ActiveCare 1
Lowest Cost, Lowest Benefits
ActiveCare 1 provides basic coverage. This plan has a $1,000 individual and $3,000 family deductible when using either network or non-network physicians. When you use a network physician, there is a $15 office-visit copayment for preventive care only. For other covered services, the plan begins to pay benefits after you meet the deductible. You can also seek care from a non-network physician; however, you may pay more of the cost. No referrals are required.
Network retail pharmacies will accept your TRS- ActiveCare ID card and charge you the negotiated Medco Health discounted price for up to a 30-day supply of your prescription. You may also obtain up to a 90-day supply of your prescription through the Medco Health Home Delivery Pharmacy Service. You will be required to pay in full when you receive your medication and submit a claim form to Blue Cross and Blue Shield of Texas. The plan will treat this as a medical claim and will pay benefits after you meet the deductible.
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Competitive Cost, Comprehensive Benefits
ActiveCare 2 is comprehensive coverage. This plan features a lower deductible than ActiveCare 1 with a $500 individual and $1,500 family deductible when using either network or non-network physicians. When you use a network physician, there is a $25 copayment for primary care office visits and a $35 copayment for specialist office visits. For other services, the plan begins to pay benefits after you meet the deductible. You can also seek care from a non-network physician; however, you may pay more of the cost. No referrals are required.
Network retail pharmacies will accept your TRS-ActiveCare ID card and charge you $10 per generic drug, $25 per preferred brand-name drug, and $45 per non-preferred brand-name drug for up to a 30-day supply of your prescription. For non-network pharmacies, you will pay in full when you receive your medication and submit a claim form to Medco Health. You will be reimbursed the amount that would have been charged by a network pharmacy, less the required copayment. Medco Health Home Delivery Pharmacy Service will charge you $20 per generic drug, $50 per preferred brand-name drug, and $90 per non-preferred brand-name drug for up to a 90-day supply.
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Highest Cost, Highest Benefits
ActiveCare 3 offers the highest benefits of the PPO plan options. With this plan you have no deductible to meet when using a network physician. When you use a network physician, there is a $20 copayment for primary care office visits and a $30 copayment for specialist office visits. You pay any applicable coinsurance for covered services. You can also seek care from a non-network physician. However, if you do, you may pay more of the cost and will need to meet a $500 individual or $1,500 family deductible for covered services. No referrals are required.
Network retail pharmacies will accept your TRS-ActiveCare ID card and charge you $10 per generic drug, $25 per preferred brand-name drug, and $40 per non-preferred brand-name drug for up to a 30-day supply of your prescription. For non-network pharmacies, you will pay in full when you receive your medication and submit a claim form to Medco Health. You will be reimbursed the amount that would have been charged by a network pharmacy, less the required copayment. Medco Health Home Delivery Pharmacy Service will charge you $20 per generic drug, $50 per preferred brand-name drug, and $80 per non-preferred brand-name drug for up to a 90-day supply.
