Silver Plan Comparison

Compare Our Silver Plans

Of the three categories of Health Insurance Marketplace offered by Community, silver plans fall in the middle. You pay moderate monthly premiums and moderate costs when you need care. And if you qualify for cost sharing reductions, silver plans can help you save a lot of money on deductibles, copayments, and coinsurance.

Use the chart below to compare our silver plans and decide which one works best for you!

Note: Rates are for illustrative purposes only. The monthly premiums in the below chart are based on a 40-year-old non-smoking Harris County resident who receives the maximum amount of subsidies (CSR 94). Your actual monthly premium will depend on several factors including age, income level, family size, geographic location, and tobacco use.

Benefits	Community Advance Preferred Silver 004 (27248TX0010004)	Community Standard Silver 12 (27248TX0010012)	Community Advance Silver 13 (27248TX0010013)	Community Silver 15 (Limited Network)* (27248TX0010015)
Monthly Premium	$122.97	$99.01	$102.16	$50.79
Annual Deductible	$0	$0	$750	Tier 1: $0 Tier 2: $1,100
Annual Out-of-Pocket Maximum	$2,900	$2,750	$750	Tiers 1 and 2: $1,100
Emergency Room Visits	10%	10%	$0 after deductible	Tier 1: 10% Tier 2: $0 after deductible
Inpatient Hospital Stay	10%	10%	$0 after deductible	Tier 1: 10% Tier 2: $0 after deductible
PCP	$10	$10	$5	Tier 1: $0 Tier 2: $0 after deductible
Specialist	$20	$20	$10	Tier 1: $5 Tier 2: $0 after deductible
Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services	$10	$10	$5	Tier 1: $0 Tier 2: $0 after deductible
Imaging (CT/MRI/PET)	10%	10%	$0 after deductible	Tier 1: 10% Tier 2: $0 after deductible
Speech Therapy	$10	$20	$0 after deductible	Tier 1: $10 Tier 2: $0 after deductible
Occupational and Physical Therapy	$10	$20	$0 after deductible	Tier 1: $10 Tier 2: $0 after deductible
Preventive Care/Screening/Immunization	$0	$0	$0	$0
Laboratory Outpatient and Professional Services	$10	$10	$0 after deductible	Tier 1: $5 Tier 2: $0 after deductible
X-rays and Diagnostic Imaging	$10	$10	$0 after deductible	Tier 1: $5 Tier 2: $0 after deductible
Skilled Nursing Facility	10%	10%	$0 after deductible	Tier 1: Not Covered Tier 2: $0 after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	10%	10%	$0 after deductible	Tier 1: 10% Tier 2: $0 after deductible
Outpatient Surgery Physician/Surgical Services	10%	10%	$0 after deductible	Tier 1: 10% Tier 2: $0 after deductible
Prescription Drugs: Generics	$5	$5	$5	$5
Prescription Drugs: Preferred Brand	$20	$20	$0 after deductible	$20
Prescription Drugs: Non-Preferred Brand	$40	$40	$0 after deductible	25%
Specialty Drugs	20%	20%	$0 after deductible	25%

*This tiered network plan offers lower costs and greater savings when you utilize Tier 1 providers. Tier 1 providers include all Harris Health System facilities and doctors, all St. Joseph facilities, and all HCA facilities. St. Joseph doctors and HCA doctors are NOT included in the
Tier 1 network.