TRS ActiveCare
Open Enrollment for the 2024 - 2025 School Year | July 8 - August 16
Medical Plans
District contributions for the 2024-2025 plan year are pending approval of the 2024-2025 budget at the June 28 school board meeting.
- TRS-ActiveCare Primary
- TRS-ActiveCare Primary+
- TRS-ActiveCare HD
- HMO
- Summary of Benefits and Coverage
TRS-ActiveCare Primary
This plan has the lowest monthly costs, $30 copays for primary care, and $0 TRS Virtual Health. It also works with a Member Rewards Program, where you can earn credit toward future health care services.
Participants (and spouses/dependents) will need a Primary Care Provider (PCP) who’s in the Texas network of providers. PCPs can help you avoid unnecessary medical costs and refer you to quality specialists.
Coverage Tier | 2023-2024 ($325 District Contribution) |
2024-2025 ($345 District Contribution*) |
Monthly Increase |
---|---|---|---|
Employee Only | $136 | $160 | $24 |
Employee/ Children | $459 | $514 | $55 |
Employee/ Spouse | $920 | $1,019 | $99 |
Employee/ Family | 1,243 | $1,372 | $129 |
*District contributions for the 2024-2025 plan year are pending approval of the 2024-2025 budget at the June 28 school board meeting.
TRS-ActiveCare Primary+
Similar to TRS-ActiveCare Primary, this plan has the lowest deductibles, maximum out-of-pocket costs and coinsurance rates.
It has $15 copays for primary care and $0 TRS Virtual Health. It also works with a Member Rewards Program, where you can earn credit toward future health care services.
Participants (and spouses/dependents) will need a Primary Care Provider (PCP) who’s in the Texas network of providers. PCPs can help you avoid unnecessary medical costs and refer you to quality specialists.
Coverage Tier | 2023-2024 ($325 District Contribution) |
2024-2025 ($345 District Contribution*) |
Monthly Increase |
---|---|---|---|
Employee Only | $216 | $247 | $31 |
Employee/ Children | $595 | $662 | $67 |
Employee/ Spouse | $1,082 | $1,195 | $113 |
Employee/ Family | $1,461 | $1,609 | $148 |
*District contributions for the 2024-2025 plan year are pending approval of the 2024-2025 budget at the June 28 school board meeting.
TRS-ActiveCare HD
This plan works with a Health Savings Account (HSA), has out-of-network coverage, and coinsurance rates instead of copays. The deductible for your tier must be met before you have out-of-network coverage or use coinsurance
You don’t need a Primary Care Provider and can choose any provider or specialist who’s in the U.S. network of providers.
Coverage Tier | 2023-2024 ($325 District Contribution) |
2024-2025 ($345 District Contribution*) |
Monthly Increase |
---|---|---|---|
Employee Only | $150 | $174 | $24 |
Employee/ Children | $483 | $538 | $55 |
Employee/ Spouse | $958 | $1,057 | $99 |
Employee/ Family | $1,290 | $1,420 | $130 |
*District contributions for the 2024-2025 plan year are pending approval of the 2024-2025 budget at the June 28 school board meeting.
HMO
If you live or work in certain counties, you may enroll in an HMO. While TRS does not set HMO rates and benefits, the TRS board must approve or reject their proposals each year.
Central and North Texas Scott & White Health Plan Rates
Participants (and spouses/dependents) will need a Primary Care Provider (PCP) who’s in the Texas network of providers. PCPs can help you avoid unnecessary medical costs and refer you to quality specialists.
Coverage Tier | 2023-2024 | 2024-2025 |
---|---|---|
Employee Only | $271.96 | TRS will no longer offer this plan as of August 31, 2024. |
Employee/ Children | $635.68 | |
Employee/ Spouse | $1,176.90 | |
Employee/ Family | $1,403.86 |
Summary of Benefits and Coverage
Prescription Drugs
Express Scripts
When you enroll in one of the BCBSTX PPO medical plan options, you automatically receive prescription drug coverage through Express Scripts which gives you access to a large, national network of retail pharmacies.
ID Cards
ID Card for Express Scripts Members
Express Scripts ID cards are available to print once you have registered on the Express Scripts website.
Drug Costs
Providers
Doctors and Hospitals
TRS-ActiveCare Primary and TRS-ActiveCare Primary+ plans require a Primary Care Provider (PCP). A PCP is also required if you need a referral to a specialist. This helps your PCP keep track of your treatment plans and make sure they’re easy to manage.
