TRS-Care Offering Texas Retired Teachers Medicare Advantage Plan in 2018

As a result of legislation passed in July 2017 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.

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The TRS’ Board of Trustees also passed a motion in September 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.

How the 2018 TRS-Care Medicare Advantage plan works

  • Deductible: $500
  • Maximum out-of-pocket: $3,500
  • Coinsurance: You pay 5% or a copay after meeting your deductible

Copays:

  • Primary care physician visit: $5*
  • Specialist visit: $10*
  • Urgent care: $35
  • Emergency room: $65
  • Outpatient hospital stay: $250*
  • Inpatient 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

 

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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