Community Health Choice Insurance
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By Wiley Long– Updated April 15th, 2025
Reviewed by Whitney Kline – Fact checked by Lou Spatafore
Community Health Choice Insurance: All You Need to Know
Community Health Choice is a local, nonprofit managed care organization dedicated to improving the health and well-being of Texans.
Founded in 1997 by the Harris Health System, Community Health Choice initially provided STAR Medicaid coverage for children from low-income families. Today, the organization has grown into a comprehensive health plan provider.
As one of the region’s largest nonprofit managed care organizations, Community Health Choice offers affordable and no-cost health insurance options for individuals, families, and businesses across Southeast Texas.
With a service area that covers more than 20 counties in the Greater Houston and Beaumont areas, and a vast network of over 19,500 providers, this carrier ensures members can access high-quality care, close to home.
Members also benefit from low copays, free 24/7 telehealth, no referrals for specialists, and preventive care services at no additional cost.
Additionally, plans include potential savings based on income eligibility and options for employer-sponsored health coverage.
Community Health Choice is committed to providing affordable, high-quality health coverage with a focus on accessibility, transparency, and Member satisfaction.
Whether you’re looking for an individual or family plan, or employer-sponsored coverage, Community Health Choice offers a range of flexible plans to meet your needs.
Comprehensive Coverage Options
Community Health Choice offers both On-Exchange (purchased through the marketplace) and Off-Exchange (purchased directly from an insurer) plans.
Members can choose coverage that best fits their budget and eligibility for government subsidies.
Plus, there are bronze, silver, and gold level options available across Select, Ultra Select and Premium plans.
No Specialist Referrals Required
Unlike many other health plans, Community Health Choice does not require referrals for specialist visits, giving members direct access to the care they need.
Expansive Provider Network
As one of the largest provider networks in Southeast Texas, Community Health Choice ensures Members have access to 20,065+ providers, specialists, hospitals, and clinics across 20 counties.
Low Out-of-Pocket Costs & No Deductible for Many Services
Community Health Choice plans are designed to minimize upfront costs for essential care.
All plans include low copays for most services, including primary care visits, urgent care, and generic medications – these are not subject to the deductible for most plans.
Transparent pricing tools are also available to allow members to compare costs and make informed healthcare decisions.
Preventive Care & Telehealth at No Extra Cost
All plans include 100% covered preventive services, and free 24/7 telehealth.
Members can proactively protect their health with annual checkups, vaccinations, and essential screenings.
Plus, they can expect high-quality, instant support via telehealth resources, on any plan.
Member Resources & Financial Assistance
Community Health Choice goes beyond standard coverage by offering:
- Personalized Member support to help navigate plans and maximize benefits.
- Financial assistance tools, including tax credits and cost-saving discounts for eligible Members.
Community Health Choice Plans
Community Health Choice offers various affordable health plans designed to fit different needs and budgets.
Current plans include Select, Select Ultra, and Premier plans.
Select Plans (Harris County Residents Only)
Designed for Harris County residents seeking lower-cost, high-quality care within a smaller network of trusted providers.
Healthcare services are provided by Memorial Hermann, Harris Health, St. Joseph, AD Hospital East, and affiliated physician groups.
These plans offer lower premiums without sacrificing quality, thanks to a smaller, more localized provider network.
Ultra Select Plans (Harris County Residents Only)
Ultra Select plans are similar to Select Plans but offered through a different set of hospitals and providers.
These plans are ideal for Harris County residents who want affordable, comprehensive care within a specific provider network.
The network for these plans includes Harris County Hospital District, HCA Hospitals, AD Hospital East, Oakbend Hospital, and affiliated physician groups.
Premier Plans (Available in 20 Counties)
Community Health Choice Premier plans provide access to one of the largest provider networks in Southeast Texas, covering 20 counties.
These plans offer greater flexibility in your choice of doctors and hospitals.
Some plans also include therapy services and prescription drug coverage without requiring a deductible.
Select, Ultra Select, and Premier Plans
All Community Health Choice Plans Include:
Low copays for most services
No referrals for specialists
Easy approval of care
Primary care visits, specialist visits, and generic drugs not subject to deductibles (on most plans)
High-quality provider network
Potential savings based on member income
Free 24/7 telehealth
All Plans Are Offered in Three Coverage Tiers
Bronze Plans
Bronze plans are ideal for those who want basic coverage for major medical events at a lower monthly cost.
These plans have the lowest monthly premiums, but higher out-of-pocket costs when care is needed.
The insurance covers around 60% of healthcare expenses, while Members pay about 40%.
Silver Plans
Silver plans are intended for individuals or families seeking a balance between affordability and comprehensive coverage.
These plans include mid-range premiums and moderate out-of-pocket costs.
The insurance covers approximately 70% of healthcare expenses, while Members pay about 30%.
