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2022 Silver Plans

2022 Silver Plans

Silver Plans Overview

Once you understand the differences, it’s easier to find the best plan that fits you and your family. We want you to get all the coverage you need without paying for benefits you don’t.

Silver cheat sheet:

  • Silver plans have mid-range premiums.
  • Silver plans have mid-range out-of-pocket costs.
  • On average, the insurance company pays 70%. You pay 30%.
  • “The comprehensive plan balanced with affordability.”
  • Compare Our Silver Plans

All Community plans come with:

 

Free preventative care

 

24/7/365 Nurse Advice Line

 

Huge doctor & hospital network

 

No referrals for specialists

Questions?

Our hours of operation are 8 a.m. – 5 p.m.

Call Us:
Local: 713.295.6704 Toll-Free 1.855.315.5386

Ready to Enroll

Which Silver plan is right for you?

Download your Evidence of Coverage

View Plan Documents

Community Advance Preferred Silver 004

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or generic medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for people who expect multiple visits to doctors/specialists throughout the year and are willing to pay a little more in premiums for lower out of pocket costs.
  • HIOS ID: 27248TX0010004

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or generic medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for people who expect multiple visits to doctors/specialists throughout the year and are willing to pay a little more in premiums for lower out of pocket costs.
  • HIOS ID: 27248TX0010004

Summary of Benefits & Coverage

View 2022 Advance Preferred Silver 004 Plan Details
  • Annual Deductible
    $3,000
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $110
  • Specialty Drugs
    50%
View 2022 Advance Preferred Silver 004 CSR 73 Plan Details
  • Annual Deductible
    $2,900
  • Maximum out-of-pocket
    $6,900
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $60
  • Non-Preferred Brand
    $100
  • Specialty Drugs
    40%
View 2022 Advance Preferred Silver 004 CSR 87 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,900
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $25
  • Specialist
    $50
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $25
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $50
  • Occupational and Physical Therapy
    $50
  • Laboratory Outpatient and Professional Services
    $25
  • X-rays and Diagnostic Imaging
    $25
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $85
  • Specialty Drugs
    30%
View 2022 Advance Preferred Silver 004 CSR 94 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,900
  • Emergency Room Visits
    10%
  • Inpatient Hospital Stay
    10%
  • PCP
    $10
  • Specialist
    $20
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    10%
  • Speech Therapy
    $10
  • Occupational and Physical Therapy
    $10
  • Laboratory Outpatient and Professional Services
    $10
  • X-rays and Diagnostic Imaging
    $10
  • Skilled Nursing Facility
    10%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    10%
  • Outpatient Surgery Physician/Surgical Services
    10%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty Drugs
    20%

Community Standard Silver 012

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for a lower deductible.
  • HIOS ID: 27248TX00100012

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for a lower deductible.
  • HIOS ID: 27248TX00100012

Summary of Benefits and Coverage

View 2022 Standard Silver 012 Plan Details
  • Annual Deductible
    $6,000
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    50%
  • Inpatient Hospital Stay
    50%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    50%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    50%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    50%
  • Outpatient Surgery Physician/Surgical Services
    50%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty Drugs
    50%
View 2022 Standard Silver 012 CSR 73 Plan Details
  • Annual Deductible
    $6,000
  • Maximum out-of-pocket
    $6,950
  • Emergency Room Visits
    50%
  • Inpatient Hospital Stay
    50%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    50%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    50%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    50%
  • Outpatient Surgery Physician/Surgical Services
    50%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty Drugs
    50%
View 2022 Standard Silver 012 CSR 87 Plan Details
  • Annual Deductible
    $500
  • Maximum out-of-pocket
    $2,850
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $25
  • Specialist
    $50
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $25
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $50
  • Occupational and Physical Therapy
    $50
  • Laboratory Outpatient and Professional Services
    $25
  • X-rays and Diagnostic Imaging
    $25
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    30%
  • Outpatient Surgery Physician/Surgical Services
    30%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $100
  • Specialty Drugs
    40%
View 2022 Standard Silver 012 CSR 94 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,750
  • Emergency Room Visits
    10%
  • Inpatient Hospital Stay
    10%
  • PCP
    $10
  • Specialist
    $20
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    10%
  • Speech Therapy
    $20
  • Occupational and Physical Therapy
    $20
  • Laboratory Outpatient and Professional Services
    $10
  • X-rays and Diagnostic Imaging
    $10
  • Skilled Nursing Facility
    10%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    10%
  • Outpatient Surgery Physician/Surgical Services
    10%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty Drugs
    20%

