2023 Silver Plans

2023 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.”

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:

Preventive Services

One of the largest Provider
and facilities network in
Southeast 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

Which Silver plan is right for you?

Plan Overview

Important Features of 2023 Premier Silver 004 Plan:
Things to Keep in Mind:

The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Silver plan.

View Quick Reference Guide

Summary of Benefits
and Coverage

Off-Exchange

Download PDF

On-Exchange

Download PDF

Zero Cost-Sharing 02

Download PDF

Limited Cost-Sharing 03

Download PDF

73% AV Level

Download PDF

87% AV Level

Download PDF

94% AV Level

Download PDF

  • Medical Deductible (Individual) Medical and Drug:
    $3,300
  • Maximum Out-of-Pocket (Individual)
    $9,100
  • Primary Care Physician Office Visit
    $30*
  • Specialist Office Visit
    $60*
  • Urgent Care Visit
    $60*
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $110
  • Specialty High-Cost Drugs
    50%

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    $3,200
  • Maximum Out-of-Pocket (Individual)
    $7,250
  • Primary Care Physician Office Visit
    $30*
  • Specialist Office Visit
    $60*
  • Urgent Care Visit
    $60*
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $60
  • Non-Preferred Brand
    $110
  • Specialty High-Cost Drugs
    40%

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    N/A
  • Maximum Out-of-Pocket (Individual)
    $2,900
  • Primary Care Physician Office Visit
    $25
  • Specialist Office Visit
    $50
  • Urgent Care Visit
    $50
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    N/A
  • Generic
    $10
  • Preferred Brand
    $50
  • Non-Preferred Brand
    $85
  • Specialty High-Cost Drugs
    30%

  • Medical Deductible (Individual):
    N/A
  • Maximum Out-of-Pocket (Individual)
    $2,000
  • Primary Care Physician Office Visit
    $10
  • Specialist Office Visit
    $20
  • Urgent Care Visit
    $20
  • Emergency Room Visit
    10%
  • Inpatient Hospital Stay
    10%
  • Prescription Drug Deductible
    N/A
  • Generic
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty High-Cost Drugs
    20%

Plan Overview

Important Features of 2023 Premier Silver 12 Plan:
Things to Keep in Mind:

The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Silver plan.

View Quick Reference Guide

Summary of Benefits
and Coverage

Off-Exchange

Download PDF

On-Exchange

Download PDF

Zero Cost

Download PDF

Limited Cost

Download PDF

73% AV Level

Download PDF

87% AV Level

Download PDF

94% AV Level

Download PDF

  • Medical Deductible (Individual) Medical and Drug:
    $3,000
  • Maximum Out-of-Pocket (Individual)
    $9,100
  • Primary Care Physician Office Visit
    $30*
  • Urgent Care Visit
    $60*
  • Emergency Room Visit
    50%
  • Inpatient Hospital Stay
    50%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty High-Cost Drugs
    50%

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    $2,500
  • Maximum Out-of-Pocket (Individual)
    $6,950
  • Primary Care Physician Office Visit
    $30*
  • Urgent Care Visit
    $60*
  • Emergency Room Visit
    50%
  • Inpatient Hospital Stay
    50%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $80
  • Non-Preferred Brand
    $120
  • Specialty High-Cost Drugs
    50%

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    $500
  • Maximum Out-of-Pocket (Individual)
    $2,500
  • Primary Care Physician Office Visit
    $25*
  • Specialist Office Visit
    $50
    Urgent Care Visit
    $50*
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $5*
  • Preferred Brand
    $70
  • Non-Preferred Brand
    $1000
  • Specialty High-Cost Drugs
    40%

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    N/A
  • Maximum Out-of-Pocket (Individual)
    $1,800
  • Primary Care Physician Office Visit
    $10
  • Specialist Office Visit
    $20
  • Urgent Care Visit
    $20
  • Emergency Room Visit
    10%
  • Inpatient Hospital Stay
    10%
  • Prescription Drug Deductible
    N/A
  • Generic
    $5
  • Preferred Brand
    $20
  • Non-Preferred Brand
    $40
  • Specialty High-Cost Drugs
    20%

 

Plan Overview

Important Features of 2023 Premier Silver 13 Plan:
Things to Keep in Mind:

The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Silver plan.

View Quick Reference Guide

Summary of Benefits
and Coverage

Off-Exchange

Download PDF

On-Exchange

Download PDF

Zero Cost

Download PDF

Limited Cost

Download PDF

73% AV Level

Download PDF

87% AV Level

Download PDF

94% AV Level

Download PDF

  • Medical Deductible (Individual)
    $8,500
  • Maximum Out-of-Pocket (Individual)
    $8,500
  • Primary Care Physician Office Visit
    $10*
  • Specialist Office Visit
    $20*
  • Urgent Care Visit
    $20*
  • Emergency Room Visit
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty High-Cost Drugs
    No charge after deductible

*Services are exempt from deductible where indicated (PCP/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    $6,800
  • Maximum Out-of-Pocket (Individual)
    $6,800
  • Primary Care Physician Office Visit
    $10*
  • Specialist Office Visit
    $15
  • Urgent Care Visit
    $20*
  • Emergency Room Visit
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    No charge after Deductible
  • Non-Preferred Brand
    No charge after Deductible
  • Specialty High-Cost Drugs
    No charge after Deductible

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    $2,200
  • Maximum Out-of-Pocket (Individual)
    $2,200
  • Primary Care Physician Office Visit
    $10*
  • Specialist Office Visit
    $15*
  • Urgent Care Visit
    $15*
  • Emergency Room Visit
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty High-Cost Drugs
    No charge after deductible

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    $700
  • Maximum Out-of-Pocket (Individual)
    $700
  • Primary Care Physician Office Visit
    $5*
  • Specialist Office Visit
    $10*
  • Urgent Care Visit
    $10*
  • Emergency Room Visit
    No charge after deductible
  • Inpatient Hospital Stay
    No charge after deductible
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    No charge after deductible
  • Non-Preferred Brand
    No charge after deductible
  • Specialty High-Cost Drugs
    No charge after deductible

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

Plan Overview

Important Features of 2023 Select Silver 19 Plan:
Things to Keep in Mind:

The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Silver plan.

