2019 Community Health Choice- Gold Limited Network Plan 006 Plan Details - HealthPocket

Community Health Choice- Gold Limited Network Plan 006

$622.52/mo

Apply For This Plan

Zip Code79936
Applicant3/23/1984 Male
Coverage Start3/24/2019
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameCommunity Health Choice- Gold Limited Network Plan 006
Plan IDhhs-27248TX0010006
Plan Year2019
Insurance ProviderCommunity Health Choice
Metal LevelGold
Plan TypeHMO
Deductible$0
Out-of-Pocket Maximum$7,900
Personal Score

Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$30 Copay
Specialist Visit$65 Copay
Laboratory Outpatient and Professional Services$30 Copay
X-rays and Diagnostic Imaging$30 Copay
Diagnostic Imaging such as MRIs, CT, and PET scans$500 Copay
Deductible - Family$0 per group
Out-of-Pocket Maximum - Family$15800 per group

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand Drugs$40 Copay
Non-Preferred Brand Drugs$80 Copay
Specialty Drugs30.00% Coinsurance

Access to doctors and hospitals

Provider directory URLhttp://www.communitycares.com
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All except primary care
Does this plan cover services outside plan service area?No - For emergency only
Does this plan cover services outside the country?Not Covered

Hospital services

Emergency Room Services$600 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$600 Copay per Day
Inpatient Physician and Surgical Services$0 Copay
Emergency Transportation or Ambulance Service$65 Copay

Maternity

Prenatal and Postnatal Care$65 Copay
Delivery and all inpatient services for maternity care$600 Copay

Mental Health

Mental/Behavioral Health Outpatient Services$30 Copay
Mental/Behavioral Health Inpatient Services$600 Copay per Day
Substance use disorder outpatient services$30 Copay
Substance use disorder inpatient services$600 Copay per Day

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, Heart Disease, Pregnancy
Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Chiropractic Care
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Routine Foot Care
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $222
Humana Connect Platinum 0/1500 Plan
$0.00Select
from $248
myCigna Copay Assure Silver
$0.00Select
from $252
IdealCare Total
$0.00Select
from $256
Humana Direct Platinum 0/1500 Plan
$0.00Select
from $275
Scott and White Health Plan Silver HMO 50
$0.00Select
/
Please select the correct zip
Brooker, Olmer
View All Details
Lodhi, Huma
View All Details
Azarcon-samonte, Patricia
View All Details
Reister, Gary
View All Details
Vande Lune, Daniel
View All Details
Weber, Alberto
View All Details
Grogan, Patricia
View All Details
Texas Federal Wellness Center Of El Paso, Pllc
View All Details
Montenegro, Janet
View All Details
Kenney, Christine
View All Details
Portilllo, Rossalyn
View All Details
Gay, Maycrystal
View All Details
Optimum Performance And Therapy Clinic, Pllc
View All Details
Anderson, Paul
View All Details
Alvidrez, Ashley
View All Details
Esperanza Medical And Wellness
View All Details
Gomez, Delia
View All Details
Orozco, Violeta
View All Details
Fajardo, John
View All Details
Lambeth, Kelly
View All Details
Montes, Jose
View All Details
Knoll, Kaylee
View All Details
Roa, Daniel
View All Details
Olmer Brooker, M.D.
View All Details
  • Phone Number
    (915) 855-7900
  • Office Locations
    1418 George Dieter Dr
    El Paso, TX 79936
1418 George Dieter Dr El Paso TX, 79936
  • What is the Gold Plan?

    ObamaCare’s Gold Plan is a type of Metal Plan on the Health Insurance Marketplace. Gold Plans qualify for Tax Credits, have high premiums, and good cost sharing. Gold plans mean higher premiums, less Tax Credits, but much better cost sharing on average than Silver or Bronze.

  • How are Gold Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Gold Plan typically pays 80% of covered medical costs.

  • How much does a Gold Plan cost?

    The monthly premium for a Gold Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and your geographic region. You can use HealthPocket’s comparison tool to compare Gold Plan premiums in your area.

  • When Can I Enroll in a Gold Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

Read More

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

Close

Health Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.