The Texas House and Senate came to an agreement on funding TRS-Care and have passed HB 21. HB 21 provides $212 million towards TRS-Care, the state-run retiree health insurance program. The funding will help retirees who are both pre-65 and over-65. Gov. Greg Abbott has now signed this bill into law.
As in the past, the Texas Retired Teachers Association has provided the best information on this, in our opinion. Go to their website at http://www.trta.org/ to get updates as this new bill is implemented. Also go to the Teacher Retirement System of Texas (TRS) website for updates as to exactly how this will affect retirees at https://www.trs.texas.gov.
Below is TRTA’s assessment of the major impact on retirees (edited by TCG). This compares an estimate of the impact of this legislation on rates and key benefits to the information published by TRS after the regular session of the Legislature passed its TRS-Care bill (as signed into law by the Governor).
- Previously: $3,000 deductible for individuals and $6,000 for families.
- Now: $1,500 deductible for individuals and $3,000 for families.
Reduced maximum out-of-pocket costs.
- Previously: $6,650 Maximum Out of Pocket (MOOP) for individuals and $13,300 for families.
- Now: $5,650 MOOP for individuals and $11,300 for families.
- Individual Premium: $200/month (no expected change – TCG – not on TRTA assessment)
- Previously: $739/month for non-Medicare retirees and spouse.
- Now: $689/month for non-Medicare retirees and spouse.
- Previously: $146/month for Medicare retirees.
- Now: $135/month for Medicare retirees.
- Previously: $590/month for Medicare retirees with a spouse.
- Now: $529/month for Medicare retirees with a spouse.
Remember that with the Medicare Advantage plan you must also sign up for Medicare A and B and pay these premiums.
TCG’s assessment is that the TRS Medicare Advantage Plan provides excellent benefits, as is the drug coverage.
The biggest issue with the Advantage plan is that some medical providers are reluctant to accept these plans. They often have to be in a network for each Advantage plan. The TRS plan does not have a network. According to TRS, their Advantage plan should be accepted by any provider that accepts Medicare. According to retired TRS members with whom we have spoken, it may take some pushing of your provider to accept the plan and you may have to call TRS-Care for assistance. But in the end, most providers will accept the plan when they understand how the TRS plan works. You have to be diligent. You also have to start working on this very soon – before your coverage under the plan starts on January 1, 2018 (if you are not already under the Advantage plan now), so that you do not have problems with your providers then or you have time to change to a different provider before then.
The steps we suggested for getting ready for these changes in our previous publication and blog on this subject are still the same. Please review our recommendations for preparing for the new benefits and rates. We are happy to answer questions.
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