Medicare Advantage Plan Rates for Retirees

Use the chart below to find the contribution for the coverage you elect.

  1. Look for the category in the left-hand column that fits your situation.
  2. Select the corresponding rate for the plans of your choice.
  3. If you have family members who remain in the HMO or PPO, select the rate based on the age of the oldest family member keeping the HMO or PPO plan.
  4. Your total monthly contribution is the sum of the rate for HMO or PPO, plus the rate for TexanPlus or Texas HealthSpring.

Family Coverage Category for
Medicare Managed Care Plans
Contributions
HMO*
PPO*
Texan Plus
Texas
Health
Spring
Retiree Only
(With Medicare)		 $98.66 $221.38
1   Retiree elects a new Plan
-
-
$15.00
$7.50
Retiree + One
(Both have Medicare)		 $192.40 $467.50
2   Both elect a new Plan
-
-
$30.00
$15.00
3   One elects a new Plan / one keeps City Plan $98.66 $221.38
$15.00
$7.50
Retiree + One
(Only one has Medicare)		 $197.34 $583.14
4   One elects a new Plan / one keeps City Plan
(less than 65)		 $93.34 $322.00
$15.00
$7.50
5   One elects a new Plan / one keeps City Plan
(age 65+)		 $316.24 $408.78
$15.00
$7.50
Retiree + Family
(Two have Medicare)		 $305.86 $717.38
6   Two elect a new Plan / one keeps City Plan
(less than 65)		 $93.34 $322.00
$30.00
$15.00
7   Two elect a new Plan / two keep City Plan
(both are less than 65)		 $275.36 $726.26
$30.00
$15.00
8   Two elect a new Plan / two+ keep City Plan
(all are less than 65)		 $429.38 $1,120.58
$30.00
$15.00
9   One elects a new Plan / two keep City Plan
(1 is 65+, 1 is less than 65)		 $197.34 $583.14
$15.00
$7.50
10   One elects a new Plan / two+ keep City Plan
(1 is 65+, 2 are less than 65)		 $335.48 $737.58
$15.00
$7.50
Retiree + Family
(Two with Medicare + one 65+ w/o Medicare)		 $305.86 $717.38    
11   Two elect a new Plan / one keeps City Plan
(65+ w/o Medicare)		 $316.24 $408.78
$30.00
$15.00
12   Two elect a new Plan / two keep City Plan
(1 is 65+, 1 is less than 65)		 $664.10 $858.44
$30.00
$15.00
Retiree + Family
(Three w/Medicare)		 $305.87 $717.39    
13 Three elect a new Plan  
-
-
$45.00
$22.50
14   Three elect a new Plan / one keeps City Plan
(1 is less than 65)		 $93.34 $322.00
$45.00
$22.50
15   Three elect a new Plan / two keep City Plan
(both are less than 65)		 $275.36 $726.26
$45.00
$22.50
16   Three elect a new Plan / two+ keep City Plan
(all are less than 65)		 $429.38 $1,120.58
$45.00
$22.50
17   Two elect a new Plan / one keeps City Plan
(age 65+)		 $98.66 $221.38
$30.00
$15.00
18   Two elect a new Plan / two keep City Plan
(1 is 65+, 1 is less than 65)		 $197.34 $583.14
$30.00
$15.00
19   Two elect a new Plan / two + keep City Plan
(1 is 65+, 2 are less than 65)		 $335.48 $737.58
$30.00
$15.00
20   One elects a new Plan / two keep City Plan
(1 is 65+, 1 is less than 65)		 $197.34 $583.14
$15.00
$7.50
21   One elects a new Plan / two+ keep City Plan
(2 are 65+, 1 is less than 65)		 $305.86 $717.38
$15.00
$7.50
Retiree + Family
(Only one has Medicare)		 $335.48 $737.58    
22   One elects a new   Plan / two keep City Plan
(both are less than 65)		 $275.36 $726.26
$15.00
$7.50
23   One elects a new Plan / two+ keep City Plan
(all are less than 65)		 $429.38 $1,120.58
$15.00
$7.50
24   One elects a new Plan / two keep City Plan
(1 is 65+, 1 is less than 65)		 $664.10 $858.44
$15.00
$7.50
25   One elects a new Plan / two+ keep City Plan
(1 is 65+, 2 are less than 65)		 $1,138.44 $1,471.62
$15.00
$7.50

