2023 Gold Plans
2023 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.”
Questions?
Our hours of operation
are 8 a.m. – 5 p.m.
Call Us:
Local: 713.295.6704
Toll-Free: 1.855.315.5386
All Community plans come with:
Preventative Services
One of the largest Provider
and facilities network in
Southwest Texas
Low copay on many
generic drugs
Most primary care visits, specialist visits, urgent care, and generic drugs are not subject to deductible
Free 24/7 telehealth
No referrals needed
for specialists
Preventative Services
Free 24/7 telehealth
One of the largest Provider and facilities network in
Southwest Texas
Low copay on many
generic drugs
No referrals needed
for specialists
Most primary care visits, specialist visits, urgent care, and generic drugs are not subject to deductible
Which Gold plan is right for you?
PREMIER GOLD PLAN 001
MODERATE MONTHLY PREMIUMS
LOW TO MODERATE COST-SHARING
Plan Overview
- Telehealth services available
- Referrals not required to see specialists
- Preventive care available at no cost
- This plan does not have a medical or pharmacy deductible
- Out-of-network services are not covered under this plan
- Prior Authorization/Step Therapy requirements apply to some medical and pharmacy benefits
The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Bronze plan.
Summary of Benefits
and Coverage
Off-Exchange
LOWEST PREMIUMS
HIGHER OUT-OF-POCKET COST FOR SERVICES
|
|
**Copay applies for first 5 days of admission for all inpatient services
PREMIER GOLD PLAN 005
MODERATE MONTHLY PREMIUMS
LOW COST-SHARING
Plan Overview
- PCP, specialist, urgent care, and generic drugs are not subject to deductible
- Telehealth services available
- Referrals not required to see specialists
- Preventive care available at no cost
- Out-of-network services are not covered under this plan
- rior Authorization/Step Therapy requirements apply to some medical and pharmacy benefits
The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to the Gold 005 Plan.
Summary of Benefits
and Coverage
Off-Exchange
On-Exchange
Zero Cost-Sharing
Limited Cost-Sharing
|
|
*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)
PREMIER GOLD PLAN 021
MODERATE MONTHLY PREMIUMS
LOW COST-SHARING
Plan Overview
- PCP, specialist, urgent care, and generic drugs are not subject to deductible
- Telehealth services available
- Referrals not required to see specialists
- Preventive care available at no cost
- Out-of-network services are not covered under this plan
- Prior Authorization/Step Therapy requirements apply to some medical and pharmacy benefits
The Advanced Premium Tax Credit can lower your monthly payment.
Summary of Benefits
and Coverage
Off-Exchange
On-Exchange
Zero Cost-Sharing
Limited Cost-Sharing
|
|
*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)
Download your Evidence Coverage
Evidence of Coverage for Enhanced Gold OO5
Evidence of Coverage for Elite Gold OO1
Evidence of Coverage for Elite Gold O14
View Plan Documents
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
|
|
Community Elite Gold 001
Community Elite HSA Gold 14
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
|
|
Community Elite Gold 001
Community Elite HSA Gold 14
Download your Evidence of Coverage for Gold OO5
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.
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
