Skip Ribbon Commands
Skip to main content
MegaMenu
Search
Teachers Retirement System

 Not eligible for Medicare?

The Pulse, June 2017 (Updated August 2017)

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

Beginning Jan. 1, 2018, the health plan options listed in your 2017 materials will no longer be available.

As a result of recent legislation passed by the 85th Texas Legislature, all TRS-Care retirees and covered spouses and dependents who are not eligible for Medicare will be transitioned to a new health plan.

Once you meet your annual deductible, the 2018 health plan will pay 80 percent of your eligible in-network medical and prescription expenses. Preventive services, such as your annual physical, cancer screenings, immunizations and flu shots, will still be available at no cost to you.

How the 2018 health plan works

How the 2018 health plan works
Plan detailsIn-networkOut-of-network
Deductible for medical and prescription expenses$3,000 individual
$6,000 family
$6,000 individual
$12,000 family
Maximum out-of-pocket for medical and prescription expenses $6,650 individual
$13,300 family
$13,300 individual
$26,600 family
Coinsurance for medical and prescription expensesYou pay 20% after meeting your deductibleYou pay 40% after meeting your deductible
Teladoc ​– Board-certified doctors diagnose, treat and write prescriptions via phone or video, available 24/7$40 consultation
Coverage for certain generic drugsNo cost for certain maintenance medications taken to prevent or treat chronic conditions. TRS will provide the list in the future.

 

Monthly premiums for non-Medicare retirees in 2018
Retiree/Surviving Spouse Only: $200*
Retiree + Spouse: $739
Retiree/Surviving Spouse + Child(ren): $433
Retiree + Family: $1,074

*TRS-Care will no longer offer a $0 premium health plan option for retiree-only coverage. Retirees will pay $200 for retiree-only coverage beginning Jan. 1, 2018.

In addition, the plan year is changing to a calendar year, with the new plan beginning on Jan. 1, 2018 (instead of Sept. 1, 2017), providing you an additional four months to prepare for the change. This also means that your deductibles and maximum out-of-pocket amounts will not start over until Jan. 1, 2018.

The vendor for our prescription drug plan is also changing. Beginning Sept. 1, 2017, CVS Caremark  will become the new administrator for pharmacy benefits. Stay tuned for more information on this transition in the coming months.

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.

 

Why the change?

TRS-Care is a self-funded health benefits program, which means the cost of every member’s health care is paid by premiums, and funds from schools, the state and active employees. Due to rising health care costs, TRS-Care was in danger of becoming too expensive to continue. These changes to the program — as well increases to premiums and additional funding from the Texas Legislature — help ensure its sustainability for you, as well as for future retirees.

What’s not changing?

We understand your doctors are important to you and have worked to insure you still have the same broad choice of quality doctors, useful tools and resources that can help you get the most from your health plan.

Planning to retire due to a disability?

If you are planning to retire due to a disability, you will pay the premium listed on this page.

Already retired through a disability?

If you retired prior to Jan. 1, 2017, receive TRS disability benefits, and are not eligible for Medicare, you won't pay a premium in the 2018 plan year (Jan. 1 - Dec. 31, 2018).

 

Want to subscribe to The Pulse?