CHRISTUS Health Medicare Plan Comparison (2025)

Service Area: Northeast Texas counties: Bowie, Camp, Cass, Cherokee, Franklin, Gregg, Harrison, Henderson, Hopkins, Marion, Morris, Panola, Red River, Rusk, Smith, Titus, Upshur, Wood, Van Zandt

Plan Overview

Benefit	Complete (HMO) H1189-003	Plus (HMO) H1189-004	Guardian (HMO) H1189-008
Monthly Premium	$0	$20	$0
Part B Rebate	N/A	N/A	$125
Out-of-Pocket Max	$4,000	$4,000	$4,400

Medical Services

Service	Complete	Plus	Guardian
Inpatient Hospital Care	$0 per day (days 1–90+)
PCP Visit	$0 (includes telehealth)
Specialist Visit	$25	$25	$25
Emergency Care	$100	$100	$125
Routine Blood Tests	$0	$0	$0
Diagnostic Radiology	$150	$125	$150

Hearing, Dental, Vision

Benefit	Complete	Plus	Guardian
Routine Hearing Exam	$0 (1 per year)
Hearing Aids	$395 – $1,595 copay per ear/year
Dental Allowance	$2,750/year	$4,500/year	$2,500/year
Dental Cleaning	$0 (up to 3/year)
Comprehensive Dental	$20 copay
Routine Eye Exam	$0 (1 per year)
Eyewear	$200/year	$300/year	$250/year

Additional Services

Service	Complete	Plus	Guardian
Durable Medical Equipment	0% – 20%	0% – 15%	0% – 20%
Diabetic Supplies	$0
Silver&Fit	$0 membership
OTC Allowance (Quarterly)	$135	$150	$100
Transportation	48 one-way trips to medical appointments
Post-Discharge Meals	14 home-delivered meals for up to 7 days

Prescription Drug Coverage

Tier	Retail (30-day)	Mail Order (90-day)
Tier 1: Preferred Generic	$0	$0
Tier 2: Generic	$5	$0
Tier 3: Preferred Brand	$47	$141
Tier 4: Non-Preferred	$100	$300
Tier 5: Specialty Drugs	33%	Not Covered
Tier 6: Select Care	$0	$0
Coverage Gap	No coverage gap
Catastrophic Coverage	No costs after $2,000 out-of-pocket on Part D drugs

Contact: 844.282.3026 / TTY 711

Open daily from Oct 1 – Mar 31 (8 a.m. to 8 p.m.). From Apr 1 – Sept 30, open Mon – Fri, 8 a.m. – 8 p.m. After-hours messages returned within 1 business day.

CHRISTUS Health Advantage is an HMO with a Medicare contract. Enrollment depends on contract renewal. Benefits and coverage may change annually.