Pre-65 Medicare-Eligible Health Care

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The information on this page applies to pre-65 retirees who are eligible for Medicare.

You can be eligible for Medicare before age 65 if you have received Social Security Disability benefits for 24 months or if you have end-stage renal disease or amyotrophic lateral sclerosis (ALS). If you have active employee coverage at the time of your retirement, your active coverage will continue through the end of the month in which you retire. Retiree coverage begins on the first of the month following retirement.

Choosing the right medical coverage in retirement is an important part of managing both your health and your expenses. If you are under age 65 and not yet eligible for Medicare, Atmos Energy offers three medical plan options—HDHP, PPO, and EPO—so you can select the level of coverage and flexibility that best fits your needs and budget. As you evaluate your options, consider how often you expect to use care, the providers you prefer, and how much you’re comfortable paying each month versus out of pocket when you receive care.

Medical

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Exclusive Provider Organization (EPO)

The EPO Plan has the highest premiums but the lowest deductible, offering more predictable costs when you receive care. You’ll pay copays for visits to primary care providers, specialists, urgent care centers, and the ER, while eligible preventive services are covered at 100% with no copay. Copays count toward your out-of-pocket maximum but do not apply to your deductible. Once you meet your deductible, the plan pays 100% of covered services for the rest of the year.

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Preferred Provider Organization (PPO)

The PPO Plan offers a balance of cost and flexibility, with mid-range premiums and deductibles. You’ll pay copays for in-network visits to primary care providers, specialists, and urgent care, while in-network preventive services are covered at 100% with no copay. Copays count toward your out-of-pocket maximum but do not apply to your deductible. After you meet your deductible, the plan pays 80% of covered in-network services, and once you reach your out-of-pocket maximum, the plan pays 100% of covered costs for the rest of the year.

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High Deductible Health Plan (HDHP)

The HDHP offers the lowest monthly premium but has the highest deductible, meaning you pay more upfront when you receive care. You’ll pay the full cost for most services—including doctor visits and many prescriptions—until you meet your deductible. However, in-network preventive care is covered at 100%, and certain preventive medications have the same copay as the PPO and EPO plans.

Once you meet your individual or family deductible, the plan pays 100% of covered in-network services for the rest of the year. Each covered family member must meet their individual deductible before most benefits begin (except preventive care). Once your out-of-pocket maximum is reached, the plan pays 100% of covered costs for the rest of the calendar year. Under family coverage, when two members meet the deductible, the full family out-of-pocket maximum is considered met—meaning all covered services are then paid at 100% for every covered family member.

Keep in mind that using out-of-network providers will result in higher costs. If you go to an out-of-network provider, you may need to manually submit a claim form.

If you enroll in the HDHP, you may be eligible for a Health Savings Account (HSA) and a Limited Purpose Flexible Spending Account (FSA). NOTE: When you become Medicare eligible, you will incur tax penalties if you continue to contribute to an HSA plan. We recommend you consult with your tax or financial advisor for guidance.

Compare the Plans
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EPO
PPO
HDHP
In-network only
In-network
Out-of-network
In-network
Out-of-network
What you pay
Primary care physician
$20 copay
Deductible and coinsurance
Deductible and coinsurance
Specialist
$30 copay
Urgent care
$35 copay
ER visit
$75 copay
Inpatient hospital stay
$200 per confinement
Preventive care services
$20 copay
Deductible and coinsurance; $300 annual limit
MDLIVE Virtual Visits
$20 copay
Deductible
Individual
$0
$250
$400
Family
$0
$500
$800
Company coinsurance after deductible
100%
90%
70%
80%
Retiree coinsurance after deductible
0%
10%
30%
20%
Medical out-of-pocket maximum
Individual
$0
$1,250
$2,500
$2,500
Family
$0
$2,500
$5,000
$5,000
Lifetime maximum
$2,000,000
$2,000,000
$2,000,000
For Your Spouse/Dependents

If you are Medicare-eligible but your spouse and/or dependent(s) are under age 65 and not Medicare-eligible, they may enroll in Atmos Energy’s Pre-65 Retiree Medical Plan through BCBSTX.

  • They may choose from the EPO, PPO, or HDHP options.
  • They will receive separate ID cards and have prescription drug coverage through Prime Therapeutics.
  • Premiums are shared between you and Atmos Energy and are either deducted from your pension or billed by HealthEquity/WageWorks.
Find an In-Network Provider
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You can find a provider in the BCBS network online or by phone.

