My wife is a retired teacher and we are both on her TRS-Care Plan and also on my retiree health insurance which I use for services at MD Anderson because I am undergoing cancer treatment.  I have just found out that I’ve lost my retiree health benefits because TRS enrolled us in the TRS Medicare Advantage plan when my wife enrolled in Medicare Parts A and B.

            My wife, Mary did not read the complete package and had no idea that when she signed us up for this TRS plan that I would lose my retiree benefits and I need these benefits because I am enrolled in a clinical trial that will only work with “Original Medicare” and not the Medicare Advantage Plan.

             What should we do??  Please give us some guidance. I am sure others readers of your column will have problems similar to ours.  Thank you, Jack from Pearland, TX

Good Morning, Jack:

TRS Care has definitely had its share of challenges because of the changes from a couple of years ago to more than 10,000 TRS retired teachers that have both Medicare Parts A and B like you and your wife.

Many company retiree health insurance plans are like your retiree plan and if you enroll in Medicare’s Part D, then you can lose your company benefits, which is stated in company benefit letters that go out every October.

Since the TRS plan has a Medicare Part D that is why you have lost your retiree health benefits because your retiree benefits is also classified as a Part D.  Medicare will not let a person have two Part D plans.

The Texas Retired Teachers Assoc. 3rd quarter 2012 newsletter on page 3 discuss how to “opt” out of the TRS Medicare Advantage plan at your own discretion with the TRS Care’s “opt-out provision”.  There is no waiting period to get back into your “old” TRS-Care plan beginning the first of the following month.

You should call TRS-Care at either 1/800-367-3636 or 866/217-2409 to disenroll from the TRS Medicare Advantage plan and return to the Original TRS-Care plan with Original Medicare.

I would also talk with the retiree insurance plan which you lost and explain your situation and ask them how you can go back to your retiree plan.  Explain to them about this mistake.

In the past few weeks, I have had numerous readers that are teachers and retiring, who are also struggling with which TRS plan to chose.  I felt I needed to explain TRS’s Medicare plans again.

Let’s discuss the difference in the 2 plans:

1)     2014 TRS-Care 2 or 3 with “Original Medicare”: TRTA members have used for years.  Depending on which plan you elect TRS 2(with $1,000 deductible and $4,400 out of pocket maximum) or TRS 3(with $300 deductible and $3,700 out of pocket maximum).  There may be a little more out of pocket and the premium is a little  higher of about $15.00 a month, but you use “Original Medicare” with you having control over choosing which doctor, hospital or healthcare professional to use not an insurance company telling you what to do.  For those having serious medical conditions, with this TRS plan you will have less worry with fewer headaches.

2)     2014 TRS Aetna Medicare Advantage Care 2 or 3 Plan: Aetna not Medicare will pay claims because with a Medicare Advantage plan then, Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. There is less out of pocket, but only if you stay in network and going out of network will cost you more.  With this TRS plan, your monthly premiums are reduced generally by $15.00 a month.

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