CHRISTUS - CHP TX Silver HD

Texas, 2018

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,000

  • Deductible

    $5,000

Enroll Now
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Call (855) 866-5590 to speak with a licensed agent about a new health plan.

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Cost Sharing Benefits (In Network)

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $5,000
Deductible (Family) $10,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible
Emergency Room Services $250 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $250 Copay after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient $1000 Copay per stay after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $30 Copay after deductible
Rehabilitative Occupational & Physical Therapy $30 Copay after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing

Deductible (Individual) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $4,500
Out of Pocket Maximum (Family) $9,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $550
Deductible (Family) $1,100
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $125
Deductible (Family) $250
Out of Pocket Maximum (Individual) $500
Out of Pocket Maximum (Family) $1,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

Other Plans in Texas

Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
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Cost Sharing Benefits (In Network)

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $5,000
Deductible (Family) $10,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible
Emergency Room Services $250 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $250 Copay after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient $1000 Copay per stay after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $30 Copay after deductible
Rehabilitative Occupational & Physical Therapy $30 Copay after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing

Deductible (Individual) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $4,500
Out of Pocket Maximum (Family) $9,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $550
Deductible (Family) $1,100
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $125
Deductible (Family) $250
Out of Pocket Maximum (Individual) $500
Out of Pocket Maximum (Family) $1,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $1000 Copay per stay after deductible
Inpatient Physician $1000 Copay after deductible

Prescription Drugs

Generic Rx $12 Copay after deductible
Preferred Brand Rx $60 Copay after deductible
Non Preferred Brand Rx $95 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

Other Plans in Texas

Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver LD Deductible $3,000 Coinsurance Not applicable Out of Pocket $5,000
Plan CHP TX Silver HD Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan CHP TX Gold Deductible $2,600 Coinsurance Not applicable Out of Pocket $4,150
Plan CHP TX Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,350
Plan CHP TX Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350