Gold Plans
Gold plans are best for those who visit doctors frequently and want lower out-of-pocket costs.
These plans have the highest monthly premiums but offer the lowest out-of-pocket costs.
The insurance covers around 80% of healthcare expenses, while Members pay approximately 20%.
How to Enroll with Community Health Choice
- Select your State, then click “Instant Quote” to get started.
- Enter your personal information into the quote form then continue.
- Find the plan you want and click “Add to Cart”.
- Then finally, enter your payment information at check out and complete the application process.
You can also give us a call at 800-913-0172, or schedule a free phone consultation and we’ll help you get signed up for Community Health Choice Plan.
If you need help, please contact an HSA for America Personal Benefits Manager.
Community Health Choice Plan Features
Feature |
Details |
|---|---|
| Deductible | Varies by plan |
| Primary Care Visits | Low copays, not subject to deductible (most plans) |
| Specialist Visits | Low copays, no referral required |
| Urgent Care | Low copays, not subject to deductible (most plans) |
| Generic Drugs | Low copays, not subject to deductible (most plans) |
| Preventive Services | 100% covered (annual checkups, screenings, vaccinations) |
| Telehealth Services | Free 24/7 telehealth access |
| Provider Network | Select & Ultra Select (limited to Harris County), Premier (available in 20 counties) |
| Member Savings Programs | Potential savings based on income and payment method |
Pros and Cons of Community Health Choice
Pros of Community Health Choice
- Comprehensive Coverage: Offers a range of affordable health plans, including Bronze, Silver, and Gold tiers with varying premium and deductible options.
- Large Provider Network: Over 20,065 providers across 20 counties in Southeast Texas, including major hospitals and clinics.
- Low Copays & No Deductible for Many Services: Many plans include low-cost primary care visits, urgent care, specialist visits, and generic medications, without needing to meet a deductible.
- Preventive Services Fully Covered: Annual checkups, vaccinations, and screenings are 100% covered with no additional cost.
- 24/7 Free Telehealth Access: All plans come with free telemedicine consultations, allowing members to speak with doctors anytime, anywhere.
- No Referrals Required for Specialists: Unlike some health plans, Community Health Choice does not require referrals for specialist visits, giving members more flexibility.
- Income-Based Savings Available: Many members qualify for lower monthly premiums through government subsidies and cost-sharing reductions.
- Focused Local Care: Select and Ultra Select plans offer lower premiums for Harris County residents by limiting providers to high-quality local hospitals.
Cons of Community Health Choice
- Limited Availability: Coverage is only available in 20 Southeast Texas counties, restricting options for those outside the service area.
- Harris County Restriction for Some Plans: Select and Ultra Select plans are only available to Harris County residents, limiting provider choices for those in other counties.
- Bronze Plans Have Higher Out-of-Pocket Costs: While Bronze plans have the lowest premiums, they come with higher deductibles and coinsurance for medical services.
- Off-Exchange Plans Not Eligible for Government Assistance: Those selecting Off-Exchange plans do not qualify for federal subsidies or cost-sharing reductions.
- Prescription Drug Deductibles Apply to Some Plans: Certain plans require members to meet a separate prescription drug deductible, increasing initial out-of-pocket costs.
Community Health Choice
Frequently Asked Questions
Q: What types of health plans does Community Health Choice offer?
A: Community Health Choice offers a variety of plans, including:
- On-Exchange Plans – Available through the Health Insurance Marketplace and eligible for government subsidies and cost-sharing reductions.
- Off-Exchange Plans – Private health plans offered directly by Community Health Choice, with identical benefits but no government subsidies.
- Select & Ultra Select Plans – Low-cost plans exclusive to Harris County residents, with care provided through a smaller, high-quality provider network.
- Premier Plans – Available across 20 Southeast Texas counties, offering a broader provider network and more flexibility.
Q: Is telehealth included in my plan?
A: Yes! Community Health Choice offers free telehealth services 24/7 for virtual doctor visits, so you can receive care from the comfort of your home.
Q: Does Community Health Choice cover preventive care?
A: Yes! Preventive services are covered at 100%, including annual checkups, vaccinations, cancer screenings, and other essential preventive care.
Q: Do I need a referral to see a specialist?
A: No. Community Health Choice plans do not require referrals for specialist visits, allowing you to access the care you need without additional steps.
Q: Who qualifies for income-based savings on premiums?
A: If you enroll in an On-Exchange Plan through the Health Insurance Marketplace, you may qualify for government subsidies or cost-sharing reductions, which can lower your monthly premium and out-of-pocket expenses.
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HSA for America can offer you free and professional advice so you can make the best choice possible regarding your health care plan. Your Personal Benefits Manager is available to answer any questions about Community Health Choice, ultimately maximizing the amount of money you can save annually while truly understanding the type of health care you will receive.
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1001-A E. Harmony Rd #519 Fort Collins, CO 80525
800-913-0172
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