Community Advance Silver 013

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for lower out of pocket costs.
  • HIOS ID: 27248TX00100013

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for lower out of pocket costs.
  • HIOS ID: 27248TX00100013

Summary of Benefits & Coverage

View 2022 Advance Silver 013 Plan Details
  • Annual Deductible
    $8,700
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 73 Plan Details
  • Annual Deductible
    $6,800
  • Maximum out-of-pocket
    $6,800
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $10
  • Specialist
    $15
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 87 Plan Details
  • Annual Deductible
    $2,300
  • Maximum out-of-pocket
    $2,300
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $10
  • Specialist
    $15
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 94 Plan Details
  • Annual Deductible
    $750
  • Maximum out-of-pocket
    $750
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $5
  • Specialist
    $10
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $5
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible

Community Silver 15 (Limited Network)*

Plan Overview

  • No deductible for Preventive Services, PCP visits, Specialists, and Generic Drugs
  • Free 24/7 telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who don’t mind having a limited provider network in exchange for lower out of pocket costs. Learn more here.
  • HIOS ID: 27248TX0010015

Summary of Benefits & Coverage

Plan Overview

  • No deductible for Preventive Services, PCP visits, Specialists, and Generic Drugs
  • Free 24/7 telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who don’t mind having a limited provider network in exchange for lower out of pocket costs.
  • HIOS ID: 27248TX0010015

Summary of Benefits & Coverage

View 2022 Silver 15 Plan Details
  • Annual Deductible
    Tier 1: $4,000
    Tier 2: $8,700
  • Maximum out-of-pocket
    Tiers 1 and 2: $8,700
  • Emergency Room Visits
    Tier1: 50%
    Tier 2: $0 after deductible
  • Inpatient Hospital Stay
    Tier1: 50%
    Tier 2: $0 after deductible
  • PCP
    Tier1: $0
    Tier 2: $0
  • Specialist
    Tier1: $40
    Tier 2: $0
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    Tier1: $0
    Tier 2: $0
  • Imaging (CT/MRI/PET)
    Tier1: 30%
    Tier 2: $0 after deductible
  • Laboratory Outpatient and Professional Services
    Tier1: $20
    Tier 2: $0 after deductible
  • X-rays and Diagnostic Imaging
    Tier1: $20
    Tier 2: $0 after deductible
  • Skilled Nursing Facility
    Tier1: Not covered
    Tier 2: $0 after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    Tier 1: 30%
    Tier 2: $0 after deductible
  • Outpatient Surgery Physician/Surgical Services
    Tier 1: 30%
    Tier 2: $0 after deductible
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    30%

Specialty Drugs
50%

View 2022 Silver 15 CSR 73 Plan Details
  • Annual Deductible
    Tier 1: $2,200
    Tier 2: $6,800
  • Maximum out-of-pocket
    Tiers 1 and 2: $6,800
  • Emergency Room Visits
    Tier1: 30%
    Tier 2: $0 after deductible
  • Inpatient Hospital Stay
    Tier1: 30%
    Tier 2: $0 after deductible
  • PCP
    Tier1: $0
    Tier 2: $0
  • Specialist
    Tier1: $20
    Tier 2: $0
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    Tier1: $0
    Tier 2: $0
  • Imaging (CT/MRI/PET)
    Tier1: 20%
    Tier 2: $0 after deductible
  • Laboratory Outpatient and Professional Services
    Tier1: $20
    Tier 2: $0 after deductible
  • X-rays and Diagnostic Imaging
    Tier1: $20
    Tier 2: $0 after deductible
  • Skilled Nursing Facility
    Tier1: Not covered
    Tier 2: $0 after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    Tier 1: 20%
    Tier 2: $0 after deductible
  • Outpatient Surgery Physician/Surgical Services
    Tier1: 20%
    Tier 2: $0 after deductible
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    30%