*Rates displayed for the HMO and PPO are for participants who do not use tobacco products. If the participant or a family member uses tobacco products, the rate is $25 higher per month. This additional amount does not apply to TexanPlus or Texas HealthSpring.

HMO Blue Texas Rates for Retirees

 

Coverage Category
HMO
PPO / OOA
Retirees under 65 - Monthly contributions
Retiree only $93.34 $322.00
Retiree + Spouse $275.36 $726.26
Retiree + Family $429.38 $1,120.58
Retirees over 65 without Medicare - Monthly contributions
Retiree only $316.24 $408.78
Retiree + Spouse $664.10 $858.44
Retiree + Family $1,138.44 $1,471.62
Retirees over 65 with Medicare - Monthly contributions
Retiree w/Medicare $98.66 $221.38
Retiree + Spouse (1 w/Medicare) $197.34 $583.14
Retiree + Spouse (2 w/Medicare) $192.40 $467.50
Retiree + Family (1 w/Medicare) $335.48 $737.58
Retiree + Family (2 w/Medicare) $305.86 $717.38

If you or a covered family member use a tobacco product, add $25 to the rates shown above.

Coverage Category Plan A Participant Contribution
Plan A (monthly) Nontobacco user's discount rate Tobacco-user's rate
Retiree only
$21.34
$46.34
Retiree +1
$40.96
$65.96
Retiree +2 or more
$53.52
$78.52

 

 

 

Disease Prevention Discount Program

Studies show that people who use tobacco are more likely to have higher medical claims and are hospitalized longer. They are also more likely to have smoking as a primary contributor to illnesses like heart, lung and pulmonary diseases that generally require long-term and costly medical intervention.

For these reasons and others, employees, retirees and their covered dependents who do not use tobacco will pay $25 less each month for health-care coverage. If you are paying the disease prevention discount premium of $25 less per month and use a tobacco product, you could lose medical coverage.
 

 

An example of how to calculate your rate

If some of your covered family members elect a new Medicare Advantage plan and some remain in the HMO or PPO plan, your contribution will be calculated in a different manner.
You are an HMO participant: Retiree + One; both are Medicare eligible, but only one elects a Medicare Advantage plan, (Texas HealthSpring).

Refer to the chart above. Go to the heading, “Retiree + One (Both have Medicare).” On May 1, you will pay $192.40.
Find line #3 that states, “One elects a new Medicare plan / one keeps city plan.” Follow line #3 across adding $98.66 (City HMO rate) + $7.50 (Texas HealthSpring rate).
Your new contribution deducted from your pension check will be $98.66 + $7.50 = $106.16. You save $86.24 per month.

 

  
   

 

 
City of Houston
Health Fair

Thursday
April 21, 2005
9 a.m. to 2 p.m.

George R. Brown
Convention Center
Exhibit Hall A

Wellness Screenings

Goodies & Fun

Door Prizes

Fitness Demonstrations

 
 

 

 

Important note:
If you are enrolled in the medical, dental or supplemental insurance plans and don’t want to make any changes - don’t do anything. Your coverage will remain in effect through April 30, 2006.

Important note: For medical and dental plans, only new enrollees will receive new ID cards for May 1, 2005. Your current ID card has no expiration date. If you need additional or replacement ID cards, order them through the provider, as usual.

 
   

 

 

 

 

 

 

 

 

 

 

 

 

 

    
     

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