A non-government entity
CHRISTUS Health Medicare Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for CHRISTUS Health Medicare Plus (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 Plus (HMO) in 2025, please refer to our full plan details page.
CHRISTUS Health Medicare Plus (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 Plus (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 Plus (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 Plus (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.00. 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:
Sign up for CHRISTUS Health Medicare Plus (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The CHRISTUS Health Medicare Plus (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay a copay for your prescriptions depending on the drug tier and pharmacy. For example, you'll pay a $5 copay for preferred generic drugs at a standard pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for 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 Plus (HMO) plan offers a range of benefits with varying costs. The plan covers inpatient hospital stays and outpatient services, with copays ranging from $0 to $325, as well as ambulance services with a $300 copay. Primary care, specialist visits, and mental health services have a $20-$25 copay. Preventive services, hearing exams, and vision services are covered, with copays for exams and eyewear benefits. Dental services are also included, with a copay for Medicare dental and an annual maximum for other services. Medical equipment, diagnostic services, and home health services are covered with copays or coinsurance depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital Psychiatric, you will pay a $318 copay for days 1-5, and no copay for days 6-90. Additional days and non-Medicare-covered stays for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, as well as upgrades for Inpatient Hospital-Acute, are 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. Individual and group sessions for outpatient substance abuse have a copay of $25, and outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the CHRISTUS Health Medicare Plus (HMO) plan. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, each with a $300 copay, and transportation services to plan-approved health-related locations, with 48 one-way trips covered per year. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the CHRISTUS Health Medicare Plus (HMO) plan. Emergency Services have a $100 copay, Urgently Needed Services have a $30 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $100 copay while Worldwide Emergency Transportation has a $300 copay.
Primary Care See details
Primary Care, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Primary Care Physician Services are covered. Chiropractic Services have a $20 copay, and Routine Chiropractic Care has a $20 copay for up to 24 visits per year. Occupational Therapy Services have a $25 copay. Physician Specialist Services have a $25 copay. Individual and Group Sessions for Mental Health Specialty Services have a $25 copay. Routine Foot Care has a $25 copay for up to 6 visits per year. Other Health Care Professional services have a copay between $0 and $25. Individual and Group Sessions for Psychiatric Services have a $25 copay. Physical Therapy and Speech-Language Pathology Services have a $25 copay. Opioid Treatment Program Services have a $25 copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered by the CHRISTUS Health Medicare Plus (HMO) plan. Additional preventive services like Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing exams are covered with a $25 copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered with a copay between $395 and $1595 for two hearing aids every year, while hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are covered with a copay between $95 and $295 for two hearing aids per year.
Vision Services See details
The CHRISTUS Health Medicare Plus (HMO) plan covers vision services including routine eye exams with a $25 copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames, are covered, with a combined maximum benefit of $300 every year. Upgrades are not covered.
Dental Services See details
The CHRISTUS Health Medicare Plus (HMO) plan covers dental services with a $25 copay for Medicare dental services, and a maximum of $4500 per year for other dental services. Oral exams are covered with a $0 copay for up to two visits per year, while Dental X-Rays are covered with a $0 copay for one per year. Restorative services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics, removable, Implant Services, Prosthodontics, fixed, and Oral and Maxillofacial Surgery are all covered with a $20 copay. Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the CHRISTUS Health Medicare Plus (HMO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 0-15% coinsurance, Prosthetics/Medical Supplies with a 15% coinsurance for Medicare-covered items, and Diabetic Therapeutic Shoes/Inserts with a $10 copay. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include a $25 copay for Diagnostic Procedures/Tests, while Lab Services are not covered. Diagnostic Radiological Services have a $125 copay, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the CHRISTUS Health Medicare Plus (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, including services not usually covered by Medicare plans. You will pay a copay for these services, with a minimum copay of $10 and a maximum copay of $10 for Cardiac Rehabilitation Services, and a minimum copay of $20 and a maximum copay of $20 for Pulmonary Rehabilitation Services. 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 Plus (HMO) plan, with no copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF, and non-Medicare-covered stays for SNF, are not covered.
Other Services See details
The CHRISTUS Health Medicare Plus (HMO) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $150 every three months, and a Meal Benefit for a chronic illness. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved