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Let%u2019s see what Gary may pay to manage his diabetes with in-network providers, services, facilitiesand labs.This example includes:%u2022 hospital stay%u2022 specialist visit %u2013 one per year%u2022 PCP visits %u2013 four per year%u2022 prescription medicationCOST OF CARE $18,300 TRS-ACTIVECARE HDDeductible $3,200Coinsurance 30% after deductibleCoinsurance for PCP 30% after deductibleCoinsurance for specialist 30% after deductibleHospital/facility coinsuranceBased on one night at a cost of $11,000 30% after deductibleInsulin out-of-pocket costsBased on yearly cost of $6,000 25% after deductibleWHAT GARY MAY PAY BASED ON $18,300 TOTAL COST OF CAREDeductible $3,200Office copays No copaysInsulin coinsurance $1,500 coinsuranceCoinsurance $2,730Health plan paid $10,870Total paid by Gary $7,430www.bcbstx.com/trsactivecare 17