Community Select Silver 019

Community Health Choice · 2027 plan year

Silver
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$10,000
Family OOP max
$20,000

Compare with other Silver plans in TX

Side by side: deductibles, out-of-pocket limits and copays.

More Community Health Choice plans in TX

Monthly premiums by age

Rating Area 10

AgeIndividualIndividual + tobacco
Under 15$435$435
21$569$683
30$646$775
40$727$872
50$1,016$1,219
60$1,544$1,853
64 and over$1,707$2,048

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$15.00

Specialist

BenefitIn-network
Specialist Visit$80.00

Hospital

BenefitIn-network
Emergency Room Services$600.00 Copay with deductible + 40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$900.00 Copay per Stay with deductible + 40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$80.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Non-Preferred Brand Drugs$100.00 Copay after deductible
Preferred Brand Drugs$45.00 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$900.00 Copay per Stay with deductible + 40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$15.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$80.00
AcupunctureNot covered
Allergy Testing$15.00 Copay after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy$80.00 Copay after deductible
Chiropractic Care$80.00 Copay after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$900.00 Copay with deductible + 40.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education$15.00 Copay after deductible
Dialysis$80.00 Copay after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance$80.00 Copay after deductible
Eye Glasses for Children$80.00 Copay after deductible
Habilitation Services$80.00 Copay after deductible
Hearing Aids30.00% Coinsurance after deductible
Home Health Care Services$80.00 Copay after deductible
Hospice Services$80.00 Copay after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy$80.00 Copay after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$40.00 Copay after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$15.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services$65.00
Prenatal and Postnatal Care$80.00 Copay after deductible
Private-Duty NursingNot covered
Prosthetic Devices30.00% Coinsurance after deductible
Radiation$80.00 Copay after deductible
Reconstructive Surgery$900.00 Copay with deductible + 40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$80.00 Copay after deductible
Rehabilitative Speech Therapy$80.00 Copay after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for Children$80.00 Copay after deductible
Routine Foot CareNot covered
Skilled Nursing Facility$900.00 Copay per Stay with deductible + 40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$900.00 Copay per Stay with deductible + 40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$15.00
Transplant$900.00 Copay with deductible + 40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders$80.00
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$40.00 Copay after deductible

Plan rules

Service area

This plan covers 1 geographic area.

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