Page 19 - Demo

TRS-ActiveCare HDThis is a high-deductible, nationwide plan. It covers innetwork preventive care at 100%, but for everything else, you must meet your deductible before the plan pays for care. Coinsurance applies for services like telemedicine, lab work, mental health appointments and all out-of-network care. This plan works with an HSA to help you pay for qualified medical expenses, tax-free. An HSA is a tax-advantaged savings account you own, so you choose how much you want to contribute, up to the legal limit, and how to use the funds. Any investments and earnings from the account are also tax free. Talk with your Benefits Administrator for more information about HSAs. TRS doesn%u2019t administer HSAs, but many employers and financial institutions do. Plan HighlightsNo PCP or referrals required %u2014 You don%u2019t have to choose a PCP or ask for referrals on this plan. You can use any provider you want %u2014 even if they%u2019re not in network. But keep in mind that out-of-network providers cost significantly more. You must also coordinate your own care, which can be time-consuming and confusing for some.No charge for preventive care %u2014 This plan covers annual wellness visits and other preventive health care and screenings at 100% before you meet your deductible when you see an in-network provider. Out-of-network coverage %u2014 This plan covers you even if you go out of network, but seeing a provider in your network always costs less. Nationwide network of providers %u2014 You have innetwork coverage, even when you%u2019re outside Texas.Convenient TRS Virtual Health visits %u2014 Get quality medical care without going to a doctor%u2019s office. Your provider can also send a prescription straight to your pharmacy.RediMD - $30 fee for medical visits Teladoc - $42 fee for medical visits - 30% coinsurance after deductible for mental health visits*TRS-ActiveCare 2 This plan is closed to new enrollees. If you%u2019re currently enrolled in this plan, you can stay on the plan for 2025-26. If you move to another plan for 2025-26, you can%u2019t return to TRS-ActiveCare 2. If you stay in this plan, you have access to a nationwide network of providers and out-of-network coverage without choosing a PCP. You can also see specialists without referrals. Coinsurance applies for services like telemedicine and all out-of-network providers.Plan HighlightsNo charge for preventive care %u2014 This plan covers annual wellness visits and other preventive health care and screenings at 100% when you see an in-network provider. Low copays %u2014 You pay $30 for primary care visits and $70 for specialists.No PCP or referrals required %u2014 You don%u2019t have to choose a PCP or get referrals on this plan. Out-of-network coverage %u2014 This plan covers you even if you go out of network, but seeing a provider in your network always costs less. Nationwide network of providers %u2014 You have innetwork coverage even when you%u2019re outside Texas.Convenient TRS Virtual Health visits %u2014 Get quality medical care without going to a doctor%u2019s office. Your provider can also send a prescription straight to your pharmacy.RediMD - $0 copay for medical visits Teladoc - $12 copay for medical visits - $0 copay for mental health visitsCopay assistance for specialty medications %u2014 Get certain specialty medications for $0 with the SaveOnSP copay assistance program.See pages 24-25 for details and a comparison of benefits for all plans.*Depending on whether a consultation is with a psychiatrist, psychologist, or social worker, other costs may be incurred.www.bcbstx.com/trsactivecare 19