Page 44 - Demo

Dependents enrolled in TRS-ActiveCare Primary or TRS-ActiveCare Primary+ plans who live out of state can receive coverage outside of Texas. The policy subscriber (employee) must complete an Out-of-State Dependent/Attestation Form, which they can get from their PHG, bswift or their BA at their employer. This form will be sent to BCBSTX to process, providing the dependent access to benefits outside of Texas. After completing the Out-of-State Dependent/Attestation Form, the dependent will receive an exception letter stating they can receive out-of-state coverage through the Participating Provider nationwide network. To search for a participating plan provider, the dependent can go to www.bcbstx.com/trsactivecareand click on the Doctors and Hospitals tab. Once the form has been approved, the dependent can see providers outside of Texas, but the other individuals on the policy plan are still required to obtain referrals and see providers within Texas. The dependent will not receive a new or separate ID card or ID number. They will receive an exception letter that will need to be used when seeing their providers.TRS-ActiveCare HD and TRS-ActiveCare 2 plans are offered through a nationwide network. All participants enrolled in these plans will have out-of-state coverage and will not need to complete a form.OUT-OF-STATE DEPENDENT COVERAGE44 www.bcbstx.com/trsactivecareba