Specialty Drugs
50%

View 2022 Silver 15 87 Plan Details
  • Annual Deductible
    Tier 1: N/A
    Tier 2: $2,900
  • Maximum out-of-pocket
    Tiers 1 and 2: $2,900
  • Emergency Room Visits
    Tier1: 25%
    Tier 2: $0 after deductible
  • Inpatient Hospital Stay
    Tier1: 25%
    Tier 2: $0 after deductible
  • PCP
    Tier1: $0
    Tier 2: $0
  • Specialist
    Tier1: $20
    Tier 2: $0
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    Tier1: $0
    Tier 2: $0
  • Imaging (CT/MRI/PET)
    Tier1: 20%
    Tier 2: $0 after deductible
  • Laboratory Outpatient and Professional Services
    Tier1: $10
    Tier 2: $0 after deductible
  • X-rays and Diagnostic Imaging
    Tier1: $10
    Tier 2: $0 after deductible
  • Skilled Nursing Facility
    Tier1: Not covered
    Tier 2: $0 after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    Tier 1: 15%
    Tier 2: $0 after deductible
  • Outpatient Surgery Physician/Surgical Services
    Tier 1: 15%
    Tier 2: $0 after deductible
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    30%

Specialty Drugs
40%

View 2022 Silver 15 CSR 94 Plan Details
  • Annual Deductible
    Tier 1: N/A
    Tier 2: $1,100
  • Maximum out-of-pocket
    Tiers 1 and 2: $1,100
  • Emergency Room Visits
    Tier 1: 10%
    Tier 2: $0 after deductible
  • Inpatient Hospital Stay
    Tier 1: 10%
    Tier 2: $0 after deductible
  • PCP
    Tier 1: $0
    Tier 2: $0 after deductible
  • Specialist
    Tier 1: $5
    Tier 2: $0 after deductible
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    Tier 1: $0
    Tier 2: $0 after deductible
  • Imaging (CT/MRI/PET)
    Tier 1: 10%
    Tier 2: $0 after deductible
  • Laboratory Outpatient and Professional Services
    Tier 1: $5
    Tier 2: $0 after deductible
  • X-rays and Diagnostic Imaging
    Tier 1: $5
    Tier 2: $0 after deductible
  • Skilled Nursing Facility
    Tier 1: Not Covered
    Tier 2: $0 after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    Tier 1: 10%
    Tier 2: $0 after deductible
  • Outpatient Surgery Physician/Surgical Services
    Tier 1: 10%
    Tier 2: $0 after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    25%
  • Specialty Drugs
    $25

Which Silver plan is right for you?

Standard Preferred Silver 009

Standard Preferred Silver 009

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for families who expect a few doctor appointments throughout the year but no major medical expenses, and who don’t mind paying a little more in premiums for a lower deductible.
  • HIOS ID: 27248TX0010009

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for families who expect a few doctor appointments throughout the year but no major medical expenses, and who don’t mind paying a little more in premiums for a lower deductible.
  • HIOS ID: 27248TX0010009

