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Frequently Asked Questions

If you have questions about your TRS-Care Standard plan, browse the FAQs below. If you don't see your question, review the full list of FAQs.

You can also call a Personal Health Guide 24/7 at 1-866-355-5999.

  • What is a deductible?

    A deductible is the amount of out-of-pocket expense that must be paid for health care services by the covered person before becoming payable by the health care plan. TRS-Care Standard features a calendar year deductible. The plan year begins Jan. 1 and ends Dec. 31 of the same year.

  • What does maximum out-of-pocket mean?

    Once you reach the plan's maximum out-of-pocket, TRS-Care Standard pays 100% of any eligible expenses for the rest of the plan year. The deductible counts toward the out-of-pocket maximum.

  • What is coinsurance?

    Coinsurance is the percentage of medical expenses that you and the plan share. For example, when using in-network providers, TRS-Care Standard pays a percentage of the allowed amount and you pay a percentage of the allowed amount after the deductible is met.

  • What are transition of care benefits?

    If you are currently seeking care or undergoing a course of treatment from an Out-of-Network provider when your TRS-Care Standard coverage becomes effective, you may request ongoing care with that provider for a period of time. To continue receiving these benefits, a Transition of Care Request Form must be completed and approved. The form and instructions for submitting the request are available on the website. The form may be mailed or faxed.

    IMPORTANT – If you're already seeing an In-Network provider, you do NOT need to complete the Transition of Care Request Form.

    All requests are subject to approval.

    If the transition of care request is approved, you may continue to see your Out-of-Network provider and receive the In-Network level of benefits. However, you may be billed for charges exceeding Blue Cross and Blue Shield of Texas’ allowable amount.

    If the transition of care request is denied, you may continue to see your Out-of-Network provider, however benefits will be paid at the Out-of-Network level.