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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 2026, 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 South 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 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 $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 $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)
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Drug Coverage
The CHRISTUS Health Medicare Plus (HMO) plan features an annual drug deductible of $250. For affordable medications, this plan offers no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care Drugs) filled at standard pharmacies. Additionally, you will pay no copay for a three-month standard mail-order supply of Tier 1 and Tier 6 drugs, and only a $10 copay for a three-month supply of Tier 2 drugs. For brand-name and specialty medications, costs are calculated using coinsurance. Tier 3 (Preferred Brand) drugs require a 25% coinsurance for both standard pharmacy and standard mail-order options. Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) medications carry a 30% coinsurance, helping you plan your prescription budget effectively.
Additional Benefits
The CHRISTUS Health Medicare Plus (HMO) plan offers comprehensive medical coverage with no copay or coinsurance for acute inpatient hospital stays, primary care provider visits, and home health services. Members also benefit from affordable outpatient care, including no copay for ambulatory surgical center services and a $25 copay for specialist visits. Emergency room visits require a $150 copay, which is waived if admitted, while urgently needed services carry a $40 copay. Additional benefits include preventive dental care with no copay and comprehensive dental services up to a $3,000 annual limit for a $20 copay. Vision and hearing benefits feature routine exams for a $25 copay, alongside a $250 annual eyewear allowance and affordable hearing aid options. Members also receive up to 48 free one-way transportation trips per year to plan-approved locations and a $125 quarterly over-the-counter allowance with no copay.
Inpatient Hospital See details
CHRISTUS Health Medicare Plus (HMO) covers inpatient acute hospital stays with no copay and no coinsurance for unlimited days, excluding upgrades and non-Medicare-covered stays. Inpatient psychiatric hospital stays are covered with no coinsurance, requiring a $50 daily copay for days 1 through 5 and no copay for days 6 through 90.
Outpatient Services See details
Outpatient services are covered by CHRISTUS Health Medicare Plus (HMO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services carry a $0 to $100 copay ($100 per stay for observation), while individual and group outpatient substance abuse sessions require a $25 copay.
Partial Hospitalization See details
CHRISTUS Health Medicare Plus (HMO) covers partial hospitalization services with a $55.00 copay and no coinsurance.
Ambulance and Transportation Services See details
CHRISTUS Health Medicare Plus (HMO) covers ground and air ambulance services with a $300 copay and no coinsurance. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay and no coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
CHRISTUS Health Medicare Plus (HMO) covers emergency services with a $150 copay, which is waived if you are 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, featuring a $150 copay for medical care and a $300 copay for emergency transportation.
Primary Care See details
Primary Care benefits under CHRISTUS Health Medicare Plus (HMO) feature no copay and no coinsurance for primary care provider and telehealth visits, while specialist, therapy, mental health, and podiatry services require a copay of up to $25 and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance for up to 24 routine visits per year, though other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by CHRISTUS Health Medicare Plus (HMO) with no copay and no coinsurance for covered care such as annual physicals, kidney education, memory fitness, remote access technologies, and various screenings. However, several sub-services are not covered, including health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation counseling, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services covered by CHRISTUS Health Medicare Plus (HMO) include one routine hearing exam per year for a $25 copay and no coinsurance, as well as unlimited fitting evaluations. Prescription hearing aids are partially covered with no coinsurance and copays from $395 to $1,595 for up to two aids yearly (excluding inner ear, outer ear, and over the ear models), while up to two OTC hearing aids are covered with a $95 to $295 copay and no coinsurance.
Vision Services See details
Vision services are partially covered by CHRISTUS Health Medicare Plus (HMO), offering one annual routine eye exam for a $25 copay and no coinsurance, while other eye exams are not covered. Covered eyewear has no copay and no coinsurance up to a $250 yearly limit, though upgrades are not covered.
Dental Services See details
CHRISTUS Health Medicare Plus (HMO) dental services are partially covered up to a $3,000 annual maximum, offering preventive care with no copay and no coinsurance. Comprehensive dental services and implants require a $20 copay with no coinsurance, and Medicare-covered dental services have a $25 copay with no coinsurance, though orthodontics and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
CHRISTUS Health Medicare Plus (HMO) covers home infusion bundled services with no copay. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by CHRISTUS Health Medicare Plus (HMO) with no copay and a 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered by CHRISTUS Health Medicare Plus (HMO), featuring durable medical equipment with no copay and 0% to 20% coinsurance, and prosthetic devices and medical supplies with no copay and 20% coinsurance. Diabetic equipment is partially covered with no coinsurance, offering therapeutic shoes and inserts for a $10 copay, though diabetic supplies themselves are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are partially covered by CHRISTUS Health Medicare Plus (HMO) because laboratory services are not covered. Covered diagnostic procedures and tests require a $75 copay with no coinsurance, while outpatient X-rays have a $10 copay, diagnostic radiological services have a $125 copay, and therapeutic radiological services require 20% coinsurance.
Home Health Services See details
Home Health Services are covered by CHRISTUS Health Medicare Plus (HMO) with no copay and no coinsurance.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by CHRISTUS Health Medicare Plus (HMO) with no coinsurance, though only some services are covered as standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered. These non-covered services require copayments ranging from $10 to $15.
Skilled Nursing Facility (SNF) See details
CHRISTUS Health Medicare Plus (HMO) covers Skilled Nursing Facility (SNF) services 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 for admission, and additional days beyond the Medicare-covered 100-day limit are not covered.
Other Services See details
Other services are partially covered by CHRISTUS Health Medicare Plus (HMO), including a meal benefit for chronic illness and a $125 quarterly over-the-counter allowance, both of which feature no copay and no coinsurance. Acupuncture is not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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