2021 Gold Plans

2021 Gold Plans

Gold 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.

Gold cheat sheet:

  • Gold plans have the highest premiums.
  • Gold plans have lower out-of-pocket costs.
  • On average, the insurance company pays 80%. You pay 20%.
  • “Get this plan if your doctor knows you better than your spouse.”

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

Which Gold plan is right for you?

  • Enhanced Gold 005
  • Elite Gold 001
  • Elite HSA Gold 14

Community Enhanced Gold 005

Plan Overview

  • No deductible for visits to PCP, Specialists, Urgent Care, or for Generic Medications
  • Free 24/7 Telehealth
  • This plan is best suited for individuals/families who may be managing multiple chronic health conditions and are okay paying higher premiums to keep out-of-pocket costs low.
  • HIOS ID: 27248TX0010005

Summary of Benefits & Coverage

Plan Overview

  • No deductible for visits to PCP, Specialists, Urgent Care, or for Generic Medications
  • Free 24/7 Telehealth
  • This plan is best suited for individuals/families who may be managing multiple chronic health conditions and are okay paying higher premiums to keep out-of-pocket costs low.
  • HIOS ID: 27248TX0010005

Summary of Benefits & Coverage

  • Annual Deductible
    $2,000
  • Maximum out-of-pocket
    $8,550
  • Emergency Room Visits
    25%
  • Inpatient Hospital Stay
    25%
  • PCP
    $20
  • Specialist
    $40
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $20
  • Imaging (CT/MRI/PET)
    25%
  • Speech Therapy
    $40
  • Occupational and Physical Therapy
    $40
  • Laboratory Outpatient and Professional Services
    $20
  • X-rays and Diagnostic Imaging
    $20
  • Skilled Nursing Facility
    25%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    25%
  • Outpatient Surgery Physician/Surgical Services
    25%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $75
  • Specialty Drugs
    35%

Community Elite Gold 001

Plan Overview

  • The Community Elite Gold 001 plan is only offered Off-Exchange.

Community Elite HSA Gold 14

Plan Overview

  • The Community Elite HSA Gold 14 plan is only offered Off-Exchange.

Which Gold plan is right for you?

Community Enhanced Gold 005

Plan Overview

  • No deductible for visits to PCP, Specialists, Urgent Care, or for Generic Medications
  • Free 24/7 Telehealth
  • This plan is best suited for individuals/families who may be managing multiple chronic health conditions and are okay paying higher premiums to keep out-of-pocket costs low.
  • HIOS ID: 27248TX0010005

Summary of Benefits & Coverage

Plan Overview

  • No deductible for visits to PCP, Specialists, Urgent Care, or for Generic Medications
  • Free 24/7 Telehealth
  • This plan is best suited for individuals/families who may be managing multiple chronic health conditions and are okay paying higher premiums to keep out-of-pocket costs low.
  • HIOS ID: 27248TX0010005

Summary of Benefits & Coverage

  • Annual Deductible
    $2,000
  • Maximum out-of-pocket
    $8,550
  • Emergency Room Visits
    25%
  • Inpatient Hospital Stay
    25%
  • PCP
    $20
  • Specialist
    $40
  • Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
    $20
  • Imaging (CT/MRI/PET)
    25%
  • Speech Therapy
    $40
  • Occupational and Physical Therapy
    $40
  • Laboratory Outpatient and Professional Services
    $20
  • X-rays and Diagnostic Imaging
    $20
  • Skilled Nursing Facility
    25%
  • Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)
    25%
  • Outpatient Surgery Physician/Surgical Services
    25%
  • Prescription Drugs: Generics
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $75
  • Specialty Drugs
    35%

Community Elite Gold 001

Plan Overview

  • The Community Elite Gold 001 plan is only offered Off-Exchange.

Community Elite HSA Gold 14

Plan Overview

  • The Community Elite HSA Gold 14 plan is only offered Off-Exchange.

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.

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.

“I always tell people to choose Community Health Choice. I tell them it’s the best health insurance they will ever be with.”

– Chandolyn
Member of Community Health Choice