Community Essential Bronze 008 HSA(No cost after deductible, No Plan Details for 2021- HealthPocket

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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Zip Code	79936 (edit)
Applicant	11/26/1985 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	Community Essential Bronze 008 HSA(No cost after deductible, No
Plan ID	hhs-27248TX0010008
Plan Year	2021
Insurance Provider	Community Health Choice
Metal Level	Expanded Bronze
Plan Type	HMO
Deductible	$0
Out-of-Pocket Maximum	$0
Plan Highlights

Access to doctors and hospitals
Provider directory URL	http://www.communityhealthchoice.org
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	Not Covered
Does this plan cover services outside plan service area?	No - For emergency only
Does this plan cover services outside the country?	Not Covered

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 Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Not Covered
Child Dental Coverage - Basic Dental Care	Not Covered
Child Dental Coverage - Orthodontia	Not Covered
Child Dental Coverage - Major Dental Care	Not Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Private-Duty Nursing Imaging (CT/PET Scans, MRIs) 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 Routine Foot Care 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 Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited Benefits	Skilled Nursing Facility Hearing Aids Home Health Care Services Chiropractic Care
More Excluded Benefits	Acupuncture Bariatric Surgery Cosmetic Surgery Infertility Treatment Long Term Care Weight Loss Programs Dental Check-Up for Children Dental Care - Adult Abortion for Which Public Funding is Prohibited Long-Term/Custodial Nursing Home Care

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Huma, Lodhi

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Nathaniel, Griffith

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Stephanie, Moreno

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Isabel, Cano

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Stephanie Gonzalez Dpm Pa

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Irving, Palacios Y Trejo

Marisela, Gomez

Alyson, Martinez

Dawn, Sackett

Erin, Ginithan

Saranya, Gangupalli

Elena, Paul

Jose, Ruiz

Huma Lodhi, M.D.

Phone Number
(915) 225-3807
Office Locations
11351 James Watt Dr
El Paso, TX 79936

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ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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Community Essential Bronze 008 HSA(No cost after deductible, No

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Benefits & Coverage

Access to doctors and hospitals

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

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