TRS Tools

We are proud to administer health benefits for the Teacher Retirement System including the following benefit plans:

  • TRS-ActiveCare Primary
  • TRS-ActiveCare Primary+
  • TRS-ActiveCare HD
  • TRS-ActiveCare 2
  • TRS-Care Standard 

TRS Health Plans

Statewide Blue EssentialsSM contracted in-network providers can see participants on these plans:

  • TRS-ActiveCare Primary and TRS-ActiveCare Primary+
    • Copays for doctor visits before meeting deductibles
    • Primary care providerselection and referrals to specialists are required
    • No out-of-network coverage, except for true emergencies

Nationwide Blue Choice PPOSM contracted in-network providers can see participants on these plans:

  • TRS-ActiveCare HD
    • High deductible plan which may include a health savings account to pay for medical care
    • Does not require PCP selection or referrals
    • Deductibles must be met before the plan pays for diagnostic care
    • Includes out-of-network coverage; participants have a lower cost share when using in-network providers
  • TRS-ActiveCare 2
    • Copays for doctor visits before meeting deductibles
    • Does not require PCP selection or referrals
    • Includes out-of-network coverage; participants have a lower cost share when using in-network providers
  • TRS-Care Standard
    • Deductible must be met before any applicable copays apply
    • Does not require PCP selection or referrals
    • Includes out-of-network coverage; participants have a lower cost share when using in-network providers

How Can You Identify TRS Participants?

TRS participants can be identified by the following on their BCBSTX ID card:

  • TRS-ActiveCare Primary and TRS-ActiveCare Primary+ plan holder ID cards indicate the TRS-ActiveCare logo and a three-character prefix of T2U.
  • TRS-ActiveCare HD and TRS-ActiveCare 2 plan holder ID cards indicate the TRS-ActiveCare logo, a three-character prefix of T2S and a network ID of BCA.
  • TRS-Care Standard plan indicates the TRS Care logo and three-character prefix of T3X and network ID of BCA

You should check patient eligibility and benefits using Availity® or your preferred vendor before every scheduled appointment. Eligibility and benefit quotes include patients’ coverage statuses and other important information, such as applicable copays, coinsurance and deductibles. It’s strongly recommended that providers ask to see every patient’s BCBSTX ID card and a photo ID to guard against medical identity theft. If services may not be covered, you should notify patients that they may be billed directly.

Prior Authorization Requirements and Recommended Clinical Review

Effective 09/01/2024, TRS participants in ASO plans no longer have any prior authorization requirements. Providers are encouraged to submit a Recommended Clinical Review preservice to prevent post service medical review for services on the TRS RCR list. Refer to the RCR page for information including the TRS RCR list and how to submit requests.  

TRS participants in fully insured plans still have outpatient prior authorization requirements. Fully insured plans can be identified by “TDI” on the ID card.

Providers can check the Prior Authorization Lists for Fully Insured and Administrative Services Only (ASO) Plans page under Utilization Management for the Prior Authorization Procedure Codes List for Fully Insured Plans and Certain ASO Groups for services that require PA for fully insured TRS participants.  

How Can You Be an In-network Provider for TRS-ActiveCare or TRS-Care Standard Participants?

  • You must have privileges at Blue Essentials or Blue Choice participating hospitals (unless inpatient admissions are uncommon or not required for your specialty or you have someone who will admit on your behalf).
  • You must have a valid National Provider Identifier number.
  • You must sign a Blue Essentials or Blue Choice PPO agreement for the designated TRS-ActiveCare or TRS-Care Standard health plan.

If you have any questions regarding these plans or are interested in participating in our provider networks, please contact your Network Management office or go to the Network Participation — How to Join page.

Outpatient Clinical Laboratory Information:

For TRS-ActiveCare Primary and TRS-ActiveCare Primary+, plan providers should refer members to in-network lab providers for outpatient lab services. To locate participating labs in the Plan network, visit Provider Finder® on the BCBSTX website.

For all TRS-ActiveCare or TRS-Care Standard participants, providers can use the following statewide in-network clinical labs:

Refer to Provider Finder® for additional participating clinical laboratory providers.

Helpful Information

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations, or warranties regarding third party vendors and the products and services they offer.