Summary of Benefits & Coverage

View 2021 Standard Preferred Silver 009 Plan Details
  • Annual Deductible
    $5,000
  • Maximum out-of-pocket
    $7,000
  • Emergency Room Visits
    30%
  • Inpatient Hospital Stay
    30%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    30%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    30%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    30%
  • Outpatient Surgery Physician/Surgical Services
    30%
  • Prescription Drugs: Generics
    $15
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $120
  • Specialty Drugs
    45%
View 2021 Standard Preferred Silver 009 CSR 73 Plan Details
  • Annual Deductible
    $3,000
  • Maximum out-of-pocket
    $6,800
  • Emergency Room Visits
    30%
  • Inpatient Hospital Stay
    30%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    30%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    30%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    30%
  • Outpatient Surgery Physician/Surgical Services
    30%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $60
  • Non-Preferred Brand
    $110
  • Specialty Drugs
    45%
View 2021 Standard Preferred Silver 009 CSR 87 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,850
  • Emergency Room Visits
    30%
  • Inpatient Hospital Stay
    30%
  • PCP
    $25
  • Specialist
    $50
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $25
  • Imaging (CT/MRI/PET)
    30%
  • Speech Therapy
    $50
  • Occupational and Physical Therapy
    $50
  • Laboratory Outpatient and Professional Services
    $25
  • X-rays and Diagnostic Imaging
    $25
  • Skilled Nursing Facility
    30%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    30%
  • Outpatient Surgery Physician/Surgical Services
    30%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $85
  • Specialty Drugs
    30%
View 2021 Standard Preferred Silver 009 CSR 94 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,500
  • Emergency Room Visits
    10%
  • Inpatient Hospital Stay
    10%
  • PCP
    $10
  • Specialist
    $20
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    10%
  • Speech Therapy
    $10
  • Occupational and Physical Therapy
    $10
  • Laboratory Outpatient and Professional Services
    $10
  • X-rays and Diagnostic Imaging
    $10
  • Skilled Nursing Facility
    10%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    10%
  • Outpatient Surgery Physician/Surgical Services
    10%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty Drugs
    20%
Advance Preferred Silver 004

Community Advance Preferred Silver 004

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or generic medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for people who expect multiple visits to doctors/specialists throughout the year and are willing to pay a little more in premiums for lower out of pocket costs.
  • HIOS ID: 27248TX0010004

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or generic medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for people who expect multiple visits to doctors/specialists throughout the year and are willing to pay a little more in premiums for lower out of pocket costs.
  • HIOS ID: 27248TX0010004

Summary of Benefits & Coverage

View 2022 Advance Preferred Silver 004 Plan Details
  • Annual Deductible
    $3,000
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $110
  • Specialty Drugs
    50%
View 2022 Advance Preferred Silver 004 CSR 73 Plan Details
  • Annual Deductible
    $2,900
  • Maximum out-of-pocket
    $6,900
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $60
  • Non-Preferred Brand
    $100
  • Specialty Drugs
    40%
View 2022 Advance Preferred Silver 004 CSR 87 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,900
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $25
  • Specialist
    $50
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $25
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $50
  • Occupational and Physical Therapy
    $50
  • Laboratory Outpatient and Professional Services
    $25
  • X-rays and Diagnostic Imaging
    $25
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    40%
  • Outpatient Surgery Physician/Surgical Services
    40%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $85
  • Specialty Drugs
    30%
View 2022 Advance Preferred Silver 004 CSR 94 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,900
  • Emergency Room Visits
    10%
  • Inpatient Hospital Stay
    10%
  • PCP
    $10
  • Specialist
    $20
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    10%
  • Speech Therapy
    $10
  • Occupational and Physical Therapy
    $10
  • Laboratory Outpatient and Professional Services
    $10
  • X-rays and Diagnostic Imaging
    $10
  • Skilled Nursing Facility
    10%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    10%
  • Outpatient Surgery Physician/Surgical Services
    10%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty Drugs
    20%
Standard Silver 12

Community Standard Silver 012

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for a lower deductible.
  • HIOS ID: 27248TX00100012

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, Urgent Care visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for a lower deductible.
  • HIOS ID: 27248TX00100012

