Plans administered by BCBSTX (medical) & Express Scripts (pharmacy)

TRS-ActiveCare Primary

• Lowest cost plan.
• Statewide provider network with in-network benefits. No out-of-network benefits.
• Will be able to apply for out-of-state coverage for dependent college students.
• A Primary Care Physician (PCP) is required. Each covered person must choose a PCP. Certain specialists such as a gynecologist or pediatrician can be chosen as PCP. Claims may be denied if a covered person does not use their PCP. Must obtain a PCP referral for specialty care.
• Copays for doctor visits and generic prescriptions before deductible.
• After deductible, insurance pays 70% of covered charges and participant pays 30% co-insurance.
• Includes zero cost generic preventive medications.
• Includes telemedicine through Teledoc and RediMD.

TRS-ActiveCare HD

• Premiums are higher than the Primary plan.
• Nationwide network with in-network and out-of-network benefits.
• No requirement for PCP or referrals.
• No copays. Participant must meet medical and pharmacy deductible before plan pays.
• Individual deductible for coverage tiers that include spouse and/or children.
• After deductible, insurance pays 70% of covered charges and participant pays 30% co-insurance.
• Includes zero cost generic preventive medications.
• Includes telemedicine through Teledoc and RediMD.
• Compatible with Health Savings Accounts (HSA’s).

TRS-ActiveCare Primary+ (PrimaryPlus)

• Premiums are higher than the HD plan.
• Statewide provider network with in-network benefits. No out-of-network benefits.
• Can apply for out-of-state coverage for dependent college students.
• A Primary Care Physician (PCP) is required. Each covered person must choose a PCP. Certain specialists such as a gynecologist or pediatrician can be chosen as PCP. Claims may be denied if a covered person does not use their PCP. Must obtain a PCP referral for specialty care.
• Copays for doctor visits and generic prescriptions before deductible.
• After deductible, insurance pays 80% of covered charges and participant pays 20% co-insurance.
• Lowest deductibles and out-of-pocket maximums of all BCBSTX plan options.
• Includes telemedicine through Teledoc and RediMD.

TRS-ActiveCare 2 – plan is closed to new participants

• Highest cost plan.
• Nationwide network with in-network and out-of-network benefits.
• No requirement for PCP or referrals.
• No copays. Participant must meet medical and pharmacy deductible before plan pays.
• After deductible, insurance pays 80% of covered charges and participant pays 20% co-insurance.
• Includes telemedicine through Teledoc and RediMD.

Plans administered by Baylor Scott & White Health Plan (medical & pharmacy)

BSWHP HMO for TRS-ActiveCare

• Highest cost plan (other than AC2 which is closed to new participants).
• Must live OR work in certain DFW area counties to participate.
• Provider network is not statewide. Only in-network benefits. No out-of-network benefits.
• No requirement for PCP or referrals.
• Copays for doctor visits and generic prescriptions before deductible.
• No co-pay for primary care visits for dependents under age 19.