2022 Elite HSA Gold 14

Overview

Once you understand the differences, it’s easier to find the best plan that fits you and your family. We want you to get all the coverage you need without paying for benefits you don’t.

Gold cheat sheet:

Gold plans have the highest premiums.
Gold plans have lower out-of-pocket costs.
On average, the insurance company pays 80%. You pay 20%.
“Get this plan if your doctor knows you better than your spouse.”

All Community plans come with:

Free preventative care

24/7/365 Nurse Advice Line

Huge doctor & hospital network

No referrals for specialists

Questions?

Our hours of operation are 8 a.m. – 5 p.m.

Call Us:
Local: 713.295.6704 Toll-Free 1.855.315.5386

Community Elite HSA Gold 14

Plan Overview

This plan is best suited for individuals, families, and business owners who want a comprehensive, low-deductible plan that can work with a health savings account.
HIOS ID: 27248TX0010014

Summary of Benefits & Coverage

Off-Exchange

Evidence of Coverage

Plan Overview

This plan is best suited for individuals, families, and business owners who want a comprehensive, low-deductible plan that can work with a health savings account.
HIOS ID: 27248TX0010014

Summary of Benefits & Coverage

Off-Exchange

Evidence of Coverage

View Elite HSA Gold 14 Plan Details

Annual Deductible
$2,000
MOOP
$6,000
Emergency Room Visits
20%
Inpatient Hospital Stay
20%
PCP
$20
Specialist
$35
Mental/Behavioral Health and Substance Abuse Disorder Outpatient Services
$20
Imaging (CT/MRI/PET)
20%
Speech Therapy
$35
Occupational and Physical Therapy
$35

Laboratory Outpatient and Professional Services
$20
X-rays and Diagnostic Imaging
$20
Skilled Nursing Facility
20%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
20%
Outpatient Surgery Physician/Surgical Services
20%
Prescription Drugs: Generics
$5
Preferred Brand
$80
Non-Preferred Brand
$100
Specialty Drugs
40%

Local and Neighborly

What does it mean when we say we are local? It means that our service area is 20 counties in the Greater Houston and Beaumont areas. It means that our Providers and facilities are near to you. That’s why we partner with about 7,500 Providers across 20 counties in Southeast Texas, including doctors and clinics at integrated-care organizations. The doctors and facilities and specialists that you see in your times of need are nearby and neighborly.

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”
– Cecily
Member of Community Health Choice