Texas health plan · 2025

CHRISTUS Catastrophic · 66252TX0010011

CHRISTUS Health Plan offers this marketplace health insurance plan (Plan ID 66252TX0010011) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Catastrophic Plan type: HMO CSR: Standard Catastrophic On Exchange Plan Issuer: CHRISTUS Health Plan
Telehealth Data pending HSA eligible No Dental Child Vision Child
Pay / Manage Plan View issuer site

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$182 – $714

Before subsidies

Estimate after subsidies

Deductible

$9,200

$18400 per group

See deductible details

Max out-of-pocket

$9,200

$18400 per group

Review MOOP rules

Office visits

Primary care 0.00% Coinsurance after deductible
Specialist 0.00% Coinsurance after deductible
HSA Not eligible

Drug tiers

Generic 0.00% Coinsurance after deductible
Preferred brand 0.00% Coinsurance after deductible

View formulary tiers

$249 / mo before subsidies

≈ $2992 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$790 / mo before subsidies

≈ $9481 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$957 / mo before subsidies

≈ $11483 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$608 / mo before subsidies

≈ $7297 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

0.00%

Emergency Room Services

0.00% Coinsurance after deductible

Durable Medical Equipment

No Charge after deductible

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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Texas). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Standard Catastrophic On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

0.00%

Emergency Room Services

0.00% Coinsurance after deductible

Durable Medical Equipment

No Charge after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 66252TX0010011
Coverage year 2025
State Texas
Issuer CHRISTUS Health Plan
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 66252TX0010011-01
Available variants

Standard Off Exchange Plan · 66252TX0010011-00

Standard On Exchange Plan · 66252TX0010011-01
Last plan update Fri, 10 Jan 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Texas N/A
PCPs in Texas N/A
Telehealth support Data pending
Nationwide providers N/A
N/A doctors statewide N/A PCPs N/A OB/GYN

Provider network(s)

['TXN001']

Providers Texas All US states
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A

Drug coverage overview

5,500 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-GENERIC 3,038
NON-PREFERRED-BRAND 1,764
SPECIALTY 698
Prior authorization Drugs
Required 1,051
Not Required 4,449
Step therapy Drugs
Required 686
Not Required 4,814
Quantity limits Drugs
Has Limit 1,660
No Limit 3,840

Customer highlights

What stands out for members

  • Issuer: CHRISTUS Health Plan · Plan ID 66252TX0010011 · 2025 filing.
  • Disease management programs available: Diabetes.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 66252TX0010011-01 (Standard On Exchange Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Year

Limited to combined 35 visits per year, including Outpatient Rehabilitation Services. Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Diabetes Care Management

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Diabetes Education

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

nan

Exclusions: nan

Home Health Care Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Laboratory Outpatient and Professional Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Other Practitioner Office Visit (Nurse, Physician Assistant)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Preventive Care/Screening/Immunization

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

nan

Exclusions: nan

Primary Care Visit to Treat an Injury or Illness

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Rehabilitative Occupational and Rehabilitative Physical Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Rehabilitative Speech Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Specialist Visit

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Urgent Care Centers or Facilities

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

No charge for virtual urgent care through CHRISTUS Health System.

Exclusions: nan

X-rays and Diagnostic Imaging

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Delivery and All Inpatient Services for Maternity Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required for inpatient care, except for: (1) forty-eight (48) hours of Inpatient care following an uncomplicated vaginal delivery or ninety-six (96) hours of Inpatient care following an uncomplicated Cesarean section or (2) Post-Partum Care. If you dont get preauthorization, benefits will be denied.

Exclusions: nan

Dialysis

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Durable Medical Equipment

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Preauthorization is required for some durable medical equipment. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Emergency Room Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 0.00% Coinsurance after deductible

nan

Exclusions: nan

Emergency Transportation/Ambulance

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

nan

Exclusions: nan

Hospice Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Inpatient Hospital Services (e.g., Hospital Stay)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

All usual Hospital services and supplies, including semiprivate room, intensive care, and coronary care units. Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Inpatient Physician and Surgical Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Mental/Behavioral Health Inpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Mental/Behavioral Health Outpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

MH/SUD office visits are subject to the listed cost sharing, while MH/SUD facility outpatient treatments are subject to the outpatient facility coinsurance.

Exclusions: nan

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Outpatient Rehabilitation Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Year

Limited to combined 35 visits per year, including Chiropractic. Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Outpatient Surgery Physician/Surgical Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Radiation

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Skilled Nursing Facility

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 25.0 Days per Year

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Substance Abuse Disorder Inpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Substance Abuse Disorder Outpatient Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

MH/SUD office visits are subject to the listed cost sharing, while MH/SUD facility outpatient treatments are subject to the outpatient facility coinsurance.

Exclusions: nan

Transplant

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Transplant Donor Coverage

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Mental health & substance use

Behavioral health visits and substance use treatment.

Autism Spectrum Disorders

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

20.00%
Tier 1 in-network 20.00%
Out-of-network 20.00%

nan

Exclusions: nan

Hearing Aids

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 1.0 Item(s) per 3 Years

To restore or correction of impaired speech or hearing loss. 1 hearing aid in each ear every 3 years limited to $2,000 benefit maximum per device

Exclusions: nan

Major Dental Care - Child

50.00%
Tier 1 in-network 50.00%
Out-of-network 50.00%

nan

Exclusions: nan

Prenatal and Postnatal Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Routine Eye Exam for Children

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

nan

Exclusions: nan

Well Baby Visits and Care

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

nan

Exclusions: nan

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Cost sharing for a 90-day supply by mail order is triple the cost sharing for a standard 30-day supply. Prescriptions for birth control are not subject to deductible, and do not have a copayment.