Online
  1. Click here.
  2. Scroll down and click Search as a Guest.
  3. Enter your city, state, or ZIP code in the field and click Continue.
  4. Click Employer Plans.
  5. Choose your state from the dropdown and click Select State.
  6. Click PPO and then choose Blue Choice PPOSM [BCA]. Click Search Selected Plan for Doctors.‍
    • Note: The Blue Choice PPO network physicians and facilities are providers for all of the Atmos Energy plans.
  7. Enter a search term in the field or browse by category.
By Phone

Call BCBSTX at 866-314-0266 to find out if your current providers are in-network.

Rightway

Rightway can help you find in-network providers and make informed decisions about your care. Visit member.rightwayhealthcare.com, call 833-543-6336, email healthguide@rightwayhealthcare.com, or download the Rightway app.

2026 Monthly Medical Premiums
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Premiums are paid on a monthly basis and are based on the plan option and level of coverage you select.

Retiree Only
Retiree + Spouse
Retiree + Child(ren)
Retiree + Family
Retiree and spouse BOTH pre-65 Medicare-eligible
EPO
$61.44
$120.65
$220.52
$280.34
PPO
$45.80
$91.60
$165.52
$213.73
HDHP
$43.57
$88.25
$157.08
$201.01
Learn More

If you have questions about your coverage or need help understanding your benefits, contact BCBSTX Customer Service at 866-314-0266.

Virtual Care through MDLIVE

MDLIVE Virtual Visits are available for a low $20 copay. Learn more here.

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Hearing Aid Coverage

Hearing aid benefits through BCBSTX are provided under the Atmos Energy Retiree Medical Plan. When you use an in-network provider, they agree to accept contracted rates as payment in full for covered basic hearing aids. You will save the most when you stay in the network; costs will be higher if you choose an out-of-network provider.

About Hearing Aid Coverage
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The plan covers one basic hearing aid per ear every 36 months, up to the contracted amount. If you choose a device that is upgraded, enhanced, or priced above the contracted rate, you will be responsible for the difference. Because pricing and contracted amounts can vary by provider and location, it’s important to review your options carefully before making a selection.

To better understand your costs, ask your provider to confirm coverage with BCBSTX for the specific hearing aid you’re considering. This will help you know what’s covered and what you may need to pay out of pocket.

Get the Most from Your Coverage
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Confirm your provider is in-network before your visit:

Verify coverage in advance for the specific hearing aid model you’re considering

Review documents carefully before signing to ensure you understand any costs you may be responsible for

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Prescription Drugs

Atmos Energy provides prescription drug coverage through Prime Therapeutics for pre-65 Medicare-eligible employees and covered family members enrolled in the Atmos Energy Retiree Medical Plan. The Medicare-eligible prescription drug program is the same for all medical plans: EPO, PPO, and HDHP.

Your enrollment is coordinated by BCBSTX with Blue MedicareRx.

Specialty prescription coverage is administered by Accredo.

Blue MedicareRx Plan Design
Retail and Mail Order
Initial phases (up to OOP of $2,100): generic, brand-name, specialty
25% coinsurance, $175 maximum (per prescription)
Catastrophic phase (after $2,100 OOP)
$0
2026 Monthly Rates for Medicare Part D Plus Plan
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If you elect coverage in the Medicare Part D Plus Plan, you and Atmos Energy share the monthly cost for coverage. Costs are based on the option and level of coverage you select and whether you and/or your spouse and dependents are eligible for Medicare.

If you are eligible for Medicare and you elect to cover your dependents who are not Medicare-eligible, they will be enrolled in the Pre-65 Retiree Medical Plan.

Monthly prescription premiums will be displayed on your statement as itemized charges for the Atmos Energy Medicare Part D Prescription Plus Plan.

Retiree Only
Retiree + Spouse
Retiree + Child(ren)
Retiree + Family
Retiree and spouse BOTH pre-65 Medicare-eligible
Part D Plus Plan
$117.29
$234.57
$234.57*
$351.87*
*Rates in the table apply ONLY to Medicare-eligible participants and assume one dependent child in the child/family options. Additional Medicare-eligible dependents will increase the rate. Contact the Atmos Energy Benefits Team for your rates.
Generic, Preferred, and Non-Preferred Drugs
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Generic drugs generally save you the most money. Brand-name drugs on the Preferred Drug List are available at a lower cost to you. Brand-name drugs on the Non-Preferred Drug List are still available, but your cost will be higher. The Preferred Drug List is available on myprime.com, or you can call 866-314-0266.

