Texas health plan · 2026

Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) · 27248TX0010022

Community Health Choice offers this marketplace health insurance plan (Plan ID 27248TX0010022) 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: Gold Plan type: HMO CSR: Standard Gold Off Exchange Plan Issuer: Community Health Choice
Telehealth Data pending HSA eligible No Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 78.93% (21.07% member share on average). Learn about AV methodology.

2026 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

$300 – $1177

Before subsidies

Estimate after subsidies

Deductible

$2,000

$4000 per group

See deductible details

Max out-of-pocket

$9,200

$18400 per group

Review MOOP rules

Office visits

Primary care $15.00
Specialist $30.00
HSA Not eligible

Drug tiers

Generic $10.00
Preferred brand $50.00

View formulary tiers

$411 / mo before subsidies

≈ $4936 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.

$1303 / mo before subsidies

≈ $15641 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.

$1579 / mo before subsidies

≈ $18943 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.

$1003 / mo before subsidies

≈ $12038 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

No Charge

Emergency Room Services

30.00% Coinsurance after deductible

Durable Medical Equipment

30.00% Coinsurance after deductible

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 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 Gold Off 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

No Charge

Emergency Room Services

30.00% Coinsurance after deductible

Durable Medical Equipment

30.00% Coinsurance 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 27248TX0010022
Coverage year 2026
State Texas
Issuer Community Health Choice
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 27248TX0010022-00
Available variants

Standard Off Exchange Plan · 27248TX0010022-00

Standard On Exchange Plan · 27248TX0010022-01

Open to Indians below 300% FPL · 27248TX0010022-02

Open to Indians above 300% FPL · 27248TX0010022-03
Last plan update Wed, 15 Oct 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 19466
PCPs in Texas 4232
Telehealth support Data pending
Nationwide providers 20716
19,466 doctors statewide 4,232 PCPs 213 OB/GYN

Provider network(s)

Providers Texas All US states
All 19466 20716
PCP 4232 4452
Allergy 18 19
OB/GYN 213 222
Dentists 13 17

Drug coverage overview

4,380 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 2,445
NON-PREFERRED-BRAND 886
SPECIALTY-DRUGS 552
MEDICAL-SERVICE-DRUGS 497
Prior authorization Drugs
Required 680
Not Required 3,700
Step therapy Drugs
Required 87
Not Required 4,293
Quantity limits Drugs
Has Limit 851
No Limit 3,529

Customer highlights

What stands out for members

  • Issuer: Community Health Choice · Plan ID 27248TX0010022 · 2026 filing.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 27248TX0010022-00 (Standard Off 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

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Year

Limited to combined 35 visits per year, including Chiropractic.

Diabetes Education

$15.00 Copay after deductible
Tier 1 in-network $15.00 Copay after deductible
Out-of-network 100.00%

Cost sharing depends on type and site of service.

Home Health Care Services

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Prior Authorization is required.

Laboratory Outpatient and Professional Services

$15.00 Copay after deductible
Tier 1 in-network $15.00 Copay after deductible
Out-of-network 100.00%

Some services require preauthorization.

Other Practitioner Office Visit (Nurse, Physician Assistant)

$15.00
Tier 1 in-network $15.00
Out-of-network 100.00%

Cost sharing and limitations depend on type and site of service.

Preventive Care/Screening/Immunization

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

Primary Care Visit to Treat an Injury or Illness

$15.00
Tier 1 in-network $15.00
Out-of-network 100.00%

$0 24/7 Virtual Care Options available under select plans for care received from a virtual provider for primary care services. Cost sharing for primary care services received from an in-person provider may cost more. Please see the Summary of Benefits and Coverage associated with this plan for more information on this benefit.

Rehabilitative Occupational and Rehabilitative Physical Therapy

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Prior Authorization is required. Limited to medical necessity.

Rehabilitative Speech Therapy

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Prior Authorization is required. Limited to medical necessity.

