CHRISTUS Gold Essential ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care)
CHRISTUS Health Plan · 2026 plan year
Gold
- Ind. medical deductible
- $3,750
- Rx deductible (separate)
- $0
- Family deductible
- $7,500
- Ind. OOP max
- $9,200
- Family OOP max
- $18,400
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
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 CHRISTUS Health Plan plans in TX
Monthly premiums by age
Rating Area 15 — the lowest-priced of the 10 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $308 | $308 |
| 21 | $402 | $603 |
| 30 | $457 | $685 |
| 40 | $514 | $771 |
| 50 | $719 | $1,078 |
| 60 | $1,092 | $1,638 |
| 64 and over | $1,207 | $1,810 |
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 | $5.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $35.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $950.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | $950.00 Copay per Stay after deductible |
| Outpatient Surgery Physician/Surgical Services | 30.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $35.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | $60.00 |
| Off Label Prescription Drugs | 30.00% Coinsurance after deductible |
| Preferred Brand Drugs | $50.00 |
| Prescription Drugs Other | 30.00% Coinsurance after deductible |
| Specialty Drugs | 45.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $950.00 Copay per Stay after deductible |
| Mental/Behavioral Health Outpatient Services | $25.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 30.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $35.00 |
| Autism Spectrum Disorders | $5.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | 20.00% |
| Brain Injury | 30.00% Coinsurance after deductible |
| Chemotherapy | 30.00% Coinsurance after deductible |
| Chiropractic Care | $25.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $950.00 Copay after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Care Management | $5.00 |
| Diabetes Education | No charge |
| Dialysis | 30.00% Coinsurance after deductible |
| Durable Medical Equipment | 30.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 30.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Gender Affirming Care | Not covered |
| Habilitation Services | $25.00 |
| Hearing Aids | 30.00% Coinsurance after deductible |
| Home Health Care Services | 30.00% Coinsurance after deductible |
| Hospice Services | 30.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $200.00 Copay after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | $35.00 |
| Inherited Metabolic Disorder - PKU | 30.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | $30.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | 50.00% |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 50.00% |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $35.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 30.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $25.00 |
| Pediatric Services Other | 30.00% Coinsurance after deductible |
| Post-Mastectomy Care | $35.00 |
| Prenatal and Postnatal Care | $35.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 30.00% Coinsurance after deductible |
| Radiation | 30.00% Coinsurance after deductible |
| Reconstructive Surgery | 30.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $25.00 |
| Rehabilitative Speech Therapy | $25.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | $950.00 Copay per Stay after deductible |
| Substance Abuse Disorder Outpatient Services | $25.00 |
| Transplant | $950.00 Copay after deductible |
| Transplant Donor Coverage | 30.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 30.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $20.00 |
Plan rules
Service area
This plan covers 38 geographic areas. One of them is covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
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