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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.

Participants with Medicare 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, an 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: $10*Emergency room: $65Inpatient hospital stay: $500*

Preventive care benefits are still covered at 100%.

*After you meet the deductible.

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

The Texas Legislature convened on July 18, 2017 for a special legislative session and passed legislation providing additional funding to TRS-Care. On Friday, Sept. 1, 2017, TRS’ Board of Trustees passed a motion to apply additional funding from the special legislative session to reduce deductibles from $3,000 to $1,500 for TRS-Care non-Medicare participants and decrease premiums for TRS-Care Medicare-eligible participants. In addition, premiums for retirees with disabled children were reduced by $200. The plan information on our website has been updated to reflect these changes. Plan participants will receive additional information including an invitation to an in-person information session in their area and new plan guides by mid-November with details about the 2018 plans.

 
Monthly premiums for Medicare retirees in 2018
Retiree/Surviving Spouse Only: $135
Retiree + Spouse: $529
Retiree/Surviving Spouse + Child(ren): $468**
Retiree + Family: $1,020**

**Medicare retirees with disabled children will have their monthly premiums reduced by $200. Their monthly premium for the Medicare Retiree + Children tier will be $268. For the Medicare Retiree + Family tier, their monthly premium will be $820.

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