Human Resources Department

Medicare Advantage Plans


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.

Medicare Open Enrollment closed on Friday, December 11

Please note that this Open Enrollment was for individuals who are 65 years old and over and who have Medicare A and B currently.

If you are under 65 years of age and are enrolled in a City of Houston Cigna Health Plan your 2021 Open Enrollment period will be this Spring.

If you did not complete a Medicare Advantage Open Enrollment form, you will not lose your coverage. You will default into the plan that is closest to your current plan. Your new plan will be effective on January 1, 2021.

If we receive your Open Enrollment form after December 11, you will not lose coverage. You will default into the plan that is closest to your current plan. Your new plan will be effective on January 1, 2021. If you selected a different plan than the one you were defaulted into, you will be eligible for coverage on your selected plan under the plan you selected on February 1, 2021.

Current Plan Defaulted Plan
Aetna Steerage PPO Aetna Premier ESA PPO
Medicare Supplement AARP & United Health Care Aetna Premier ESA PPO
Kelsey Care Advantage HMO Kelsey Care Advantage HMO
WellCare Texan Plus HMO Aetna Basis PPO
Cigna Health Spring Aetna Basic PPO

Please contact retiree@houstontx.gov or Kelsey Care Advantage 713-442-2264 or Aetna 888-267-2637(TTY:711).

Post Medicare Advantage Open Enrollment Check List


1. If you were covered by a City of Houston Medical Plan on January 1, 2010 and filled paperwork to opt-out of a city plan, you may elect to re-enroll (opt-back in) at any time. If you have Medicare Parts A and B, you can only opt-back into a City-Sponsored Medicare Plan.

2. If you plan to opt-out of City of Houston Medicare Plans and require proof of coverage, please utilize the Letter of Creditable Coverage.

3. To change Medicare Plans after January 1, 2021, you must contact the Benefits Division by the 15th of the month for coverage to be effective the 1st of the following month.

Aetna Checklist

Kelsey Checklist

Aetna Medicare Advantage Basic PPO Welcome Kit

Aetna Medicare Advantage Premier PPO Welcome Kit

Your 2021 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)

Continuity of Care

The UnitedHealthcare, WellCare TexanPlus or Cigna HealthSpring plans, will not be offered in 2021. To ease the transition to a new plan/vendor, complete a continuity of care form with the plan vendor of your choice.

2021 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 2021 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 2021 Monthly Contribution
Subscriber Only $63.00
Subscriber + Child(ren) $126.00
Subscriber + Spouse $126.00
Subscriber + Family $189.00


KelseyCare Advantage HMO
Coverage Type 2021 Monthly Contribution
Subscriber Only $42.00
Subscriber + Child(ren) $84.00
Subscriber + Spouse $84.00
Subscriber + Family $126.00

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 2021 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.


Pharmacy Prescription Chart

Pharmacy Information

Summary of Benefits