TRS ActiveCare Provider Finder
*TRS-ActiveCare HD does not require a PCP or referrals.
Personal Health Guide (PHG)
A Personal Health Guide (PHG) can help you find an in-network provider 24/7. Call 1-866-355-5999 or chat through the BCBSTX App, available in the Apple App Store or Google Play Store.
Virtual Health
Getting care when and where you need it is more important than ever. Your BCBSTX coverage includes TRS Virtual Health, so you have access to convenient, quality health care from home or on the go, without having to travel to a doctor’s office.
View the TRS Virtual Health flier for more information. It is also available in Spanish.
Resources
Save Money On Health Care Using These Tools
- See your Primary Care Provider (PCP). Your PCP is your advocate in health care. They’ll help you stay on top of your preventive care, which is covered at 100% by your health plan. Your PCP can take care of most health issues and simple medical procedures. They’ll refer you to an in-network specialist when needed.
- Go in network for care. You’ll always pay less when you see in-network providers. Use (TRS-ActiveCare Provider Finder® or TRS-Care Standard Provider Finder® ) to make sure a provider is in network before your visit. You can also log in to Blue Access for MembersSM (BAMSM), use the BCBSTX App, or call a Personal Health Guide at 1-866-355-5999.
- Use telemedicine.
- TRS Virtual Health lets you get convenient, quality health care anytime from home or anywhere, without having to go to a doctor’s office. Depending on your plan, you’ll pay a $0 or $30 copay, which is less than you’d pay for a visit to an urgent care clinic.
- Call the 24/7 Nurseline. When a health issue happens and you’re not sure if you should go to the emergency room, an urgent care center or make an appointment with your doctor, registered nurses can help you decide and may keep you from paying for more than you need. The 24/7 Nurseline at 1-833-968-1770 is available 24 hours a day, seven days a week at no extra cost to you.
- Many providers can help you online or over the phone. Check with your doctor or specialists to see if they offer virtual appointments. You’ll pay the same as you would for a regular visit and avoid the higher cost of an urgent care center.
- Research and compare costs for care. You can save a lot of money by checking and comparing costs for in-network labs, high-tech imaging, surgical procedures, and more. Use the Cost Estimator in TRS-ActiveCare Provider Finder® or TRS-Care Standard Provider Finder® ) to research and compare costs.
You’ll see what you may need to pay based on your plan’s copay, coinsurance, deductible, and other benefits. Personal Health Guides can also help you with cost estimates and comparisons. - Don’t pay more than you should for your medications. If you’re currently taking a name-brand drug, you may be able to save up to 80% by switching to a generic. Depending on your health plan, you may have no cost or no deductible for certain generic drugs classified as preventive.
Use the Caremark Mail Order Pharmacy or a Retail-Plus pharmacy to save on drugs you take regularly. The drug cost estimator, generic drug list and the pharmacy locator can help you start saving now (TRS-ActiveCare Pharmacy Locator or TRS-Care Standard Pharmacy Locator). - Take advantage of your health and wellness benefits. Your TRS-ActiveCare plan is loaded with wellness benefits to help you get and stay healthy.
- Well onTarget® and its companion AlwaysOn® mobile app can help you reach health and wellness goals and track your progress all in one place. Take a health assessment to see how your health measures up. Then, get a personalized report with suggested programs.
You’ll find videos, podcasts, and other online tools to help support your wellness journey. You can even get one-on-one help from a coach by phone or secure online messaging. All of this is included at no cost in your health plan. - The Fitness Program offers no-contract gym memberships at affordable rates. There’s even a virtual fitness program so you can stay active from the comfort and convenience of your own home.
- Reward yourself with Blue PointsSM. This program lets you earn points for completing healthy activities, like taking a health assessment, linking a fitness device, or exercising. Your points can be used in the online shopping mall to buy books, music, sporting goods and more.
- Enjoy discounts with Blue365®. Save money on health and wellness products and services that aren’t covered by your health plan. You won’t need to file any claims or get referrals and preauthorization. Weekly “Featured Deals” will be emailed to you.
- Member Rewards can help you shop for medical care, compare costs, and earn credit toward future medical expenses. This program is only available to participants enrolled in the TRS-ActiveCare Primary and TRS-ActiveCare Primary+ plans.
- Well onTarget® and its companion AlwaysOn® mobile app can help you reach health and wellness goals and track your progress all in one place. Take a health assessment to see how your health measures up. Then, get a personalized report with suggested programs.