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Teachers Retirement System

Your TRS-Care Standard costs explained

The Pulse, April 2018

Now that the 2018 TRS-Care plans have been in effect for a few months, TRS wants to help you understand parts of your plan that may seem confusing. In particular, we’ve received questions about the TRS-Care Standard family deductible and maximum out-of-pocket costs. Here’s how that works.

If you and your family are enrolled in the TRS-Care Standard plan, you have an in-network family deductible of $3,000. A single person or multiple persons in the family can meet this deductible. Even if you are on a family plan, you – an individual – will pay no more than $5,650. Collectively, you and your family will pay no more than $11,300 in out-of-pocket in-network expenses. This means that if two of the family members meet the family maximum out-of-pocket amount, the plan will cover all in-network expenses at 100 percent for the rest of the plan year.

TRS-Care Standard Plan Costs
Plan detailsIn-network Out-of-network
Deductible $1,500 individual
$3,000 family
$3,000 individual
$6,000 family
Maximum out-of-pocket $5,650 individual
$11,300 family
$11,300 individual
$22,600 family

For example, the Garcia family has family coverage on the TRS-Care Standard plan. Joe, the TRS retiree, covers his wife, Martha, and son, Junior. Joe has few health care expenses while Martha and Junior have high health care costs so that together, they will meet the $3,000 deductible in the middle of the plan year. Junior is on a high-cost prescription drug. While the most that the family will pay out-of-pocket in the year is $11,300, he will pay no more than $5,650 in the year.

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