TRS-ActiveCare Patient Forms

Below are prescription drug formularies, enrollment forms (specialty and mail order pharmacy), etc For TRS-ActiveCare Patients (Effective 09.01.2019).

Pharmacy Information

Electronic Prior Authorization Portals

To initiate or renew Prior Authorizations through on-line system

Telemedicine Medical Services & Telehealth Services

Any contracted FirstCare provider can provide telemedicine medical services and/or telehealth services, for certain circumstances and conditions, to a FirstCare member.
  • No pre-authorization is required by an in-network FirstCare provider. However, if an out-of-network provider is needed, pre-authorization is required. In these cases, FirstCare requires a 48-hour advance notice prior to the member receiving telemedicine services from an out-of-network provider.
  • Covered services are subject to all applicable copayments, coinsurance, and deductible amounts, not exceeding those for the same covered service provided in an in-person location such as a doctor’s office, clinic, or hospital.
  • Telemedicine provider reimbursement is related to the type of medical provider, complexity of care delivered, and the place of service. For more information, please refer to your FirstCare provider contract.
If you have any questions, contact your FirstCare Provider Relations Representative.



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