Human Resources Department

Medicare Advantage Plans

Medicare image
Ready to Enroll?

Medicare Open Enrollment

Open Enrollment is the time to evaluate your City of Houston Medicare Advantage Plan coverage and make any necessary changes. This Decision Guide will help you navigate your options for the 2022 benefit year. The choices you make during Open Enrollment are for benefits effective January 1, 2022, through December 31, 2022.

If you are already enrolled in a City of Houston Medicare Advantage Plan and you are happy with it, you do not need to do anything to remain enrolled.

If you are Medicare eligible and you want to be covered by the City of Houston’s Medicare plans, your participation in Open Enrollment is essential. The annual opportunity also allows you to add or drop eligible dependents from coverage.

Medicare Virtual Meetings

Representatives from the City of Houston and plan vendors will present information of your 2022 benefit options. You have the option to watch the webinar online or dial in by phone and listen.

Call 800-582-0984 to listen by phone. Go to the links below to participate online.

Date Time Meeting Link
Tuesday, Nov. 9 6 p.m. - 8 p.m. November 9 Meeting Link
Friday, Nov. 19 8 a.m. - 10 a.m.
Monday, Nov. 22 1 p.m. - 3 p.m.

Appointments by Phone

Not sure which plan to select? Schedule a phone appointment with a KelseyCare Advantage or Aetna Healthcare representative to determine which plan is right for you.

Aetna Health Care:
1-800-307-4830 (TTY: 711)

KelseyCare Advantage:
713-442-2COH (2264)

Important News About 2022

The Kelsey-Seybold Physicians network now accepts Aetna Basic PPO and Aetna Premier ESA PPO. You will pay Aetna plan copayments and deductibles if you go to a Kelsey-Seybold Clinic.

Medicare benefits image

Medicare is health insurance for people age 65 or older, certain people under 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD).

Whether you are an active or a retired City of Houston employee, you become eligible for Medicare on the first day of the month in which you turn age 65, or if your birthday is on the first of the month, on the first day of the prior month.

COVID-19 Vaccine Information

We understand some KelseyCare Advantage members are eager to get the COVID-19 vaccine.

Key facts to know:

  • The vaccine is FREE to Medicare Advantage members.
  • The Federal Government is responsible for paying for the vaccine serum.
  • KelseyCare Advantage covers the cost of administering the vaccine.
  • KelseyCare Advantage does not control which providers receive allocations of the vaccine or when.
  • The CDC has established a Phased Implementation of Vaccination and Sub-Prioritization Among Populations and availability is based on supply.

Kelsey-Seybold Clinic received a limited supply of the vaccine and is currently only able to vaccinate Phase 1a First Responders and a limited number of Phase 1b patients.

All KelseyCare Advantage members have been accounted for to the Texas Department of Health Services as part of their planning for allocation and distribution of the vaccine. Kelsey-Seybold Clinic will communicate with you when we are ready to schedule your COVID-19 vaccine.

KelseyCare Advantage and Kelsey-Seybold Clinic are committed to your health and well-being. We want you to have the vaccine as soon as possible and will let you know as soon as we are ready to schedule your appointment. Until then, we ask for your patience and understanding.

For more information visit the KelseyCare Advantage COVID-19 website.

Kelsey-Seybold Clinic COVID-19 Frequently Asked Questions

If you are interested in getting the vaccine outside of Kelsey-Seybold Clinic, you can check the Texas COVID Vaccine Availability website.

Your 2022 Plan Options

  • Aetna Basic PPO
  • Aetna Premier ESA PPO
  • KelseyCare Advantage HMO

Contact Information for Medicare Advantage Plans

KelseyCare Advantage
7 days a week, 8 a.m. – 8 p.m. CST
713-442-2COH (2264)

Aetna Health Care
Monday - Friday, 7 a.m. – 8 p.m. CST
1-888-267-2637 (TTY: 711)

2022 Monthly Medicare Advantage Plan Contributions

Under all plans, you must pay a monthly premium to cover eligible family members. You also must pay the federal government for your premiums for Medicare Part A (if any) and Medicare Part B.

The premiums shown below apply to Medicare eligible retirees and their dependents, for whom the City of Houston pays 75% of the cost of monthly premiums. For monthly contributions for dependents under 65, see Monthly Medical Plan Rates for Retiree Under 65 Without Medicare.

Aetna Basic PPO
Coverage Type 2022 Monthly Contribution
Subscriber Only $18.00
Subscriber + Child(ren) $36.00
Subscriber + Spouse $36.00
Subscriber + Family $54.00

Aetna Premier ESA PPO
Coverage Type 2022 Monthly Contribution
Subscriber Only $63.00
Subscriber + Child(ren) $126.00
Subscriber + Spouse $126.00
Subscriber + Family $189.00

KelseyCare Advantage HMO
Coverage Type 2022 Monthly Contribution
Subscriber Only $42.00
Subscriber + Child(ren) $84.00
Subscriber + Spouse $84.00
Subscriber + Family $126.00

Pharmacy Prescription Chart

Pharmacy Coverage

All of the City of Houston’s Medicare Advantage Plans include Part D, and offer comparable or better pharmacy benefits. The drug formularies established by Medicare for 2022 serves as the model for Medicare plan formularies.

If requested from your chosen provider*, you will receive a formulary list when you enroll in a plan. You can also find out how much your prescriptions will cost by calling the plan, visiting the plan’s website or viewing the chart below.

Medicare Prescription Chart

Medicare Advantage Documents