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CHRISTUS Health Medicare Complete (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CHRISTUS Health Medicare Complete (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on CHRISTUS Health Medicare Complete (HMO) in 2026, please refer to our full plan details page.
CHRISTUS Health Medicare Complete (HMO) is a HMO plan offered by CHRISTUS Health available for enrollment in 2025 to people living in Northeast Texas. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that CHRISTUS Health Medicare Complete (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about CHRISTUS Health Medicare Complete (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For CHRISTUS Health Medicare Complete (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $250.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for CHRISTUS Health Medicare Complete (HMO)
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Drug Coverage
The CHRISTUS Health Medicare Complete (HMO) plan features an annual drug deductible of $250. For prescription drugs, this plan offers no copay for Tier 1 preferred generics and Tier 6 select care drugs at standard pharmacies and through standard mail order. Tier 2 generic medications require a low $5 copay for a one-month supply at standard pharmacies, or a $10 copay for a three-month standard mail-order supply. Higher-tier medications are subject to coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 30% coinsurance. These coinsurance rates apply to standard pharmacy purchases as well as standard mail-order services for Tier 3 and Tier 4 drugs.
Additional Benefits
The CHRISTUS Health Medicare Complete (HMO) plan offers robust medical coverage designed to keep your out-of-pocket costs low. Members benefit from no copays and no coinsurance for primary care visits, telehealth services, and covered acute inpatient hospital stays. For other essential services, the plan features no coinsurance and clear copays, including $35 or less for specialists and $130 for emergency care. This plan also provides valuable everyday benefits, such as preventive dental care and home health services with no copay and no coinsurance. Vision benefits feature no copay for eyewear up to a $200 annual limit, while routine hearing and vision exams require a $35 copay. Additionally, members can take advantage of practical extras like a quarterly over-the-counter allowance and a chronic illness meal benefit, both offered with no copays or coinsurance.
Inpatient Hospital See details
CHRISTUS Health Medicare Complete (HMO) inpatient hospital benefits are partially covered, as upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered. Covered acute stays have no copay and no coinsurance, while psychiatric stays have no coinsurance and a copay of $318 per day for days 1 through 5 and no copay for days 6 through 90.
Outpatient Services See details
CHRISTUS Health Medicare Complete (HMO) covers outpatient services with no coinsurance, featuring a $0 to $325 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay or coinsurance, while outpatient substance abuse sessions have a $35 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by CHRISTUS Health Medicare Complete (HMO) with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
CHRISTUS Health Medicare Complete (HMO) covers ground and air ambulance services with a $300 copay and no coinsurance per service. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay and no coinsurance, though rides to any health-related location are not covered.
Emergency Services See details
CHRISTUS Health Medicare Complete (HMO) covers emergency services with a $130 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered with no coinsurance, requiring a $130 copay for medical care and a $300 copay for emergency transportation.
Primary Care See details
CHRISTUS Health Medicare Complete (HMO) covers primary care physician visits and telehealth services with no copay and no coinsurance. Most other primary care benefits, including specialist visits, physical therapy, and mental health services, require a copay of up to $35 and no coinsurance, while chiropractic care is partially covered with a $15 copay for routine care and other chiropractic services not covered.
Preventive Services See details
Preventive Services are partially covered by CHRISTUS Health Medicare Complete (HMO) with no copay and no coinsurance for covered services like annual physical exams, kidney disease education, and diabetes self-management. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services under CHRISTUS Health Medicare Complete (HMO) are covered, including one annual routine hearing exam for a $35 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $395 to $1,595 for up to two aids yearly, though inner ear, outer ear, and over the ear types are not covered. Up to two OTC hearing aids are also covered per year with a copay of $95 to $295 and no coinsurance.
Vision Services See details
CHRISTUS Health Medicare Complete (HMO) provides partially covered vision services with no deductibles, featuring a $35 copay and no coinsurance for one annual routine eye exam, while other exam services are not covered. Eyewear is covered with no copay and no coinsurance up to a $200 annual limit for contacts or eyeglasses, though upgrades are excluded.
Dental Services See details
CHRISTUS Health Medicare Complete (HMO) provides partially covered dental services up to a $3,000 annual maximum, though orthodontics and maxillofacial prosthetics are not covered. Medicare-covered dental services require a $35 copay and no coinsurance, while covered preventive services have no copay and no coinsurance, and covered comprehensive services require a $20 copay and no coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by CHRISTUS Health Medicare Complete (HMO) with no copay. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the CHRISTUS Health Medicare Complete (HMO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment is partially covered under CHRISTUS Health Medicare Complete (HMO), offering durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic therapeutic shoes and inserts are covered with a $10 copay and no coinsurance, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are partially covered by CHRISTUS Health Medicare Complete (HMO), as laboratory services are not covered. Covered diagnostic procedures and tests require a $50 copay and no coinsurance, while radiological services incur a $25 copay for X-rays, a $125 copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered by CHRISTUS Health Medicare Complete (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the CHRISTUS Health Medicare Complete (HMO) with no coinsurance. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by CHRISTUS Health Medicare Complete (HMO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. A prior three-day inpatient hospital stay is required before admission, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by CHRISTUS Health Medicare Complete (HMO), offering a chronic illness meal benefit and a $115 quarterly over-the-counter allowance with no copay and no coinsurance for both benefits. Acupuncture is not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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