TRS Health Care Benefits Guide: #1 Savings Tip for Texas Teachers
- Burton Hayden
- 2 days ago
- 6 min read
Are you a teacher in Texas and tired of the exorbitant family premiums for your TRS health care plan?
Good news!
There’s a better way for teachers to get quality affordable health insurance at a fraction of the cost!
Not From Texas? We’ve got a comprehensive Teachers Health Insurance Guide just for you!
What kind of health insurance are Texas Teachers currently being offered?
TRS ActiveCare plans are health insurance options offered to Texas public school employees, including teachers and educational staff.
These plans are administered by the Teacher Retirement System of Texas (TRS) and aim to provide comprehensive health care coverage to meet the needs of educators.
TRS offers a variety of health plans to choose from, including:
TRS-ActiveCare Primary Summary:
– Lowest premium of all three plans
– Copays for doctor visits before you meet your deductible
– Statewide network
– Primary Care Provider (PCP) referrals required to see specialists
– Not compatible with a Health Savings Account (HSA)
– No out-of-network coverage
TRS-ActiveCare Primary+ Summary:
– Lower deductible than the HD and Primary plans
– Copays for many services and drugs
– Higher premium
– Statewide network
– PCP referrals required to see specialists
– Not compatible with a Health Savings Account (HSA)
– No out-of-network coverage
TRS-ActiveCare HD Summary:
– Compatible with a Health Savings Account (HSA)
– Nationwide network with out-of-network coverage
– no requirement for PCPs or referrals
– Must meet your deductible before plan pays for non-preventive care
These options may not be the best fit for everyone.
If you already have health insurance coverage through a spouse or another source, you may not need additional coverage through TRS ActiveCare.
Additionally, if you prefer a higher level of flexibility in choosing health care providers outside of the TRS ActiveCare network, you might consider alternative options. It’s important to carefully evaluate your individual needs and circumstances before making a decision.
Average Cost of a TRS Health Care Plan:
The cost of TRS ActiveCare plans vary based on factors such as individual or family enrollment, the region, and the specific plan chosen.
For example, in Region 10 the TRS ActiveCare Primary+ Individual + Family plan premium would be $1,941, whereas the Region 1 TRS ActiveCare Primary+ Individual + Family plan premium would be $1,571.
It’s crucial to review the available plans and associated premiums to determine the exact cost for your situation.
Why Might A Teacher Opt-Out Of Taking A TRS Health Care plan?
High Family Plan Premiums:
School districts typically contribute anywhere from 50%-100% to a teacher's coverage, but often do not contribute anything toward the family's portion, making TRS Health Plans expensive for families, because the teacher must have the difference deducted from their own paycheck.
Flexibility And Coverage:
Planning to move? Travel frequently? A private health insurance plan with nationwide coverage that can move with you may be a better long-term option.
Is your doctor in-network? What kind of health care needs does your family have? Understanding your families health needs can help you decide if a TRS Health Plan is right for you.
#1 Savings Tip ForTexas Teachers:
While many districts will cover anywhere from 50% – 100% of the teacher’s health insurance premium, teachers are often surprised to discover that their district may not be contributing anything at all to their family’s premium–
– this can amount to hundreds of dollars being deducted from the teacher’s paycheck to cover their family’s monthly premium.
For Example: Sarah, * a teacher in Carrollton, TX, was having nearly $1,300 deducted from her paycheck every month to cover the health insurance premiums for her family of five.
#1 Savings Tip For Texas Teachers: Find out how much your district contributes to your dependent’s health insurance premiums.
What's The Alternative For A Teacher's Dependents?
When looking for alternatives to TRS ActiveCare plans, there are several real options:
What Do Teachers Need To Know To Decide If Switching Is Right For Them?
District Contributions: Is your school district contributing anything to your dependents premiums? School districts typically contribute anywhere from 50%-100% to a teacher’s coverage, but often do not contribute anything toward the family’s portion, making TRS Health plans expensive for families, because the teacher must have the difference deducted from their own paycheck.
Conditions and Coverage: Private insurance options can offer greater flexibility, lower out-of-pocket expenses (like $0 copays, free telehealth, and $0 outpatient deductibles), and a wider range of benefits.
Flexibility and Changes: You can cancel or remove participants from your TRS ActiveCare plan without cost or penalty. However, switching back to TRS plans or making changes outside of open enrollment periods may have limitations.
Texas teachers do not have to make this decision alone: We will reach out to help you compare your options – completely free!
Top Frequently Asked Questions About TRS Health Plans:
Does my entire family need to be on the same plan?
No, it's not necessary for your entire family to be on the same plan. School districts in Texas contribute to teachers' coverage, making it relatively affordable for the teacher. However, most districts do not contribute anything toward the family's coverage, resulting in expensive TRS Health plans for the entire family, so it's important to consider placing dependents on their own plan for greater savings.
How much do school districts contribute to a teacher's health insurance coverage?
Districts commonly contribute either 50% or 100% of the teacher's coverage. It's important to note that most districts only contribute to the teacher's coverage, leaving the spouse and children essentially self-insured despite being listed on the Teachers Health plan.
Can I opt out of the health insurance plan provided by my school district?
Yes, in most school districts, you are not required to participate in the health insurance plan offered by your school district.
When should I consider switching from my TRS Health Care plan to a private insurance option?
If your district pays 50% of the teacher’s portion and that teacher does not have a spouse or kids, the teacher can typically get better benefits at the same price as their current Teachers Health plan. (benefits like: $0 co-pays, $0 deductibles, access to the largest PPO network in the US, and 20 preventative care doctors visits per year)
If your district pays 50% of the teacher’s portion and that teacher does have a spouse and/or children, the teacher can expect to get better benefits at the same price as their Teachers Health plan, and also save 40%-50% on their spouse and/or children’s healthcare costs by switching them to private health insurance. (again, these are benefits like: $0 co-pays, $0 deductibles, access to the largest PPO network in the US, and 20 preventative care doctors visits per year, per individual on the plan)
If your district pays 100% of the teacher’s portion (districts like Frisco and Plano) and nothing for the rest of the family, the teacher can keep themselves on their TRS Health plan and save 40%-50% off their monthly premiums by switching the rest of the family to a private health insurance option. Family members on private health insurance will typically experience the same enhanced benefits listed above. ($0 co-pays, $0 deductibles, access to the largest PPO network in the US, and 20 preventative care doctors visits per year).
Can I switch plans if I have a pre-existing condition?
In most cases, switching plans is possible even if you have a pre-existing condition. Talk to one of our licensed health insurance agents to explore your options and find the right fit for you.
Is there a cost or penalty to switch from a TRS Health Care plan to private insurance?
No, there is no cost or penalty for removing family members or canceling your TRS Health plan.
Can I cancel or remove participants from my Teachers Health Care plan anytime during the year?
Unfortunately, you can only switch during your district's open enrollment period, typically occurring during the summer months. Ensure that your new plan is active before canceling the TRS plan to ensure seamless coverage. Your Revolt Healthcare Advisor can assist in ensuring a smooth transition.
What if I want to return to a TRS Health Care Plan after having private insurance?
Private health insurance generally offers better benefits, a wider network of doctors, and lower monthly premiums. However, if circumstances change, you can return to a TRS plan during the next open enrollment period, usually held in the summer months. Qualifying life events may also allow changes outside the regular enrollment period.
Texas teachers no longer need to endure outrageously high premiums just to keep their families Insured
Affordable health insurance alternatives exist that offer better benefits at a lower price.
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