2021. Employees Retirement System of Texas (ERS) retirees, surviving dependents and other participants can visit the ERS website for more information about their health insurance options through the GBP. Recent KelseyCare Advantage participants should continue to contact KelseyCare Advantage for questions about claims with dates of service through December 31, 2020.

KelseyCare Advantage is pleased to be a retiree benefit choice for Employees Retirement System of Texas. Our plan covers benefits that are important to you, such as doctor office visits, inpatient hospital care, outpatient surgery and more! Please see below for a detailed listing of the benefits covered by KelseyCare Advantage.

Download a complete benefit description:

 

Benefit Description
Member Pays PY 2020
Physicians and Lab Services 
Physician office visit  $0 copayment
Specialist office visit  $0 copayment
Routine physical exams  $0 copayment
Diagnostic x-rays, mammography, and lab test  $0 copayment
High Tech Radiology  $0 copayment
Immunizations  $0 copayment
Well woman exam
 $0 copayment
Vision and Hearing screen
 $0 copayment 
Hearing Testing  $0 copayment
Rehabilitative Therapy  $0 copayment 
Allergy Testing  $0 copayment 
Allergy serum  $0 copayment
Allergy serum administration  $0 copayment 
Routine eye exam  $0 copayment 
Office Surgery  $0 copayment 
Hospital Services
Impatient Hospital Care  $0 copayment 
Outpatient/Services surgery  $0 copayment 
Emergency Care  $0 copayment 
Urgent Care  $0 copayment 
Extended Care Services
Skilled nursing facility  Days 1-100 $0 copayment
Home Health  $0 copayment 
Other Medical Services
Durable Medical Equipment  covered 100%
Prosthesis  covered 100%
Ambulance  $0 copayment
Wellness
SilverSneakers  $0 copayment
Behavioral Health
Impatient mental health  $0 copayment
Outpatient mental health  $0 copayment for individual
 $0 copayment for group
Outpatient substance abuse care  $0 copayment for individual
 $0 copayment for group
Plan year out-of-pocket (per person)  $3,400

Family having fun together outside. Family having fun together outside.

Logon to your personal MyKelseyOnline account and schedule your appointment yourself. It’s fast and easy.

Visit MyKelseyOnline

Have questions about KelseyCare Advantage?

Call us at:
713-442-2ERS (2377)
Toll-Free: 1-877-853-9075
TTY/TDD: 711
8 a.m. to 5 p.m., Monday through Friday
Extended hours may be available during specific enrollment periods.

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