CHRISTUS Health Medicare – Southeast Texas 2025 Plan Comparison
CHRISTUS Health Medicare – 2025 Plan Comparison
Southeast Texas Counties: Hardin, Jasper, Jefferson, Newton, Orange, Tyler
Plan Overview
| Benefit |
Medicare Plus (HMO) H1189-010 |
Medicare Guardian (HMO) H1189-008 |
| Monthly Premium |
$0 |
$0 |
| Part B Rebate |
$1 |
$125 |
| Max Out-of-Pocket |
$4,000 |
$4,400 |
Medical Services
| Service |
Plus |
Guardian |
| Inpatient Hospital Care |
$0/day (days 1–90+) |
$0/day (days 1–90+) |
| PCP 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 |
| Hearing Exam |
$0 (1 per year) |
$0 (1 per year) |
| Hearing Aids |
$395–$1,595 copay per ear/year |
| Dental Allowance |
$5,000/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 per year) |
$0 (1 per year) |
| Eyewear Allowance |
$250/year |
$250/year |
Additional Benefits
| Benefit |
Plus |
Guardian |
| Durable Medical Equipment |
0%–15% |
0%–20% |
| Diabetic Supplies |
$0 |
$0 |
| Fitness Program (Silver&Fit) |
$0 membership |
$0 membership |
| OTC Allowance (quarterly) |
$175 |
$100 |
| Transportation (Medical) |
48 one-way trips |
48 one-way trips |
| Meals After Hospital Stay |
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 |
$5 |
$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 cost 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 returned 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.