Find an In-Network Retail Pharmacy
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Most large national chain pharmacies participate in the Prime Therapeutics network. To find pharmacies in your area, go to myprime.com or call 866-314-0266. Or you can present your Blue MedicareRx ID card to pharmacy staff, and they will verify your eligibility.

Mail Order Program
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You may save money on maintenance medications by using the mail order program. Ask your doctor for a 90-day prescription with refills, and ensure that it includes the patient’s full name, the doctor’s name, and the exact medication details (strength, quantity, and dosage). For more information or to get started, visit express-scripts.com/rx or call 833-715-0942.

You have options for mail order pharmacies:

Learn More
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For questions about your prescription drug coverage and to access drug lists, drug cost estimates, pharmacy locations, the prime mail profile, and the prime mail order form, go to myprime.com or call 866-314-0266.

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Dental

Atmos Energy offers dental coverage through BlueCare Dental, part of BCBSTX, for pre-65 retirees and eligible family members. Your benefits vary based on the type of service—preventive, basic, major, or orthodontia. In addition to comprehensive dental coverage, BlueCare Dental offers tools and information through its Dental Wellness Center® to help you make better dental care choices.

Your level of dental coverage does not need to be the same level of coverage you select for medical.

Coverage
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Annual Deductible
Coverage
Maximum

Preventive care

  • Oral exams/cleanings – Two per year (plus one for expectant mothers)
  • Bite-wing X-ray – One per year
  • Panoramic X-ray – One every five years
None
100%
N/A
Basic treatment
‍Includes cavity fillings, root canals, gum treatment, and oral surgery
$50
(combined Basic and Major)
80%
$2,000 per person annually (combined Basic and Major)
Major treatment
Includes crowns, dentures, implants, and bridgework
$50
(combined Basic and Major)
50%
$2,000 per person annually (combined Basic and Major)
Orthodontia
‍Child and adult orthodontics
None
50%
$2,000 lifetime limit per person
Providers
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The BlueCare Dental PPO plan allows you to visit any licensed dentist, but choosing an in-network provider can help you pay less and get the most from your benefits:

  • Lower costs: Dentists agree to negotiated rates, so you pay less.
  • No surprise charges: You won’t be billed above the allowed amount (only your deductible, copay, or coinsurance applies).
  • No referrals needed: You can see a specialist without a referral.
  • Less paperwork: Your dentist files claims for you.
  • Large network: Access to over 137,000 dentists nationwide, including 25,000 specialists.

To find an in-network provider, click here and choose BlueCare DentalSM. Then enter your location information and click Find a Dentist. You can also call BCBSTX at 866-314-0266 to determine if your current provider is in-network.

If you use an out-of-network provider, you may need to submit a claim manually using this form.

ID Cards
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Your dental ID card is different from your medical ID card. Need to print a copy of your ID card? Log in to bcbstx.com.

2026 Monthly Dental Costs
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Dental premiums are paid on a monthly basis. Premiums are based on the plan option and level of coverage you select and whether you and/or your spouse are age 65 or older.

  • For spouses under 65: If you are 65 or over but your spouse is under 65, your spouse will pay the Retiree Only rate or Retiree + Children rate listed in the table.
Coverage Level
Retiree and Spouse Under 65
Retiree
$8.67
Retiree + Spouse
$15.17
Retiree + Child(ren)
$15.17
Retiree + Family
$23.83
Need Help with Your Dental Benefits?
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If you have questions about your dental coverage, contact BCBSTX Dental Customer Service for support. Customer Advocates can help you:

  • Understand your benefits, claims, and eligibility
  • Find an in-network dentist near you
  • Get answers to coverage and cost questions

Call 866-314-0266 from Monday to Friday, 8 a.m. to 6 p.m. CT.

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Vision

Atmos Energy offers vision coverage through EyeMed for pre-65 retirees and eligible family members. The plan includes coverage for comprehensive eye exams, frames and lenses, or contact lenses. You can choose to see in- or out-of-network providers, but you’ll typically pay less when you use an in-network provider. The plan also offers discounts on additional services and items not fully covered.

Your level of vision coverage does not need to be the same level of coverage you select for medical.

