The new TRS-ActiveCare plan year starts Sept. 1 for the 2025-26 school year. We want to make sure you have a clear understanding of your plan benefits, plan changes and programs available.
Overview of Benefits
There are three TRS-ActiveCare plans – TRS-ActiveCare Primary, TRS-ActiveCare Primary+ and TRS-ActiveCare HD. These plans differ in what you pay for premiums, coinsurance, deductibles and maximum out-of-pocket amounts.
Plan | Coinsurance | Deductibles | Maximum Out of Pocket | Copays |
TRS-ActiveCare Primary | 30% after deductible | Individual: $2,500 Family: $5,000 | Individual: $8,050 Family: $16,100 | PCP: $30 Specialist: $70 |
TRS-ActiveCare Primary+ | 20% after deductible | Individual: $1,200 Family: $2,400 | Individual: $6,900 Family: $13,800 | PCP: $15 Specialist: $70 |
TRS-ActiveCare HD | 30% after deductible | Individual: $3,300 Family: $6,600 | Individual: $8,300 Family: $16,600 | N/A |
TRS-ActiveCare Primary and TRS-ActiveCare Primary+ are physician-directed plans. Meaning, your Primary Care Provider manages your health care and coordinates your care with other providers. An overview of these plans includes:
low copays for doctor visits and generic medications before you meet your deductible
combined medical and pharmacy deductibles and maximum out-of-pocket amounts
no charge for diagnostic labs at your doctor’s office or at an independent, in-network lab
preventive care is 100% covered
a low copay for TRS Virtual Health visits
Primary Care Provider (PCP) required
specialist visits need a referral from your PCP
broad statewide network with no regional boundaries
flexibility to offer out-of-network coverage to dependents who live out of state
predictable cost-sharing with set copays
prescription benefits, including coverage for specialty medications
TRS-ActiveCare HD is a high-deductible plan that works with a Health Savings Account. An overview of this plan includes:
higher deductible
must meet your deductible before the plan starts to pay
no PCP required
no referrals needed for specialist visits
broad nationwide network with coverage outside Texas
out-of-network coverage
prescription benefits, including coverage for specialty medications
works with an HSA
To learn more about your benefits, review the Coverage and Benefits section on our website.
Plan Changes
TRS-ActiveCare HD
Individual and family maximum out of pocket increased to meet IRS guidelines.
Individual and family deductibles increased to comply with IRS HSA requirements.
TRS-ActiveCare Primary and TRS-ActiveCare Primary+
Starting Sept. 1, 2025, the following services won’t require a referral:
dermatologist visits
eye exams (both routine and diagnostic)
physical therapist visits
These changes apply to all plans:
Airrosti Remote Recovery program gives you physical therapy services designed to relieve common aches and pains at no additional cost (TRS ActiveCare HD plan must meet deductible first).
The Member Rewards program is expanding to include more than facilities and procedures. Now you can also get rewards for choosing top-performing doctors for your health care.
Your deductible resets Sept. 1, 2025. This happens every new plan year.
Like always, TRS-ActiveCare plans include:
100% covered preventive care
broad provider networks
low copays
extensive mental health benefits
specialty drug coverage
wellness benefits include $0 cost one-on-one health coaching; Ovia HealthTM for prenatal care, pregnancy, parenting and menopause support; and the Fitness Program
Programs Included in Your Plan
Whether you want to work on your diet or fitness, focus on saving money or improve your mental health, we have you covered!
Through Blue Access for MembersSM, you and your family have access to online resources filled with practical and useful information. With BAMSM, you can:
check the status or history of a claim
view and print Explanation of Benefits statements
search for an in-network health care provider, hospital or pharmacy
get a digital ID card
access programs and services
Doctors and Hospitals
Use Provider Finder® to find a doctor, hospital or other type of medical care. You can search by location, gender or specialty. You can also research providers using patient reviews, certifications and recognition information.
Health and Fitness
The Fitness Program offers affordable, no-contract memberships at gyms nationwide. Choose what works best for you based on location, budget or personal preference. There’s even a virtual-only option! You’ll also save money on wellbeing services like acupuncture, massage and personal training.
Get one-on-one coaching from credentialed health experts from Well onTarget® at no added cost! Your coach can help you lose weight, improve your fitness level, manage your diet, improve your blood pressure and more.
Mental Health Care is Health Care
In-Person – See an in-network therapist, psychiatrist or other mental health professional. Headway is a new program that makes finding mental health providers and scheduling appointments easier.
Virtually – Use Teladoc to speak with a licensed mental health provider online or over the phone.
Digitally – Learn to Live is a digital mental health program available at no added cost to you. Its programs can help you with stress, anxiety, depression, substance abuse and more.
Women’s and Family Health
Your TRS-ActiveCare plan provides support for your health in every stage of life including pregnancy, parenting and menopause with Ovia HealthTM apps. Each app offers daily personalized articles and tips to achieve your goals, unlimited messaging with registered nurses and real-time health data.
Well onTarget also offers digital self-guided courses to support healthy pregnancies through every stage. Topics include healthy foods, body changes and labor.
Save Money
Get rewards for your hard work through Blue PointsSM. Earn points for completing healthy activities like joining the Fitness Program and working out. Redeem points for gift cards when you’re ready to treat yourself.
Earn up to $599 per plan year when you use Member Rewards for certain procedures like Magnetic Resonance Imaging (MRIs), Computed Tomography (CT) scans, colonoscopies and more.
Save money with Blue365® and get offers on health and wellness products and services from top retailers that aren’t covered by insurance. Sign up to have weekly featured deals emailed to you.
Have a question?
Personal Health Guides are your plan experts. They help make it easy to understand your health plan and maximize your benefits. Connect with a PHG by calling 1-866-355-5999 or chatting through the BCBSTX App, available in the Apple App Store or Google Play Store. You can find all of this information and more in the Enrollment Toolkit.