Specialist Visit

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

Urgent Care Centers or Facilities

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

$0 24/7 Virtual Care Options available under select plans for care received from a virtual provider for urgent care services. Cost sharing for urgent care services received from an in-person provider may cost more. Please see the Summary of Benefits and Coverage associated with this plan for more information on this benefit.

X-rays and Diagnostic Imaging

$15.00 Copay after deductible
Tier 1 in-network $15.00 Copay after deductible
Out-of-network 100.00%

Prior Authorization is required.

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing and limitation depend on type and site of service. Injectable chemotherapeutic agents require preauthorization.

Delivery and All Inpatient Services for Maternity Care

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Will cover 48-hour hospital stay for uncomplicated vaginal delivery and 96-hour hospital stay for uncomplicated caesarean section.

Dialysis

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing depends on type and site of service.

Durable Medical Equipment

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Certain services require preauthorization (DME over $500).

Emergency Room Services

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 30.00% Coinsurance after deductible

Emergency Transportation/Ambulance

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network $30.00 Copay after deductible

Prior authorization required for out of network ambulance services, out of area transfers, non-emergency ground transportation, air transportation, and facility to facility transfers.

Exclusions: Travel or ambulance services for convenience.

Hospice Services

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing and limitations depend on type and site of service.

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

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% 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.

Inpatient Physician and Surgical Services

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

Prior Authorization is required for inpatient surgical services.

Mental/Behavioral Health Inpatient Services

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required.

Mental/Behavioral Health Outpatient Services

$15.00
Tier 1 in-network $15.00
Out-of-network 100.00%

Certain services require preauthorization. Cost sharing depends on type and site of service. This benefit (Mental/Behavioral Health Outpatient Services, Substance Abuse Disorder Outpatient Services, and Habilitation Services) is subject to different cost-sharing depending on whether the service is an office visit or other outpatient service. Office visits are subject to copays, while facility-based services are subject to coinsurance.

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

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Cost sharing and limitations depend on the type and site of service. Preauthorization is required for outpatient surgeries.

Outpatient Rehabilitation Services

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Limited to Medically Necessary outpatient Rehabilitative Therapy visits to or by a Participating Provider other than a Primary Care Physician. Prior authorization is required.

Outpatient Surgery Physician/Surgical Services

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Outpatient services and Habilitation Services are subject to different cost-sharing depending on whether the service is an office visit or other outpatient service. Office visits are subject to copays, while facility-based services are subject to coinsurance. Preauthorization is required for outpatient surgeries.

Radiation

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing and limitation depend on type and site of service. Proton beam radiation requires preauthorization.

Skilled Nursing Facility

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Limit: 25.0 Days per Year

Cost sharing and limitation depend on type and site of service. Prior authorization is required.

Substance Abuse Disorder Inpatient Services

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required.

Substance Abuse Disorder Outpatient Services

$15.00
Tier 1 in-network $15.00
Out-of-network 100.00%

Certain services require preauthorization. Cost sharing depends on type and site of service. This benefit (Mental/Behavioral Health Outpatient Services, Substance Abuse Disorder Outpatient Services, and Habilitation Services) is subject to different cost-sharing depending on whether the service is an office visit or other outpatient service. Office visits are subject to copays, while facility-based services are subject to coinsurance.

Transplant

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required. Cost sharing and limitation depend on type and site of service.

Exclusions: Subject to the conditions described below, benefits for covered services and supplies provided to a Participant by a Hospital, Physician, or Other Provider related to an organ or tissue transplant will be determined as follows, but only if all the following conditions are met: The transplant procedure is not Experimental/Investigational in nature; and Donated human organs or tissue or an FDA-approved artificial device are used; and The recipient is a Participant under the Plan; and The transplant procedure is preauthorized as required under the Plan; and The Participant meets all of the criteria established by CHC in pertinent written medical policies; and The Participant meets all of the protocols established by the Hospital in which the transplant is performed. Donor expenses for a Participant in connection with an organ or tissue transplant is not a covered benefit if the recipient is not covered under this Plan. No benefits are available for any organ or tissue transplant procedure, or services performed in preparation for, or in conjunction with, such procedure, which CHC considers to be Experimental/Investigational.

