CHRISTUS Health Medicare – 2025 Plan Comparison

South Texas Counties: Aransas, Bee, Jim Wells, Kleberg, Nueces, Refugio, San Patricio

Plan Overview

Benefit	Medicare Plus (HMO) H1189-005	Medicare Guardian (HMO) H1189-008
Monthly Premium	$0	$0
Part B Premium Rebate	N/A	$125
Annual Max Out-of-Pocket	$4,000	$4,400

Medical Services

Service	Plus	Guardian
Inpatient Hospital Care	$0/day (days 1–90+)
Primary Care Visits	$0 (includes telehealth)
Specialist Visits	$25	$25
Emergency Care (Worldwide)	$125	$125
Routine Blood Tests	$0	$0
Diagnostic Radiology	$125	$150

Dental, Vision & Hearing

Benefit	Plus	Guardian
Routine Hearing Exam	$0 (1/year)	$0 (1/year)
Hearing Aids	$395–$1,595 copay per ear/year
Dental Allowance	$3,000/year	$2,500/year
Dental Cleaning	$0 (up to 3/year)	$0 (up to 3/year)
Comprehensive Dental	$20 copay	$20 copay
Eye Exam	$0 (1/year)	$0 (1/year)
Eyewear Allowance	$250/year	$250/year

Additional Benefits

Benefit	Plus	Guardian
Durable Medical Equipment	0%–15%	0%–20%
Diabetic Supplies	$0	$0
Fitness (Silver&Fit)	$0 membership	$0 membership
OTC Allowance (Quarterly)	$190	$100
Transportation (Medical)	48 one-way trips	48 one-way trips
Post-Discharge Meals	14 meals for 7 days	14 meals for 7 days

Prescription Drug Coverage

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

Contact Information

Phone: 844.282.3026 / TTY 711

Availability: Oct 1 – Mar 31: Daily, 8 a.m. – 8 p.m.
Apr 1 – Sept 30: Mon – Fri, 8 a.m. – 8 p.m. (voicemail after hours responded next business day).

CHRISTUS Health Advantage is an HMO with a Medicare contract. Enrollment depends on contract renewal. Limitations, copayments, and restrictions may apply. Benefits and costs may change on Jan 1 each year.