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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 2025, 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 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4000.00 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:
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Drug Coverage
The CHRISTUS Health Medicare Complete (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you'll pay a copay for your prescriptions, depending on the drug tier and pharmacy. For example, standard generic drugs have a $5.00 copay. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for your Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The CHRISTUS Health Medicare Complete (HMO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. Emergency, urgent, and ambulance services are covered with copays ranging from $35 to $300. The plan also provides coverage for primary care, specialist visits, and various therapies, all with copays, as well as preventive, hearing, vision, and dental services. This plan includes additional benefits such as home health services with no copay, and cardiac and pulmonary rehabilitation with low copays. It also offers coverage for medical equipment, diagnostic services, and skilled nursing facility stays, with copays or coinsurance applying in some cases. Other benefits include coverage for over-the-counter items and a meal benefit for chronic illnesses.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute, are covered, with additional days for Inpatient Hospital-Acute being unlimited, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric has a copay of $318 for days 1-5, and no copay for days 6-90, with additional days and Non-Medicare-covered stays not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay between $0 and $325, observation services with a $325 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services are covered with a $25 copay for both individual and group sessions, while outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the CHRISTUS Health Medicare Complete (HMO) plan, with a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the CHRISTUS Health Medicare Complete (HMO) plan. Ground and air ambulance services have a copay of $300, and transportation services to plan-approved health-related locations are covered for up to 48 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the CHRISTUS Health Medicare Complete (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $100 copay, Urgently Needed Services have a $35 copay, and Worldwide Emergency Transportation has a $300 copay, all with no coinsurance.
Primary Care See details
The CHRISTUS Health Medicare Complete (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $25 copay, and mental health specialty services, podiatry services, psychiatric services, and Opioid Treatment Program Services, with a minimum copay of $25. The plan also covers physical therapy and speech-language pathology services with a $25 copay, and additional telehealth benefits.
Preventive Services See details
The CHRISTUS Health Medicare Complete (HMO) plan covers preventive services, including annual physical exams, with no copay. Additional preventive services, such as health education, in-home safety assessments, and others are not covered.
Hearing Services See details
Hearing Services include coverage for hearing exams, with a $25 copay, and prescription hearing aids, with a copay between $395 and $1595. OTC hearing aids are also covered, with a copay between $95 and $295.
Vision Services See details
Vision services, including routine eye exams, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are covered. Eye exams have a $25 copay, and eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
Dental services include a $25 copay for Medicare dental services and a maximum plan benefit coverage of $2750 per year for other dental services. Oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatments are covered with limits on the number of visits per year, while other diagnostic and preventive dental services are unlimited. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery each have a $20 copay, but maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services includes coverage for Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the CHRISTUS Health Medicare Complete (HMO) plan, with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical equipment benefits are covered by CHRISTUS Health Medicare Complete (HMO). Durable Medical Equipment (DME) has a 0-20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with some services requiring a copay or coinsurance. Diagnostic Procedures/Tests have a $50 copay, while Lab Services are not covered. Diagnostic Radiological Services have a $150 copay, Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the CHRISTUS Health Medicare Complete (HMO) plan with no copay and no coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, with a copay of $10 for Cardiac Rehabilitation Services. Pulmonary Rehabilitation Services are also covered, with a copay between $15 and $20. Intensive Cardiac Rehabilitation Services and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the CHRISTUS Health Medicare Complete (HMO) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The CHRISTUS Health Medicare Complete (HMO) plan's Other Services benefit covers Over-the-Counter (OTC) Items with a maximum benefit of $135 every three months, and a Meal Benefit for chronic illnesses. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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