Exclusions: nan

Non-Preferred Brand Drugs

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Cost sharing for a 90-day supply by mail order is triple the cost sharing for a standard 30-day supply. Prescriptions for birth control are not subject to deductible, and do not have a copayment.

Exclusions: nan

Off Label Prescription Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Preferred Brand Drugs

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Cost sharing for a 90-day supply by mail order is triple the cost sharing for a standard 30-day supply. Prescriptions for birth control are not subject to deductible, and do not have a copayment.

Exclusions: nan

Prescription Drugs Other

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Specialty Drugs

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Basic Dental Care - Adult

Coverage details pending

nan

Exclusions: nan

Dental Check-Up for Children

0.00%
Tier 1 in-network 0.00%
Out-of-network 0.00%

One visit and exam every 6 months

Exclusions: nan

Infusion Therapy

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Major Dental Care - Adult

Coverage details pending

nan

Exclusions: nan

Nutritional Counseling

Coverage details pending

nan

Exclusions: nan

Orthodontia - Adult

Coverage details pending

nan

Exclusions: nan

Orthodontia - Child

50.00%
Tier 1 in-network 50.00%
Out-of-network 50.00%

Medically necessary. Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Prosthetic Devices

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Medically necessary foot orthotics are not subject to a calendar year maximum.

Exclusions: nan

Routine Dental Services (Adult)

Coverage details pending

nan

Exclusions: nan

Weight Loss Programs

Coverage details pending

nan

Exclusions: nan

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

nan

Exclusions: nan

Acupuncture

Coverage details pending

nan

Exclusions: nan

Allergy Testing

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

nan

Exclusions: nan

Bariatric Surgery

Coverage details pending

nan

Exclusions: nan

Brain Injury

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Cosmetic Surgery

Coverage details pending

nan

Exclusions: nan

Eye Glasses for Children

0.00%
Tier 1 in-network 0.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

nan

Exclusions: nan

Gender Affirming Care

Coverage details pending

nan

Exclusions: nan

Habilitation Services

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Habilitative and rehabilitative limits cannot be combined for plans issued or renewed on or after January 1, 2017. Habilitation services includes autism services, and the benchmark plan does not impose age or maximums on autism coverage. MH/SUD office visits are subject to the listed cost sharing, while MH/SUD facility outpatient treatments are subject to the outpatient facility coinsurance. Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Imaging (CT/PET Scans, MRIs)

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. If you don't get preauthorization, benefits will be denied.

Exclusions: nan

Infertility Treatment

Coverage details pending

nan

Exclusions: nan

Inherited Metabolic Disorder - PKU

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Long-Term/Custodial Nursing Home Care

Coverage details pending

nan

Exclusions: nan

Pediatric Services Other

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Post-Mastectomy Care

0.00% Coinsurance after deductible
Tier 1 in-network 0.00% Coinsurance after deductible
Out-of-network 100.00%

Texas State Required Benefit

Exclusions: nan

Private-Duty Nursing

Coverage details pending

nan

Exclusions: nan

Reconstructive Surgery

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Examples of covered services include: Treatment provided for reconstructive surgery following cancer surgery; Reconstruction of the breast on which mastectomy has been performed.

Exclusions: nan

Routine Eye Exam (Adult)

Coverage details pending

nan

Exclusions: nan

Routine Foot Care

Coverage details pending

nan

Exclusions: nan

Treatment for Temporomandibular Joint Disorders

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Though state law only mandates coverage for temporomandibular joint (TMJ) disorders for large group plans and HMOs, the benchmark plan covers TMJ. Therefore, it is considered part of the EHB package for Texas.

Exclusions: nan

Variant attributes

CHRISTUS Catastrophic · Variant 66252TX0010011-01

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Standard Catastrophic On Exchange Plan

HIOS Product ID

66252TX001

Metal Level

Catastrophic

Plan ID (Standard Component ID with Variant)

66252TX0010011-01

Plan Marketing Name

CHRISTUS Catastrophic

Plan Variant Marketing Name

CHRISTUS Catastrophic (3 Free PCP visits)

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

66252

Issuer Marketplace Marketing Name

CHRISTUS Health Plan

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

TXN001

Out of Country Coverage

Yes

Out of Country Coverage Description

Emergency Services

Out of Service Area Coverage

No

Service Area ID

TXS011

State Code

TX

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$9,200

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$5,200

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,800

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

$18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

$9200 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

$9,200

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$9200 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$9,200

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

$18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

$9200 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$9,200

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

TXF001

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

3

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Diabetes

EHB Percent of Total Premium

1.0

First Tier Utilization

100%

Import Date

2025-01-10 00:01:52

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

2025-01-01

Plan Expiration Date

2025-12-31

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Plan ID

66252TX0010011

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

$18400 per group

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

$9200 per person

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

$9,200

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$18400 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$9200 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$9,200

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

$18400 per group

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

$9200 per person

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$9,200

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Texas?

CHRISTUS Catastrophic (66252TX0010011) is a Catastrophic HMO from CHRISTUS Health Plan in Texas for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does CHRISTUS Catastrophic support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is CHRISTUS Catastrophic HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental add-ons: Child.

Vision add-ons: Child.

Does CHRISTUS Catastrophic support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with CHRISTUS Catastrophic?

The issuer lists disease management resources for: Diabetes.

Is there out-of-country coverage for CHRISTUS Catastrophic?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency Services

Does CHRISTUS Catastrophic cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies.

How do I enroll in or manage payments for CHRISTUS Catastrophic?

Use the issuer portal https://ssoprod.healthplan.com/sp/ACS.saml2 to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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