View Quick Reference Guide

Summary of Benefits
and Coverage

Off-Exchange

Download PDF

On-Exchange

Download PDF

Zero Cost Variation

Download PDF

AI/AN Limited Cost

Download PDF

73% AV Level

Download PDF

87% AV Level

Download PDF

94% AV Level

Download PDF

  • Medical Deductible (Individual)
    $4,900
  • Maximum Out-of-Pocket (Individual)
    $9,100
  • Primary Care Physician Office Visit
    $30*
  • Specialist Office Visit
    $80*
  • Urgent Care Visit
    $80*
  • Emergency Room Visit
    30%
  • Inpatient Hospital Stay
    30%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $40
  • Non-Preferred Brand
    $80
  • Specialty High-Cost Drugs
    50%

*Services are exempt from deductible where indicated (PCP/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    $4,900
  • Maximum Out-of-Pocket (Individual)
    $9,100
  • Primary Care Physician Office Visit
    $30*
  • Specialist Office Visit
    $80*
  • Urgent Care Visit
    $80*
  • Emergency Room Visit
    30%
  • Inpatient Hospital Stay
    30%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $40
  • Non-Preferred Brand
    $80
  • Specialty High-Cost Drugs
    50%

*Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    $500
  • Maximum Out-of-Pocket (Individual)
    $3,000
  • Primary Care Physician Office Visit
    $20*
  • Specialist Office Visit
    $40*
  • Urgent Care Visit
    $40*
  • Emergency Room Visit
    30%
  • Inpatient Hospital Stay
    30%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $25
  • Non-Preferred Brand
    $60
  • Specialty High-Cost Drugs
    50%

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    N/A
  • Maximum Out-of-Pocket (Individual)
    $1,500
  • Primary Care Physician Office Visit
    $5
  • Specialist Office Visit
    $25
  • Urgent Care Visit
    $25
  • Emergency Room Visit
    10%
  • Inpatient Hospital Stay
    10%
  • Prescription Drug Deductible
    N/A
  • Generic
    $5
  • Preferred Brand
    $15
  • Non-Preferred Brand
    $40
  • Specialty High-Cost Drugs
    30%

Plan Overview

Important Features of 2023 Premier Silver 20 Plan:
Things to Keep in Mind:

The Advanced Premium Tax Credit can lower your monthly payment. If you’re eligible, you can apply it to any Silver plan.

View Quick Reference Guide

Summary of Benefits
and Coverage

Off-Exchange

Download PDF

On-Exchange

Download PDF

Zero Cost Variation

Download PDF

AI/AN Limited Cost

Download PDF

73% AV Level

Download PDF

87% AV Level

Download PDF

94% AV Level

Download PDF

  • Medical Deductible (Individual)
    $5,800
  • Maximum Out-of-Pocket (Individual)
    $8,900
  • Primary Care Physician Office Visit
    $40*
  • Specialist Office Visit
    $80*
  • Urgent Care Visit
    $60*
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $20*
  • Preferred Brand
    $40*
  • Non-Preferred Brand
    $80
  • Specialty High-Cost Drugs
    $350

*Services are exempt from deductible where indicated (PCP/Urgent Care/Generic Rx)

  • Medical Deductible (Individual):
    $5,700
  • Maximum Out-of-Pocket (Individual)
    $7,200
  • Primary Care Physician Office Visit
    $30*
  • Specialist Office Visit
    $60*
  • Urgent Care Visit
    $45*
  • Emergency Room Visit
    40%
  • Inpatient Hospital Stay
    40%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $20*
  • Preferred Brand
    $40*
  • Non-Preferred Brand
    $80
  • Specialty High-Cost Drugs
    $350

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    $800
  • Maximum Out-of-Pocket (Individual)
    $3,000
  • Primary Care Physician Office Visit
    $20*
  • Specialist Office Visit
    $40*
  • Urgent Care Visit
    $30*
  • Emergency Room Visit
    30%
  • Inpatient Hospital Stay
    30%
  • Prescription Drug Deductible
    Combined with Medical Deductible
  • Generic
    $10*
  • Preferred Brand
    $20*
  • Non-Preferred Brand
    $60
  • Specialty High-Cost Drugs
    $250

* Services are exempt from deductible where indicated (PCP/Specialist/Urgent Care/Generic RX)

  • Medical Deductible (Individual):
    N/A
  • Maximum Out-of-Pocket (Individual)
    $1,700
  • Primary Care Physician Office Visit
    $0
  • Specialist Office Visit
    $10
  • Urgent Care Visit
    $5
  • Emergency Room Visit
    25%
  • Inpatient Hospital Stay
    25%
  • Prescription Drug Deductible
    N/A
  • Generic
    $0
  • Preferred Brand
    $15
  • Non-Preferred Brand
    $50
  • Specialty High-Cost Drugs
    $150

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