Summary of Benefits and Coverage

View 2022 Standard Silver 012 Plan Details
  • Annual Deductible
    $6,000
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    50%
  • Inpatient Hospital Stay
    50%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    50%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    50%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    50%
  • Outpatient Surgery Physician/Surgical Services
    50%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty Drugs
    50%
View 2022 Standard Silver 012 CSR 73 Plan Details
  • Annual Deductible
    $6,000
  • Maximum out-of-pocket
    $6,950
  • Emergency Room Visits
    50%
  • Inpatient Hospital Stay
    50%
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    50%
  • Speech Therapy
    $60
  • Occupational and Physical Therapy
    $60
  • Laboratory Outpatient and Professional Services
    $30
  • X-rays and Diagnostic Imaging
    $30
  • Skilled Nursing Facility
    50%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    50%
  • Outpatient Surgery Physician/Surgical Services
    50%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty Drugs
    50%
View 2022 Standard Silver 012 CSR 87 Plan Details
  • Annual Deductible
    $500
  • Maximum out-of-pocket
    $2,850
  • Emergency Room Visits
    40%
  • Inpatient Hospital Stay
    40%
  • PCP
    $25
  • Specialist
    $50
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $25
  • Imaging (CT/MRI/PET)
    40%
  • Speech Therapy
    $50
  • Occupational and Physical Therapy
    $50
  • Laboratory Outpatient and Professional Services
    $25
  • X-rays and Diagnostic Imaging
    $25
  • Skilled Nursing Facility
    40%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    30%
  • Outpatient Surgery Physician/Surgical Services
    30%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $100
  • Specialty Drugs
    40%
View 2022 Standard Silver 012 CSR 94 Plan Details
  • Annual Deductible
    $0
  • Maximum out-of-pocket
    $2,750
  • Emergency Room Visits
    10%
  • Inpatient Hospital Stay
    10%
  • PCP
    $10
  • Specialist
    $20
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    10%
  • Speech Therapy
    $20
  • Occupational and Physical Therapy
    $20
  • Laboratory Outpatient and Professional Services
    $10
  • X-rays and Diagnostic Imaging
    $10
  • Skilled Nursing Facility
    10%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    10%
  • Outpatient Surgery Physician/Surgical Services
    10%
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty Drugs
    20%
Advance Silver 13

Community Advance Silver 013

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for lower out of pocket costs.
  • HIOS ID: 27248TX00100013

Summary of Benefits & Coverage

Plan Overview

  • No deductible for PCP visits, urgent care visits, specialist visits, or Generic Medications
  • Free 24/7 Telehealth
  • Eligible for cost-sharing reductions
  • This plan is best suited for individuals and families whose income qualifies them for extra savings known as cost-sharing reductions, and who are willing to pay a higher premium for lower out of pocket costs.
  • HIOS ID: 27248TX00100013

Summary of Benefits & Coverage

View 2022 Advance Silver 013 Plan Details
  • Annual Deductible
    $8,700
  • Maximum out-of-pocket
    $8,700
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $30
  • Specialist
    $60
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $30
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 73 Plan Details
  • Annual Deductible
    $6,800
  • Maximum out-of-pocket
    $6,800
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $10
  • Specialist
    $15
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 87 Plan Details
  • Annual Deductible
    $2,300
  • Maximum out-of-pocket
    $2,300
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $10
  • Specialist
    $15
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $10
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible
View 2022 Advance Silver 013 CSR 94 Plan Details
  • Annual Deductible
    $750
  • Maximum out-of-pocket
    $750
  • Emergency Room Visits
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • PCP
    $5
  • Specialist
    $10
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $5
  • Imaging (CT/MRI/PET)
    No charge after deductible
  • Speech Therapy
    No charge after deductible
  • Occupational and Physical Therapy
    No charge after deductible
  • Laboratory Outpatient and Professional Services
    No charge after deductible
  • X-rays and Diagnostic Imaging
    No charge after deductible
  • Skilled Nursing Facility
    No charge after deductible
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    No charge after deductible
  • Outpatient Surgery Physician/Surgical Services
    No charge after deductible
  • Prescription Drugs: Generics
    $5
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty Drugs
    No charge after deductible

Download your Evidence of Coverage

View Plan Documents

Local and Neighborly

What does it mean when we say we are local? It means that our service area is 20 counties in the Greater Houston and Beaumont areas. It means that our Providers and facilities are near to you. That’s why we partner with about 7,500 Providers across 20 counties in Southeast Texas, including doctors and clinics at integrated-care organizations. The doctors and facilities and specialists that you see in your times of need are nearby and neighborly.

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Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”

– Cecily
Member of Community Health Choice
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Medicaid
Health Plan
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03/01/2027

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