TRS-Care Information

For over the past 30 years, the state of Texas has provided healthcare to its retired teachers through TRS-Care (Teacher Retirement System). During this time TRS-Care, working together with Medicare, has provided benefits for hundreds of thousands of retired teachers and their dependents.

This program was originally funded back in 1985 with enough to maintain the fund through the fiscal year of 2000. Nevertheless, the Texas Legislature is under no continuing obligations to continue to provide benefits.

In June 2017, the TRS (Teacher Retirement System of Texas) Board of Trustees approved new health plan designs and premiums.  These changes went into effect on January 1st, 2018.

TRS-Care premiums and deductibles have continued to increase so many retired teachers have begun to leave, instead opting for plan options with original Medicare instead. This is expected to continue since premiums for retired teachers are expected to continue to increase.

For a few folks with expensive medications, we may recommend you stay with TRS-Care. However, retirees with just a few medications or most inexpensive generic medications will find a Part D plan to be an extremely affordable option. They can pair this with their Medicare and a Medicare supplement plan for great coverage.

Retirees should also consider coverage for their dependents if any. Medicare with a Medigap plan will only allow coverage for yourself. You may not carry any dependents on a Medigap plan, although your spouse may qualify for their own coverage if they too are Medicare eligible. If you need to cover family members in your plan, staying with TRS-Care might make the most sense until your dependents are able to obtain other’s own coverage.

The rule regarding TRS-Care has always been that if you leave the program after the age of 65, you cannot re-enroll in the program. This is common practice with many group insurance plans and is meant to prevent “adverse selection.”  Adverse selection is when the healthiest and least expensive participants in a program leave to pursue less costly insurance options and participants who are less healthy and need expensive care and treatment stay in the program, causing overall program costs to rise quickly. By keeping a large, diverse group in TRS-Care, the plan is better able to provide financial stability for the group of participants.

Lastly, dropping TRS-Care means you cannot return to it in the future. Although, with Medicare and Medicare Supplement options being so affordable and comprehensive, this is less of a concern than it used to be.

No doubt the costs of TRS-Care for retired teachers will continue to rise. Fortunately, there are several affordable options along with Medicare which can provide great coverage to the individuals to whom it makes sense. It is especially important to carefully review your TRS-Care and Medicare literature provided by the Teacher Retirement System. Get informed so you can make an educated decision for yourself.

Medicare eligibility at age 65

TRS strongly urges you to enroll in Medicare as soon as you’re eligible for it. You can enroll three months prior to the month you turn 65. The earlier you sign up, the sooner TRS can verify your Medicare status and enroll you in the TRS-Care Medicare Advantage® plan and TRS-Care Medicare Rx® plan on the first day of your birthday month. If your birthday is on the first of the month, your Medicare coverage will take effect on the first of the previous month.

If you don’t sign up early enough to make your effective date the first day of your birthday month, you risk having a gap in TRS-Care coverage. Keep in mind that the period for enrolling in the TRS-Care program is shorter than the enrollment period for Medicare. The enrollment period for Medicare extends for three months after your 65th birthday, but you must apply for enrollment in the TRS-Care program no later than 31 days from the end of the month in which you turn 65. If you enroll after you turn 65, you may have a break in coverage, or you may not be able to enroll in TRS-Care.

We also advise working with Ashford Insurance Agents, who can help you, compare your TRS-Care costs against your other options. We will find out if moving to a Medigap plan makes sense for you. If you are turning 65 soon and enrolling in Part B, you may take advantage of your 6-month window to join any Medigap plan without any medical underwriting. If you are over 65 already, we will explain your rights for guaranteed issues when leaving a TRS plan.

f you choose to leave TRS-Care, and you are eligible for Medicare, you may need the “guaranteed issue” letter mentioned above if you choose a Medigap insurance supplement. This letter confirms that your current coverage is ending. You will not need the letter if you choose a private Medicare Advantage plan, as these have annual open enrollment periods. Again, please be extremely cautious when comparing the benefits and costs between TRS-Care and alternative programs. Ask yourself if the deal offered in the alternative plan is worth leaving TRS-Care permanently.

Ashford Insurance is here to help!  If you would like to know the options available to you outside of the TRS plan, give us a call.

To get all the details on the TRS-Care health benefits, click the following link:

TRS-Care for Participants with Medicare