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance 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. Each ear, every three years. Prior authorization is required.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Routine Eye Exam for Children

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Covered services for children 18 and under.

Well Baby Visits and Care

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

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$10.00
Tier 1 in-network $10.00
Out-of-network 100.00%

Subject to formulary requirements and preauthorization may be required (when generic is not the preferred agent).

Non-Preferred Brand Drugs

$100.00 Copay after deductible
Tier 1 in-network $100.00 Copay after deductible
Out-of-network 100.00%

Subject to formulary requirements and preauthorization may be required.

Preferred Brand Drugs

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Subject to formulary requirements and preauthorization may be required.

Specialty Drugs

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 100.00%

Subject to formulary requirements and preauthorization may be required.

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

Cost sharing and limitation depend on type and site of service. Limited to treatment for a Dental Injury to a Sound Natural Tooth.

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing and limitation depend on type and site of service. Preauthorization is required.

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

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

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing depends on type and site of service.

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

For select frames, standard lenses, and contact lenses only.

Habilitation Services

$30.00 Copay after deductible
Tier 1 in-network $30.00 Copay after deductible
Out-of-network 100.00%

Cost sharing depends on type and site of service. Limited to medical necessity. Prior authorization is required.

Imaging (CT/PET Scans, MRIs)

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Out-of-network 100.00%

Preauthorization is required.

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance 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. Preauthorization is required. Cost sharing depends on type and site of service.

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Treatment for Temporomandibular Joint Disorders

$30.00
Tier 1 in-network $30.00
Out-of-network 100.00%

Prior authorization required for temporomandibular joint surgery.

Variant attributes

Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) · Variant 27248TX0010022-00

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Standard Gold Off Exchange Plan

HIOS Product ID

27248TX001

Metal Level

Gold

Plan ID (Standard Component ID with Variant)

27248TX0010022-00

Plan Marketing Name

Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options)

Plan Variant Marketing Name

Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options)

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

27248

Issuer Marketplace Marketing Name

Community Health Choice

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

TXN002

Out of Country Coverage

No

Out of Service Area Coverage

No

Service Area ID

TXS002

State Code

TX

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.78927266

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

$2,100

SBC Scenario, Having a Baby, Copayment

$300

SBC Scenario, Having a Baby, Deductible

$2,000

SBC Scenario, Having Diabetes, Coinsurance

$100

SBC Scenario, Having Diabetes, Copayment

$500

SBC Scenario, Having Diabetes, Deductible

$2,000

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$10

SBC Scenario, Treatment of a Simple Fracture, Copayment

$200

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,000

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

per group not applicable

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

per person not applicable

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

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

TXF002

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

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

EHB Percent of Total Premium

1

First Tier Utilization

100%

Import Date

10/15/2025

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

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

HMO

QHP/Non QHP

Both

Source Name

HIOS

Plan ID

27248TX0010022

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

$4000 per group

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

$2000 per person

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

$2,000

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

$4000 per group

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

$2000 per person

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

$2,000

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

per group not applicable

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

per person not applicable

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

Not Applicable

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?

Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) (27248TX0010022) is a Gold HMO from Community Health Choice in Texas for the 2026 coverage year.

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

Does Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) 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 Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) 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 coverage is not listed for this plan.

Vision add-ons: Child.

Does Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) support mail-order prescriptions?

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

Is there out-of-country coverage for Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options)?

No, out-of-country services are not covered for this plan.

Does Community Select Gold 022 (No deductible for PCP, Specialist, Urgent Care & Generics, $0 PCP 24/7 Virtual Care Options) cover care outside the service area?

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

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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