Community First Care Plan - Gold
Community First · 2027 plan year
Gold
- Ind. deductible
- $750
- Family deductible
- $1,500
- Ind. OOP max
- $8,500
- Family OOP max
- $17,000
Compare with other Gold plans in TX
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Community First plans in TX
Monthly premiums by age
Rating Area 18
| Age | Individual |
|---|---|
| Under 15 | $381 |
| 21 | $498 |
| 30 | $566 |
| 40 | $637 |
| 50 | $890 |
| 60 | $1,353 |
| 64 and over | $1,495 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $35.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $70.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $250.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | $600.00 |
| Urgent Care Centers or Facilities | $35.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | $50.00 |
| Preferred Brand Drugs | $25.00 |
| Specialty Drugs | 30.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 30.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $35.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | $250.00 |
| Acupuncture | Not covered |
| Allergy Testing | $70.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | $105.00 |
| Chiropractic Care | $70.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 30.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | No charge |
| Dialysis | $105.00 |
| Durable Medical Equipment | $35.00 |
| Emergency Transportation/Ambulance | $250.00 |
| Eye Glasses for Children | $35.00 |
| Habilitation Services | $105.00 |
| Hearing Aids | $70.00 |
| Home Health Care Services | $35.00 |
| Hospice Services | $70.00 |
| Imaging (CT/PET Scans, MRIs) | $125.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | $105.00 |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | $125.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $35.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $105.00 |
| Outpatient Rehabilitation Services | $105.00 |
| Prenatal and Postnatal Care | $35.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | $35.00 |
| Radiation | $105.00 |
| Reconstructive Surgery | 30.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $105.00 |
| Rehabilitative Speech Therapy | $105.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | $35.00 |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $35.00 |
| Transplant | 30.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | $70.00 |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $125.00 |
Plan rules
Service area
This plan covers 1 geographic area.
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