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Teachers Retirement System

 Eligible for Medicare

The Pulse, June 2017 (Updated August 2017)

What you need to know about your 2018 TRS-Care health benefits

As a result of recent legislation passed by the 85th Texas Legislature, beginning Jan. 1, 2018, TRS-Care will offer a single TRS-Care Medicare Advantage plan. The plan will be available to Medicare-eligible retirees and their Medicare-eligible dependents, and is similar to the current TRS-Care Medicare Advantage 2 plan.

Medicare-eligible participants will still have access to a Medicare prescription drug plan — an option similar to the current level 2 Medicare prescription drug plan through TRS-Care. In addition, beginning Jan. 1, 2018, SilverScript, a affiliate of CVS Caremark will begin administering the prescription drug plan.

What’s not changing is your access to a broad choice of quality doctors across the state. Unlike many Medicare Advantage plans, TRS-Care Medicare Advantage allows you to go to any doctor you choose, as long as they accept Medicare and agree to bill Humana.

TRS-Care Medicare Advantage Plan
How the 2018 TRS-Care Medicare Advantage plan works
Deductible: $500Maximum out-of-pocket: $3,500Coinsurance: You pay 5% or a copay after meeting your deductible
Copays:
Primary care physician visit: $5 Urgent care: $35Outpatient hospital stay: $250
Specialist visit: $10Emergency room: $65Inpatient hospital stay: $500

Preventive care benefits are still covered at 100%

In most cases, you must also purchase and maintain Medicare Part B in order to have benefits through TRS-Care.

Prescription drug plan details
 Retail copays Mail order or Retail-Plus copays (up to 90-day supply)
Generic$5$15
Preferred brand$25$70
Non-preferred brand$50$125

Important Update

Aug. 16, 2017

The Texas Legislature convened on July 18, 2017 for a special legislative session. On Aug. 15, 2017, the Legislature passed HB 21 that will add $212 million in funding to TRS-Care over the coming biennium. TRS is finalizing plan designs now. We will communicate the updates after the TRS Board of Trustees meets on Aug. 25, 2017. The additional funding will have a positive impact on the plan designs and premiums.

 
Monthly premiums for Medicare retirees in 2018
Retiree/Surviving Spouse Only: $146
Retiree + Spouse: $590
Retiree/Surviving Spouse + Child(ren): $504
Retiree + Family: $1,106

 

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