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Best Medicare Advantage Plans for 2019 Rating is from U.S. News and World Report, a leading publisher of annual authoritative rankings including Best Medicare Plans. Our plan does not have a direct relationship with U.S. News. This award was not given by Medicare. Our overall rating from Medicare for 2019 is 5.0. Our plan’s official CMS Star Rating can be found at www.Medicare.gov.

​ERS Benefits

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.

A complete benefit description is available by printing a Summary of Benefits or Evidence of Coverage (Member Handbook)
Benefit Description ​​Member Pays PY 2019
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 tests
$0 copayment
High Tech Radiology
$0 copayment
Immunizations
$0 copayment
Well woman exam
$0 copayment
Vision and Hearing screenings
$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
Inpatient 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 copay per day
Home Health
$0 copayment
Other Medical Services
Durable Medical Equipment
covered 100%
Prosthesis
covered 100%
Ambulance
$0 copayment
Wellness
SilverSneakers
$0 copayment
Behavioral Health
Inpatient 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
   

Have questions about KelseyCare Advantage?

Call us at:
(713) 442-2ERS (2377)
Toll-Free: (877) 853-9075
TTY/TDD: (866) 302-9336
8 a.m. to 5 p.m., Monday through Friday

Extended hours may be available during specific enrollment periods.​​​​​​​​​​​​​​​​​​