Coverage
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In-Network
Out-of-Network (Copay Applies)
Exams (one exam every year)
By an ophthalmologist or optometrist
$10 copay
Reimbursement up to $42
Retinal imaging
$0 copay
Reimbursement up to $20
Eyewear (standard lenses, per pair)*
Single vision
$10 copay
Reimbursement up to $42
Bifocal
$10 copay
Reimbursement up to $56
Trifocal
$10 copay
Reimbursement up to $71
Lenticular
$10 copay
Reimbursement up to $94
Frames (one frame every year with eyeglass lenses or contact lenses)
Frames (standard) per pair
100% up to $130
Reimbursement up to $93
Contact lenses (per pair)*
Contact lens fitting
$25 copay: One per 12 months
Reimbursement up to $42
Conventional lenses
$130 allowance, 15% off amount over $130
Reimbursement up to $110
Disposable lenses*
$130 allowance
Reimbursement up to $110
* Plan covers either eyeglass lenses or contact lenses every calendar year.
Providers
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The EyeMed vision plan allows you to visit any licensed dentist, but choosing an in-network provider can help you pay less and get the most from your benefits.

‍To find an in-network provider, click here. In the Network field, choose Insight Network and then enter your location details. You can also call EyeMed at 866-800-5457 to determine if your current provider is in-network.

If you use an out-of-network provider, you may need to submit a claim manually using this form.

2026 Monthly Vision Costs
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Vision premiums are paid on a monthly basis. Premiums are based on the plan option and level of coverage you select and whether you and/or your spouse are age 65 or older.

For spouses under 65: If you are 65 or over but your spouse is under 65, your spouse will pay the Retiree Only rate or Retiree + Children rate listed in the table.

Coverage Level
Retiree and Spouse Under 65
Retiree
$7.21
Retiree + Spouse
$15.51
Retiree + Child(ren)
$11.71
Retiree + Family
$21.30
Cost Transparency Tool
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Learn how to use the Cost Transparency Tool to estimate your costs before receiving care.

ID Cards
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EyeMed does not distribute ID cards. Simply inform your provider that you are an EyeMed member or access your ID card by logging in to EyeMed.com.

Discounts
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EyeMed offers discounts on upgraded eyeglass lens options, as well as on certain elective procedures such as LASIK, other refractive surgeries, cosmetic eyelid surgery, and more. These discounts are available only when you use an EyeMed in-network provider in the Insight Network who is identified in the provider directory as participating in these discount programs.

Lens Discounts

Member’s In-Network Cost
Lens Options
Photochromic (plastic)
$75
Tint (solid and gradient)
$15
UV Treatment
$15
Standard plastic scratch coating
$15
Standard polycarbonate (age 19 and over)
$40
Premium Anti-Reflective Coatings
Standard
$45
Tier 1
$57
Tier 2
$68
Tier 3
20% off retail price
Other add-on services and materials
20% off retail price

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Additional Member Discounts

  • 40% off additional pairs of glasses and 15% off conventional lenses after your funded benefit is used
  • 20% off items not covered by the plan, including non-prescription sunglasses
  • LASIK/PRK discounts through the US Laser Network: 15% off retail or 5% off promotional pricing
  • Hearing care savings through Amplifon: 40% off exams and a low-price guarantee on hearing aids
Need Help with Your Vision Benefits?
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Go to EyeMed.com or download the mobile app. You can also call EyeMed at 866-800-5457.

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Free Support with Rightway

Finding the provider and navigating your medical care doesn’t have to be complicated. With Rightway, pre-65 retirees have free, personalized support to help you choose high-quality providers, schedule care, and make informed decisions about your health. Rightway acts as your healthcare advocate, offering access to a dedicated clinical team and an easy-to-use portal. Rightway can help you:

  • Find doctors, dentists, optometrists, and specialists based on your needs, preferences, and location
  • Coordinate and schedule appointments—saving you time and effort
  • Navigate your care and make confident healthcare decisions

Rightway is available at no cost to pre-65 retirees. To get started, go to member.rightwayhealthcare.com, call 833-543-6336, email healthguide@rightwayhealthcare.com, or download the Rightway app.

Learn more about Rightway here.

The Fine Print

To access legal notices, SPDs, SARs, and other disclosures, visit the Document Library.

Need Assistance?

Atmos Energy Benefits Team

800-888-0149
800-888-0149
retiree@atmosenergy.com
retiree@atmosenergy.com
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